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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Early pancreatic carcinoma is defined as a tumor of less than 2 cm in diameter, limited to the pancreas without extension to adjacent structures or organs and without lymph-node and distant metastasis (T1a, N0, M0). In analysing 693 pancreatic cancer patients seen at the Surgical Clinic of Erlangen since 1969 we found only 3 early lesions (0.4%). There is a variety of diagnostic signs like unexplained abdominal pain, the development of pancreatic insufficiency, weight loss in excess of 10%, sudden onset of diabetes and elevation of serum and urine amylase. These early symptoms should be clarified by special pancreatic screening tests (ERCP, CT, US, angiography). CT and US alterations may be missing, because of the small tumor size. The proof of a pancreatic duct stenosis indicates laparotomy and resection. One of three of our patients survived longer than 6 years without recurrence. As reported, the 5-year-survival rate of early pancreatic cancer is 86%.
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PMID:[Early cancer of the exocrine pancreas: diagnosis and prognosis]. 356 19

Emphysematous pyelonephritis is a severe infection characterized by the presence of gas within the renal parenchyma and perirenal tissues. Two cases of this disease are presented. They were the 16th and 17th case reported in Japan. Case 1 was a 63-year-old woman with diabetes mellitus and liver cirrhosis. She was hospitalized for abdominal pain and anuria. Renal X-rays showed a gas shadow in and around the left kidney, but no evidence of upper urinary tract obstruction. Although hemodialysis was done, she died of heart failure. Case 2 was a 54-year-old man with diabetes mellitus was admitted with the complaint of fever and left abdominal pain. Renal X-rays showed a gas shadow in and around the left kidney but no evidence of upper urinary tract obstruction. He was treated with intensive antibiotic therapy, control of blood sugar, intravenous drips and percutaneous drainage. Clinical features improved, but deteriorated after 40 days of therapy. The gas shadow remained unchanged on CT scanning, and aortography showed the occlusion of the left renal artery. Nephrectomy was done after 50 days. Seventeen cases of emphysematous pyelonephritis in the literature including our cases are reviewed, especially the choice of the treatment is discussed.
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PMID:[Two cases of emphysematous pyelonephritis--considerations on the choice of treatment]. 359 89

We report the first case of the Pancreatic fibrosis calcification syndrome (PFCS) in a Liberian. The patient presented with the classical features of the syndrome - a history of recurrent abdominal pain, diabetes mellitus, malabsorption and pancreatic calcification on plain abdominal X-ray. The patient also has situs inversus; we believe that this combination is a casual one. Since describing this case, five more cases have been diagnosed; we believe that this condition is not rare in Liberia.
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PMID:Pancreatic fibrosis calcification and situs inversus in a Liberian female; a case report. 373 86

An autopsy case of clostridial gas gangrene occurring in a 54-year-old man with colon adenocarcinoma, liver cirrhosis, and diabetes mellitus is reported. The patient died 4 days after the onset of symptoms with episodes of vomiting and abdominal pain. Gangrene of both hips and perineum, hemolysis, renal failure, and disseminated intravascular coagulation were the dominant clinical features. Clostridium septicum was isolated from the subcutaneous tissue fluid. Adenocarcinoma of the ascending colon with ulceration found at autopsy was supposed to be an entry of the organism. Histologically, lesions of subcutaneous tissue and muscles were characterized by the absence of inflammatory infiltrates in spite of extensive necrosis. A summary of 35 cases of gas gangrene hospitalized to the Osaka University Hospital for the past 16 years indicates that clostridial gas gangrene patients with underlying diseases such as malignant neoplasm, diabetes, liver cirrhosis or immunodeficiency have a relatively poor prognosis.
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PMID:A case of nontraumatic clostridial gas gangrene occurring in a patient with colon adenocarcinoma, liver cirrhosis, and diabetes mellitus. 373 9

27 patients who presented with pyogenic liver abscess from 1957 to 1984 are analyzed retrospectively and compared with the literature. Diagnosis and start of therapy were frequently delayed because of the unspecificity of symptoms. Symptoms included fever, abdominal pain, weakness, and loss of weight. In 50% of all patients, the abscess was found by chance at laparotomy or autopsy. The most frequent causes of abscess formation were cholestasis due to extrahepatic obstruction and intraabdominal infections. Frequently a predisposing condition such as carcinoma, diabetes mellitus or alcohol abuse was found. The overall mortality was 25%, and was higher in patients with multiple abscesses of the liver (36%) than in patients with solitary abscesses (10%). With the introduction of new imaging procedures (ultrasound, computer tomography), the abscesses can be punctured under view and the antibiotic therapy can be based on bacterial analysis. The causative bacterial organism could be identified by cultures of the abscess fluid and blood in up to 90%. The bacteria identified usually were identical to the intestinal flora. Using specific antibiotic therapy, surgical treatment is often unnecessary and can be reserved for abscesses resistant to conservative treatment and for those due to correction of the original source of abscess formation.
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PMID:[Pyogenic liver abscess]. 376 87

We operated on 102 patients (89 men and 13 women) who had chronic pancreatitis. The mean age at the time of surgery was 45 1/2 years. Of these patients, 77 had resections (57 distal pancreatectomies, 17 duodenopancreatectomies, an three total pancreatectomies) and 25 had diversion procedures (15 Puestow operations and 10 internal drainage of cysts). The indication for surgery was abdominal pain in 88% and the presence of jaundice in 21%. Our patients had severe pancreatic disease: 64% had pseudocysts, 41% had calcifications, and 26% had calculi in the duct of Wirsung. The postoperative mortality rate was low (3%), but morbidity occurred in 18% (mostly after resection procedures). The incidence of diabetes after surgery was high after resection (57%) but it also occurred after diversion procedures (10%). The quality and length of survival was similar after resections and after diversions, although patients with alcoholic pancreatitis had the worst long-term prognosis. Reoperations were performed in 16% of all patients; the incidence was lower after duodenopancreatectomy.
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PMID:Surgery for chronic pancreatitis. 381 Apr 83

Mild to moderate hypertriglyceridemia is not associated with specific signs or symptoms in either IDDM or NIDDM. However, symptoms of the "chylomicronemia syndrome," including abdominal pain and acute pancreatitis, can occur when poorly controlled diabetes is present in a patient with a familial form of hyperlipidemia. The low-carbohydrate, high-fat diet that was commonly recommended for diabetics during past years may have contributed to the elevated plasma LDL levels in some individuals. Such "diabetic diets" may also have played a role in the predisposition of diabetics toward atherosclerotic complications.
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PMID:Hyperlipidemia: forestalling complications in older diabetics. 388 43

Pressure activity in the stomach and upper intestine was studied in 104 patients referred to the Mayo Clinic for evaluation of functional symptoms (nausea, vomiting, upper abdominal pain, or other dyspeptic symptoms in the absence of structural gut abnormalities). Manometric abnormalities were found in 75 patients. Forty-three of these had gastric abnormalities and 32 patients had both gastric and intestinal abnormalities. In the stomach, decreased antral phasic pressure activity after a solid meal was the most common abnormality. In the upper intestine, unpropagated bursts of phasic and tonic contractile activity were a relatively frequent abnormality but a number of other altered manometric patterns also were observed. Digestive tract symptoms were not good predictors of the presence or site of the gastrointestinal manometric abnormalities. Patients with associated neurologic, urologic, or metabolic (diabetes) disease were more likely to exhibit manometric abnormalities than were those without evidence of disease outside the gut. Almost two-thirds of the patients with symptoms and normal manometry presented features suggestive of psychiatric disease. We conclude that in patients with severe functional-type symptoms gastrointestinal manometry is a useful technique to evidence the underlying gut motor disturbance that is present in a relatively high proportion of these patients.
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PMID:Manometric evaluation of functional upper gut symptoms. 397 47

A study of bacteriuria was conducted among 426 of the 436 children under the age of 13 in a general practice in north-west London. Three girls and one boy were found to have asymptomatic bacteriuria, and a further girl with bacteriuria presented with abdominal pain and fever. The calculated incidence of urinary tract infection was 1.4% per annum. Most of the childhood urinary infections in this practice occurred before the age of 5 years, and the incidence of significant bacteriuria in this age group was 4.9% per annum. Five other children (four girls and one boy) in the practice were known to have had proved urinary tract infection. Of the total of eight children known to have had significant bacteriuria and investigated radiologically, three girls and two boys had radiological abnormalities in the urinary tract.Pyuria and proteinuria did not prove to be useful in the prediction of asymptomatic bacteriuria. Urinary tract infection with renal tract abnormality was found in this practice to be at least five times as common as diabetes in childhood.
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PMID:Study of childhood urinary tract infection in general practice. 544 Feb 35

A 36 year old woman was admitted because of upper abdominal pain, fullness and weight loss. Pancreatic scintigram revealed abnormal accumulation of the radioisotope in the pancreatic head, and hepatic scintigram showed multiple filling defect in the bilateral lobe. Celiac angiogram demonstrated a tumor stain at the pancreatic head, encasement of the splenic artery and metastasis to the liver. The diagnosis of malignant glucagonoma was substantiated by high serum glucagon level of 1,100 pg/ml. Streptozotocin of 1.5g was administered intravenously once a week, totalling 9g. Thereafter, blood level of glucagon declined to the normal range, accompanied by improvement of diabetes mellitus and weight gain. At laparotomy, there was an over fist-sized mass at the body and tail of the pancreas, infiltrating the pancreatic head and periaortic region, and was found unresectable. On light microscopy, biopsied specimen was seen to be a tumor that contained glucagon. Secretary granules resembling A cell granules were observed by electron microscopy. She died of emaciation 6 years after the onset of the disease. Eighteen cases of glucagonoma reported in Japan, and 64 cases in Europe and the United States were reviewed in terms of the diagnosis and treatment.
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PMID:[Glucagonoma]. 609 16


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