Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A patient with intermittent right upper quadrant abdominal pain thought to represent acute cholecystitis had common bile duct obstruction due to an enlarged right renal pelvis. A Tc-99m-HIDA scan provided the first clue to the diagnosis. The case reinforces the value of cholescintigraphy in diagnosing pathology outside the biliary system.
 ...
PMID:Hepatobiliary imaging of common bile duct obstruction by a hydronephrotic kidney. 706 Feb 97

Pancreatic cystadenoma is an unusual lesion of the pancreas, typically occurring as an isolated lesion in a middle-aged woman with abdominal pain or an asymptomatic epigastric mass. Jaundice is unusual. Two types of pancreatic cystadenoma are distinguished: microcystic and mucinous; the latter has a tendency to malignant degeneration. A patient with Von Hippel-Lindau disease and pancreatic cystadenoma developed jaundice due to common bile and pancreatic duct obstruction. Cystic and adenomatous lesions of the pancreas are common in Von Hippel-Lindau disease, but jaundice due to common bile duct obstruction has not previously been reported.
 ...
PMID:Pancreatic cystadenoma in Von Hippel-Lindau disease: an unusual cause of pancreatic and common bile duct obstruction. 716 67

A syndrome of distal common bile duct obstruction secondary to the fibrotic effects of chronic pancreatitis has been recognized for some time. A group of ten characteristic patients, seven of whom have undergone surgery, is discussed. The diagnostic techniques and surgical procedures are presented, and the results are analyzed. Three patients with the syndrome were not operated upon and one improved spontaneously. The typical patient was a male alcoholic, average age 48 years, with a history of chronic, relapsing pancreatitis and abdominal pain. The most consistently abnormal laboratory value is a markedly elevated alkaline phosphates level. Endoscopic retrograde pancreaticocholangiography and transhepatic cholangiography are the most useful diagnostic procedures. Fifteen per cent of the most useful diagnostic procedures. Fifteen per cent of the patients operated upon required emergent surgery for acute cholangitis and sepsis. Another 29 per cent required prompt intervention for progressive hepatic failure secondary to biliary cirrhosis. The authors advocate an aggressive approach to establish biliary drainage in the presence of acute cholangitis or biliary cirrhosis. If a dilated pancreatic duct can be demonstrated and abdominal pain is the principal problem a direct procedure on the pancreas is needed.
 ...
PMID:Biliary obstruction in chronic pancreatitis: indications for surgical intervention. 724 5

The purpose of this study was to evaluate the usefulness of endoscopic pancreatocholangiography in a group of patients having undergone surgical operations on bile ducts. This is a retrospective study including 64 patients in whom cholocystectomy was performed both with or without previous exploration of bile ducts. Forty five of these patients were jaundiced and 20 had abdominal pain as main symptoms. Forty nine were females and 15 males, their ages ranging between 18 and 80 years. The canulation of Vate's ampulla and the adequate darkening of the bile ducts was achieved in every case and the cholangiography showed recidual or recurring lithiasis in 75 per cent of the cases; in 67 per cent there was postsurgical stenosis of bile ducts; remnant cystic duct in 74.8 per cent; stenosis of Oddi's sphincter in 50.9 per cent, and in 13.3 a diagnosis of cholestasis was established. This procedure was quite useful in order to establish the correct diagnosis in this group of patients having a postcholecystectomy syndrome.
 ...
PMID:[Endoscopic cholangiography in the postcholecystectomy syndrome]. 732 87

The authors investigated whether parenteral nutrition-associated cholestasis (PNAC) in surgical neonates could be alleviated by the administration of cholecystokinin-octapeptide (CCK). Two groups of infants were studied, after major abdominal or cardiac surgery in the newborn period. The low-dose group consisted of three infants with PNAC who received cholecystokinin-octapeptide (Sincalide) at a dose of 0.02 micrograms/kg intravenously (IV), twice daily. The high-dose group comprised eight infants with PNAC who received an initial dose of 0.02 micrograms/kg IV or intramuscularly, three times daily on the first day, followed by a daily doubling of the dose up to as high as 0.32 micrograms/kg. In the low-dose group, direct bilirubin levels declined a mean of 50.2 +/- 14.5%. In the high-dose group, direct bilirubin levels declined a mean of 23.4 +/- 14.3%. In three patients in the high-dose group, no decline occurred. All three had clinical signs of overt liver failure and died of liver failure within 2 months after treatment with CCK. By excluding these patients from the high-dose group, the decline in bilirubin levels increased to 49.6 +/- 10.9%. Side effects from CCK occurred in two patients and consisted of abdominal pain and feeding intolerance. Treatment with CCK appears to be associated with a decline in direct bilirubin levels, provided overt liver failure has not developed.
 ...
PMID:Treatment of parenteral nutrition-associated cholestasis with cholecystokinin-octapeptide. 747 37

Five cases of acalculous cholecystitis associated with Cryptosporidium intestinal infection in HIV infected patients are reported. Clinical, Biological and Microbiological features as well as imaging studies are described. All the patients were males. Risk factors for HIV infection included previous I.V. drug abuse (3), homosexuality (1) and unknown (1). On admission a similar history of weight loss, fever, abdominal pain, diarrhea, anorexia and asthenia, together with biological data of cholestasis, was present in all patients. Ultrasound studies showed a distended gallbladder without calculi and a thickened wall, the bile duct being dilated in four of five cases. Cryptosporidium were found in stool specimens of all patients as well as histologically in one of two patients who underwent surgery while CMV was shown in the other one. Endoscopic retrograde cholangiography was performed in four cases showing a congestive, edematous and protruded papila in three patients, being normal in the fourth with a choledocal stenosis.
 ...
PMID:[Acalculous cholecystitis and intestinal cryptosporidiosis: frequent association in HIV patients]. 757 11

Gallbladder stones remain asymptomatic over a long period. The biliary colic is the typical pain caused by these stones. Dyspeptic symptoms seem to be unrelated to the presence of gallstones. Acute cholecystitis, a serious complication of gallstone disease, spans a wide spectrum of clinical findings. The typical signs are right upper abdominal pain and tenderness, fever, leucocytosis and Murphy's sign. 35% of patients experience gallbladder empyema or perforation. Localized gallbladder perforation, characterized by high fever, severe right upper abdominal pain and tenderness and a palpable mass is often difficult to distinguish from acute cholecystitis. Free perforation into the abdominal cavity causes diffuse peritonitis. Gallbladder perforation into the lumen of an adjacent organ produces fistulas, mostly with minimal symptoms or a pain relief after decompression of the inflamed gallbladder. Air in the bile ducts and on some occasions bile-acid-induced diarrhea may result. Rarely, the perforation of large stones leads to an occlusion of the GI tract and results in a gallstone ileus. Common bile duct stones may be asymptomatic or cause bile duct obstruction with biliary colics and jaundice. Acute bacterial cholangitis characterized by Charcot's triad (pain, jaundice and fever) and the acute biliary pancreatitis with its typical symptoms are the serious complications of common bile duct stones, associated with a high mortality rate. The clinical manifestations of a gallstone disease and its complications reveal important diagnostic features, but the most important diagnostic features, modalities are the imaging procedures. They are decisive for an accurate therapy.
 ...
PMID:[Clinical manifestations of cholelithiasis and its complications]. 776 32

We report the case of a 46-year old HIV-infected patient who suffered from severe recurrent diarrhoea for 18 months. In stool cultures cryptosporidiae were identified. The cryptosporidial enteritis was unresponsive to therapy. In the further course of cryptosporidial infection the patient developed HIV-associated cholangitis with increasing upper abdominal pain, progredient laboratory cholestasis and morphological changes indicating posthepatic cholestasis. Papillary stenosis with erosive papilitis caused by cryptosporidia was diagnosed. Sphincterotomy significantly improved the clinical status of the patient. Cholangitis with associated crytosporidial infection in a HIV-infected patient ist discussed and necessary diagnostic and differential therapeutic approaches are described.
 ...
PMID:[Sclerosing cholangitis with papillary stenosis in an HIV-infected patients with Cryptosporidium infection]. 797 86

A 27-yr-old Jamaican male presented with a 2-month history of jaundice, pruritus, intermittent diarrhea, and right upper quadrant abdominal pain. Over the next month, his abdominal pain and diarrhea improved, but his jaundice and pruritus worsened. He was afebrile and profoundly jaundice, with a benign abdominal examination. Medical workup included a normal abdominal ultrasound, iron studies, ceruloplasm, and serum electrophoresis. Negative viral (Epstein-Barr virus, cytomegalovirus, mononucleosis, hepatitis A, B, C) studies, ANA, AMA, ASMA, RPR were noted. He denied any alcohol, drug, or toxin exposure. Liver tests revealed total bilirubin of 25.6 mg/dl, direct bilirubin of 13.9 mg/dl, alkaline phosphatase 278 IU/L, AST 45 IU/L, and ALT 71 IU/L. Liver biopsy demonstrated centrilobular zonal necrosis and cholestasis most consistent with a toxic reaction. The patient was again interviewed regarding potential toxins, and he admitted to the ingestion of ackee fruit, a native Jamaican fruit that is illegal in the United States. Shortly after he had ceased intake of the fruit, his symptoms resolved and his liver function tests returned to normal. We present a case of chronic ackee fruit ingestion that led to cholestatic jaundice, vomiting, and abdominal pain.
 ...
PMID:Cholestatic jaundice due to ackee fruit poisoning. 807 44

Nine patients are described with jaundice, upper abdominal pain and malaise attributable to dextropropoxyphene hepatotoxicity. In each case the history was suggestive of large bile duct obstruction. All patients underwent ultrasound examination and percutaneous liver biopsy. Three patients also underwent endoscopic retrograde cholangio pancreatography. The histological features of the biopsies concur with previously reported cases of dextropropoxyphene hepatotoxicity. The histological changes seen on biopsy were remarkably constant, consisting of centrilobular cholestasis, portal tract inflammation and bile duct abnormalities, in all cases mimicking large bile duct obstruction. Fifteen previous patients with probable dextropropoxyphene hepatotoxicity have been described. The occurrence of 9 further cases at one centre, 6 presenting within 12 months, suggests that it is much more common than previously assumed and may be misdiagnosed as large bile duct obstruction.
 ...
PMID:Dextropropoxyphene induced hepatotoxicity: a report of nine cases. 815 Nov 9


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>