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

DT, a 63-year-old white male with insulin-dependent diabetes mellitus and severe peripheral vascular disease, was admitted with a five-day history of vague abdominal pain and diarrhea. On the day of admission he vomited three times, was noted to have a bloody stool, and came to the emergency room. DT denied hematemesis, fever, or chills. He had bilateral leg amputations and had sustained three myocardial infarctions, the last one 15 months before this admission. He had never experienced symptoms of abdominal angina. Of significance was his history of congestive heart failure, mitral regurgitation, and atrial fibrillation. His medications on admission included digoxin 0.25mg per day, furosemide 40mg per day, and NPH insulin 15 units per day. On admission to the hospital his oral temperature was 38 degrees C, pulse was 90/min, respiratory rate was 24/min, and blood pressure was 134/80mmHg. Abdominal examination revealed a distended abdomen with hypoactive bowel sounds and mild tenderness. Chest x ray revealed cardiomegaly. The electrocardiogram demonstrated atrial fibrillation. A plain film of the abdomen was positive for gallstones and edema of the bowel wall (thumb-printing). Laboratory results included blood urea nitrogen 48mg%, creatinine 1.2mg%, hemoglobin 18g/dl, and hematocrit 52.9%. White blood cell count was 11,900 cells/cc with 33% polymorphonuclear leukocytes, 47% bands, 8% lymphocytes, 11% monocytes, and 1% atypical lymphocytes. The prime considerations for differential diagnosis were mesenteric ischemia and infectious gastroenteritis. While it was appreciated that mesenteric ischemia, if present, might warrant surgical intervention, the risk of anesthesia itself in this patient was felt by his attending physicians to exceed 30%. Furthermore, the clinical findings were only "suggestive" of mesenteric eschemia. They were certainly not "diagnostic." In view of this dilemma, a consultation with the Division of Clinical Decision Making was requested.
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PMID:Abdominal pain, atherosclerosis, and atrial fibrillation. The case for mesenteric ischemia. 716 38

Type V hyperlipoproteinemia is an unusual entity in children. Only 6 cases have been described so far to our knowledge. Authors present a 9 year old male that came for diagnosis of a hepatosplenomegaly. There was no evidence of abdominal pain, xanthomas or pancreatitis. Secondary disorders such as uncontrolled insulinopenic diabetes mellitus, glycogen storage disease, administration of estrogen compounds, nephrotic syndrome or uremia, and dysglobulinemias were excluded. His father presented the same lipoprotein pattern suggesting a dominant mode of inheritance. The administration of heparin showed a good response of serum proteinlipase.
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PMID:[Primary hyperlipoproteinemia in childhood (author's transl)]. 728 88

The cases of 380 patients with pancreatitis were analyzed retrospectively. There were 237 men (62%) and 143 women (38%). Etiologic factors included: alcoholism, 62%; biliary lithiasis, 16.6%; idiopathic, 12%; miscellaneous, 7%; and trauma, 2.4%. Acute pancreatitis occurred in 279 patients (73%); 189 (67%) were treated nonoperatively, 90 (33%) underwent operation; electively in 43 and urgently in 47. Postoperatively, one patient (2.3%) died in the elective group and 14 (30%) in the emergency group. Chronic pancreatitis occurred in 101 patients. Their pertinent findings were: alcoholism in 78%, biliary lithiasis in 8%, absence of abdominal pain in 15%, diabetes in 40%, and jaundice in 20%. Fifty patients were treated without operation; 43 were alcoholics, 17 of them died in the follow-up period. Fifty-one patients, 36 of them alcoholics, underwent a variety of operations, with three deaths (6%); 21 were improved after operation. It was concluded that 30% of patients with acute pancreatitis require operation, mainly to correct biliary lithiasis. Emergency operations dictated by relentless deterioration or uncertain diagnosis had a high operative mortality (30%), particularly in patients with necrotizing or hemorrhagic pancreatitis. Operative treatment for chronic pancreatitis was most effective when directed toward specific goals, including pseudocysts, obstructed pancreatic or common bile ducts. Operations done without specific anatomical objectives were often therapeutic failures.
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PMID:Evaluation and treatment of acute and chronic pancreatitis. A review of 380 cases. 738 28

During August 1989-August 1994 at the referral-based obstetric practice of MacKay Memorial Hospital in Taipei, Taiwan, obstetricians saw 8 pregnant women with acute pancreatitis. All but 1 patient had gallstones and/or hyperlipidemia. None had ever been diagnosed with pancreatitis or gallstones in the past. None suffered from alcoholism. One woman was lost to follow-up at 33 weeks gestation. No pregnant woman died. Magnesium sulfate and nifedipine controlled preterm labor in 2 patients. Two women underwent cesarean section (fetal distress and elective). Pancreatitis struck all but 1 during the 3rd trimester of pregnancy. One woman presented at 23 weeks gestation with loss of consciousness, abnormally low volume of circulating plasma in the body, upper gastrointestinal bleeding, and a dead fetus. She also had diabetes mellitus which had gone untreated for 2 years. After spontaneous delivery of the dead fetus, she developed metabolic encephalopathy, sepsis, respiratory distress, and acute renal failure. She completely recovered and left the hospital 62 days after arriving. Physicians instituted conservative treatment for pancreatitis and a fat-restricted diet for hyperlipidemia. Labor was induced in 3 women after determining fetal lung maturity. Pancreatitis symptoms diminished after delivery. At 2 weeks postpartum, they underwent cholecystectomy. In fact, all but 3 women underwent cholecystectomy. Five patients had a fever greater than 38 degrees Celsius upon admission. Three patients were jaundiced. All 8 patients experienced nausea and/or vomiting and abdominal pain. Six women had low serum calcium levels. Only 1 had a serum lactic dehydrogenase level above 350 IU/L. Primiparous women were just as likely to develop pancreatitis during pregnancy as multiparous women. These findings suggest that early diagnosis and prompt treatment of acute pancreatitis are essential to a favorable outcome.
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PMID:Acute pancreatitis in pregnancy. 766 Jul 65

In select patients with pancreatitis, pancreatectomy may be the only alternative for treatment of abdominal pain. Segmental autotransplantation of the distal pancreas to the thigh has been shown to be successful in preventing or reducing the severity of diabetes following pancreatectomy. We present the postoperative anatomy and potential complications identified on cross-sectional imaging.
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PMID:Segmental autotransplantation of the distal pancreas to the thigh: CT and ultrasound features. 782 33

A female patient with hereditary chronic pancreatitis is described. She presented initially at the age of 18 years with abdominal pain due to acute pancreatitis. Predisposing etiological factors were not recognized. During the ensuing years she had recurrent episodes of abdominal pain and chronic pancreatitis with extensive pancreatic calcifications was finally demonstrated. Six other family members within three generations were affected by chronic pancreatitis suggesting an autosomal dominant mode of transmission. None of the affected patients showed signs of diabetes mellitus, aminoaciduria or hyperparathyroidism.
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PMID:Hereditary pancreatitis--a case report. 788 74

A case of severe autonomic diabetic neuropathy with abolished visceral pain sensitivity is reported. A patient was admitted who presented jaundice without abdominal pain. Diabetes was diagnosed. The pathogenesis of jaundice was traced to the inflammation of a postoperative stenosis of the choledochus. An episode of gallstone disease had occurred 7 years before. Interestingly, although there were stones located both in the gallbladder and in the distal extremity of the choledochus, no pain was present. Possible relationships between gallstone disease and diabetic autonomic neuropathy are discussed.
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PMID:[Asymptomatic choledocholithiasis associated with diabetic neuropathy. Report of a case]. 792 85

The aim of the present study was to elucidate the connection between yersiniosis and chronic inflammation. During the period 1974-83, Yersinia enterocolitica infection was diagnosed in 458 hospitalized patients by antibody response, or isolation. The patients were followed for 4-14 years (1987); 160 were readmitted with chronic disease. Fifty-three patients had persistent joint complaints, 18 developed ankylosing spondylitis, 14 rheumatoid arthritis, and 17 iridocyclitis. Thirty-eight patients suffered from chronic abdominal pain, and another 28 from chronic diarrhoea. Two who underwent proctocolectomy microscopically had ulcerative colitis. Eleven patients developed neurological disease; others developed conditions such as chronic nephritis, thyroid disease, insulin-dependent diabetes, etc. Chronic hepatitis, found in 22 patients, was significantly correlated with positive test for antinuclear antibody and rheumatoid factor, and with death. Several patients developed chronic multiorgan disease, probably with chronic hepatitis as pivot. Regarding the whole material, the difference between observed and expected cumulative survival rates remained significant for 8 years (0.9189 < 0.9456; p < 0.025), indicating a substantial impact on long-term survival exerted by chronic yersiniosis.
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PMID:Yersinia enterocolitica: an inducer of chronic inflammation. 796 May 1

We describe two patients with type 2 diabetes who presented with abdominal pain secondary to thoracic polyradiculopathy. In the first patient abdominal pain occurred in association with marked abdominal distension; extensive negative gastrointestinal investigations were performed before the correct diagnosis was made by electromyography showing thoracic paraspinal muscle denervation. In the second case, truncal sensory symptoms alone were evident at the time of diagnosis of diabetes mellitus. While muscle laxity was absent, extensive paraspinal muscle denervation was detected. Tolrestat, an aldose reductase inhibitor, was associated with good clinical response of symptoms due to peripheral neuropathy and thoracic polyradiculopathy. The pathogenesis of thoracic polyradiculopathy is uncertain but is likely to be the result of multiple infarcts along the course of thoracic spinal nerves accounting.
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PMID:Thoracic polyradiculopathy--abdominal wall swelling and sensory symptoms in diabetes mellitus. 796 Jun 57

A mass within the head of the pancreas causing obstructive jaundice is frequently adenocarcinoma, or infrequently focal pancreatitis. Groove pancreatitis is an inflammation of the head of the pancreas which fills the anatomic space between the head of the pancreas on 1 side and the second part of the duodenum on the other. Obstruction from either cause may cause vomiting, abdominal pain, and loss of weight. It is sometimes impossible to differentiate between the 2 conditions clinically. We present 2 women, aged 41 and 42 years, respectively, with recent onset of diabetes mellitus, obstructive jaundice, abdominal pain and severe loss of weight in whom diagnosis was difficult. In 1 repeated fine needle biopsy directly from the mass did not show adenocarcinoma, but she died of the disease a few months later. The other, in whom malignancy was also suspected, recovered from what was retrospectively diagnosed as groove pancreatitis.
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PMID:[Groove pancreatitis and adenocarcinoma of the pancreatic head]. 799 83


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