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Query: UMLS:C0000737 (
abdominal pain
)
31,184
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
A 20-year-old man with severe physical weakness (from which he soon recovered spontaneously) was found to have hypoproteinaemia and lymphocytopenia (768/microliters). Ten years later, after having been free of symptoms in the meantime, oedema, ascites and
abdominal pain
occurred, associated with loss of physical capacity. Enteric loss of protein (alpha 1-antitrypsin clearance increased about thirtyfold) with a total serum protein concentration of only 3.7 g/dl, as well as histological evidence of lymphangiectasia of the small and large intestines provided the diagnosis of primary intestinal lymphangiectasia. In the course of the disease
cholelithiasis
and (after treatment with tranexamic acid) thrombosis of the axillary vein occurred. No treatment has been of any avail and the patient has been unable to work for three years.
...
PMID:[Therapy-refractory primary intestinal lymphangiectasis]. 191 11
Fibric acid derivatives (FADs) are a class of drugs that have been shown to reduce the production of very low-density lipoprotein (VLDL) while enhancing VLDL clearance due to the stimulation of lipoprotein lipase activity. The drugs can reduce plasma triglyceride levels while raising high-density lipoprotein (HDL) cholesterol levels. Their effects on low-density lipoprotein (LDL) cholesterol levels are less marked and more variable. There is evidence that oral gemfibrozil (Lopid, Parke-Davis, Morris Plains, NJ) can reduce the risk of serious coronary events, specifically in those patients who had elevations of both LDL cholesterol levels and total plasma triglyceride levels with lower HDL cholesterol levels. Newer FADs (bezafibrate, ciprofibrate, fenofibrate) have been shown to have greater efficacy in reducing LDL cholesterol than gemfibrozil but, in general, these drugs are not as effective as the other primary drugs used to lower LDL levels. The FADs are also used to treat adult patients with very high levels of triglycerides who have pancreatitis and whose disease cannot be managed with dietary therapy. The FADs are well tolerated, with dyspepsia and
abdominal pain
the most common adverse effects. A small risk of
cholelithiasis
exists with these drugs, and caution should be used when combining these drugs with HMG-CoA reductase inhibitors because the combination increases the incidence of hyperlipidemic myositis and rhabdomyolysis.
...
PMID:Effects of gemfibrozil and other fibric acid derivatives on blood lipids and lipoproteins. 204 26
Oriental cholangiohepatitis, an endemic disease in Southeast Asia, is characterized by recurrent attacks of
abdominal pain
, fever, and jaundice. Pathologically, the intra- and extrahepatic ducts are dilated and contain soft, pigmented stone and pus. There is proliferation of bile ducts and infiltration of inflammatory cells along the periportal spaces and hepatic parenchyma. Localized intrahepatic segmental ductal stenosis may be present, especially in the lateral segment of the left lobe or posterior segment of the right hepatic lobe. The cause of the disease is not known, but associations with clonorchiasis, ascariasis, and nutritional deficiency have been suggested. Sonographic and CT findings include intra- or extrahepatic duct stones, dilatation of the extrahepatic duct with relatively mild or no dilatation of the intrahepatic ducts, localized dilatation of the lobar or segmental bile ducts, increased periportal echogenicity, segmental hepatic atrophy, and
gallstones
. Cholangiographic findings include bile duct stones; disproportionately severe dilatation of the extrahepatic ducts with mild or no dilatation of the intrahepatic ducts; and focal strictures, acute peripheral tapering, straightening, rigidity, decreased arborization, and an increased branching angle of the intrahepatic bile ducts.
...
PMID:Oriental cholangiohepatitis: pathologic, clinical, and radiologic features. 204 4
Two cases of ectopic liver tissue in patients submitted to an elective cholecystectomy for
gallstones
cholecystitis are reported. In the literature most part of cases are revealed as an uncommon cause of
abdominal pain
. A better definition of ectopic liver tissue versus accessory lobes is made.
...
PMID:[Accessory liver. Report of 2 cases]. 207 8
Oriental cholangiohepatitis is characterized by recurrent attacks of
abdominal pain
, fever, chill, and jaundice and grossly dilated extrahepatic and intrahepatic ducts containing soft, pigmented stone and pus. Sonograms were studied in 48 patients in whom the diagnosis was later proved during surgery (n = 34) or on the basis of clinical and laboratory findings and endoscopic retrograde cholangiography (n = 14). The sonographic findings included intrahepatic and/or extrahepatic bile duct stones (n = 47); moderate to severe dilatation of the extrahepatic ducts with relatively mild or no dilatation of intrahepatic bile ducts (n = 41); localized dilatation of the lobar or segmental bile ducts, especially the left hepatic lobe (n = 16); and
gallstones
(n = 22). Our experience suggests that the preoperative diagnosis of oriental cholangiohepatitis can be strongly suggested by sonographic findings.
...
PMID:Oriental cholangiohepatitis: sonographic findings in 48 cases. 211 46
Reports of adults with Williams syndrome (WS) have been rare. We have evaluated 13 adult WS patients and reviewed 16 case reports of WS in patients older than age 16 years. Adults in our study had progressive multisystem medical problems. Cardiovascular complications were common (12/13) including hypertension (8), supravalvular aortic stenosis (9), aortic hypoplasia (3), pulmonic artery stenosis (4), peripheral stenoses (3), and mitral valve prolapse (2). Joint limitation (12/13) was progressive, often accompanied by kyphoscoliosis and lordosis. Recurrent urinary tract infections in 6 individuals led to radiologic studies showing urethral stenosis in 2, and bladder diverticula and vesicoureteral reflux in 3. Gastrointestinal problems included obesity (5), chronic constipation (7), diverticulosis (3), and
cholelithiasis
(4). Hypercalcemia was documented in 5 patients, although others had hypercalcemic symptoms (
abdominal pain
, polyuria, and constipation). One 45-year-old man had parathyroid hyperplasia. Previous reports likewise document significant morbidity. Thus, Williams syndrome in an adult appears to dictate aggressive evaluation and monitoring. Investigation of calcium metabolism should be undertaken in each adult WS patient.
...
PMID:Adults with Williams syndrome. 189 83
From April to August 1990, 60 patients underwent laparoscopic cholecystectomy. Patients with biliary colic were included, but those who had florid acute cholecystitis, morbid obesity or scars in the upper portion of the abdomen were excluded. Three patients had acute cholecystitis, 56 had chronic cholecystitis and 1 had hydrops of the gallbladder. Nineteen patients had had previous lower abdominal surgery. Five patients did not require analgesia, but the remainder needed parenteral analgesia on an average of 1.7 occasions and enteral analgesia on an average of 1.8 occasions. There were no intraoperative complications, and no patient had the procedure completed by standard surgery. Postoperative hospital stay averaged 2.5 days. The mean follow-up was 39 days. Few postoperative complications were noted: two patients suffered from ileus; two patients had biliary colic postoperatively (one required endoscopic sphincterotomy with stone extraction, and in the other no common-duct stones were seen on retrograde cholangiography); one patient had an intra-abdominal abscess, which was drained percutaneously; and one patient complained of upper
abdominal pain
that was incisional in origin. Laparoscopic cholecystectomy should be considered the procedure of choice for elective treatment of uncomplicated symptomatic
gallstone
disease.
...
PMID:Laparoscopic cholecystectomy: a report of 60 cases. 182 56
One of the more difficult problems in
cholelithiasis
surgery is posed by the internal biliary fistula. This lesion is defined as an abnormal communication between the accessory biliary tract (gall bladder or cystic duct) and the gastrointestinal tract or main bile duct. Twenty-six patients with internal biliary fistula were operated on over a 12-year period in the Abdominal Surgery Department of Peking Union Medical Hospital. Right upper quadrant
abdominal pain
was present in all, but variable in degree and persistence. Most of the patients had jaundice, fever and chills. No particular clinical picture is associated with
cholelithiasis
, and preoperative diagnosis is rare. When internal biliary fistula is diagnosed, the patient should be advised to accept the operation. At operation, adhesions were strikingly dense. In order to protect the main bile duct from injury, it is sometimes necessary to open the gall bladder, then extract stones and perform cholangiography to assess the situation.
...
PMID:[Analysis of 26 cases of internal biliary fistula]. 214 90
Thirty duodenal and three upper-jejunal endocrine tumors are reported. Clinical manifestations included: a) the Zollinger-Ellison syndrome (10 cases); b) peptic ulcer disease in which hypergastrinemia was not documented (3 cases); c) cholestasis or
cholelithiasis
(4 cases); d)
abdominal pain
(4 cases); e) gastro-intestinal bleeding (1 case); f) celiac sprue (1 case). Ten further tumors were discovered incidentally, at autopsy or in pathological specimens after gastrectomy or duodenopan-createctomy. Histological pattern was trabecular in 19 cases, insular in 2 and mixed in ten cases. Two cases were typical ganglioneuromatous paragangliomas. All tumors were examined immunohistochemically. Twelve tumors contained gastrin, four somatostatin, six both of these peptides, one serotonin, two both gastrin and serotonin, and two tumors contained gastrin, serotonin and somatostatin. Ganglioneuromatous paragangliomas combined somatostatin and/or pancreatic polypeptide containing endocrine cells with protein-S100-positive Schwann cells. In four tumors no peptide or amine was demonstrated. Gastrin cell tumors (63.6% of our cases), both functionally active (gastrinomas) and clinically silent, predominated in the proximal duodenum, while somatostatin cell tumors (15.1%) and paragangliomas were mostly found in the periampullary region. Two tumors were classified as malignant on the basis of lymph node metastases, and both were jejunal gastrinomas associated with Zollinger-Ellison syndrome. Two somatostatin cell tumors had manifestations of von Recklinghausen's disease.
...
PMID:Endocrine tumors of the duodenum and upper jejunum. A study of 33 cases with clinico-pathological characteristics and hormone content. 216 Apr 22
The clinical profiles of 139 patients with
gallstones
found coincidentally during ultrasonography were reviewed and the patients followed prospectively for five years. Indications for ultrasonography included follow-up of abdominal malignancy (33%), evaluation of abdominal aortic aneurysm or other arteriosclerotic vascular disease (22%), renal insufficiency (12%), and lower
abdominal pain
(7%). At the time of
gallstone
detection, 14 patients (10%) had symptoms attributable to
cholelithiasis
. Over the next five years, only 15 patients (11%) developed episodes resembling biliary pain. Nine patients underwent cholecystectomy during this period. Three of the cholecystectomies were incidental to other abdominal procedures. Two cholecystectomies were performed as emergencies for
gallstone
complications with no perioperative mortality. Interestingly, 54 patients (40%) with coincidental
gallstones
died during the follow-up period. All the deaths were unrelated to
gallstones
. These data indicate that ultrasonographically detected coincidental
gallstones
rarely have clinical significance, leading strong support to the expectant management of most patients with purely coincidental
gallstones
.
...
PMID:Clinical significance of ultrasonographically detected coincidental gallstones. 218 Jun 54
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