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)

An emergency liver transplantation was performed in a 22 year-old female for fulminant hepatitis. The donor had had splenectomy with portal vein thrombosis which was diagnosed and removed during portoscopy. Nineteen days later, abdominal pain with shock and hepatic failure occurred. X-rays showed pneumoperitoneum and aeric images in the liver area. Laparotomy disclosed massive liver necrosis with gaz under the Glisson's capsula. The hepatic artery was thrombosed. In spite of emergency retransplantation, the patient died 8 days later, due to systemic aspergillosis. Thrombosis of hepatic artery was particular by the importance of gaz-forming infection, and emphasizes the role of rejection. The discovery of portal thrombosis allows to outline the precautions necessary in case of splenectomized donors. The severeness of aspergillosis is underscored.
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PMID:[Gazeous necrosis of the liver due to hepatic artery thrombosis after liver transplantation]. 176 77

Effectiveness, toxicity and complications of 5-fluorouracil (FU) and mitomycin-C (MMC) treatment were analyzed in 30 patients with metastatic colorectal cancer confined to the liver. The treatment schedule was FU 2.0-2.5 g/day for 5 days followed by MMC 10 mg/m2 every 2 h on day 6 to a maximum total dose of 60 mg. Treatment courses were repeated every 6 weeks and were given on an outpatient basis via external pump and arterial port systems. In 30 fully evaluable patients, one complete response, 17 partial responses (overall response rate 60%), and stabilization of disease in 8 patients (26%) were obtained for a median duration of 13 months. Median overall survival was 18.2 months (25.5 months for responding patients, 15 months for nonresponders). Grade 1-2 toxicity (WHO classification) consisted of leukopenia (23%), mucositis (20%), nausea/vomiting (16%), and abdominal pain (10%). Two patients (7%) developed severe mucositis. No life-threatening side effects were observed; in particular, there was no sclerosing cholangitis or chemical hepatitis. Catheter-related problems (occlusion, displacement, rupture, infection) occurred in 10 patients (33%) at a median follow-up time of 12 months. We conclude that intra-arterial FU and MMC constitute an effective, safe, and nontoxic treatment in metastatic colorectal cancer confined to the liver. Catheter-related problems are the most important factors limiting treatment.
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PMID:Phase II study of intra-arterial fluorouracil and mitomycin-C for liver metastases of colorectal cancer. 190 15

Simvastatin, a 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitor, has been administered to approximately 2,400 patients with primary hypercholesterolemia with a mean follow-up of 1 year in controlled clinical studies and their open extensions. Approximately 10% of this population received simvastatin for a period of greater than or equal to 2 years. The population on whom this safety analysis is based had a mean age of 50 years; 62% were men and approximately 27% had preexisting coronary artery disease. Simvastatin was titrated to the maximal daily dose of 40 mg each evening in 56% of the study population (last recorded dose). The most frequently reported drug-related clinical adverse experiences were constipation (2.5%), abdominal pain (2.2%), flatulence (2.0%) and headaches (1%). Persistent elevations of serum transaminase levels greater than 3 times the upper limit of normal were observed in only 1% of this cohort with only 0.1% of the total population requiring discontinuation of therapy. There were no clinically apparent episodes of hepatitis. Discontinuation of therapy due to myopathy was extremely rare (0.08%). Only minimal increases in the frequency of lens opacities (1%) were observed from baseline to the last lens examination during follow-up, consistent with the expected increase in lens opacity development due to normal aging. Patients who were greater than or equal to 65 years old had a clinical and laboratory safety profile comparable to the nonelderly population.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Long-term safety and efficacy profile of simvastatin. 195 Oct 69

25 children (18 boys and 7 girls) were treated for non-Hodgkin's lymphomas (NHL) during 1982-1990. The age at diagnosis was 2-15 years. Five of the 25 children died. Of the 25 children 6 patients had the diagnosis of intraabdominal NHL. The presenting abdominal symptoms for these 6 patients were abdominal pain in 4 cases, nausea 3, abdominal distention 2, icterus 1 and diarrhoea 1. Four of the 6 patients with abdominal NHL underwent laparotomy but the diagnosis was unknown before surgery. The indication for explorative laparotomy was in all cases a tumor of unknown etiology combined with ascites in 2 cases and icterus in 1 case. At surgery there was a tumor localized around the porta hepatitis in 1 case and in the right ovarium in 1 case. Furthermore, spread infiltrative growth of tumor was found in 3 cases, with infiltration of the peritoneum in 2 of these cases. A specimen for peroperative histological examination was taken and gave the conclusive diagnosis of NHL in 4 of 6 cases. Staging laparotomy, palliative tumor resection and radical surgery are preferably avoided. For proper treatment an adequate biopsy is important. The management of children with NHL is a multidisciplinary approach.
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PMID:Abdominal manifestations of non-Hodgkin's lymphomas. 203 8

We describe the clinical features, liver histology, and ultrastructure in reversible diclofenac-induced hepatitis and review previous reports of this entity. Although rarely reported, diclofenac hepatitis may be severe, and even fatal. Symptoms, which develop from 1 week to 11 months after starting the drug, include jaundice, pruritus, fever, abdominal pain, nausea, vomiting, and rash. Bilirubin and alkaline phosphatase are mildly elevated, transaminases often markedly so. The nature of the idiosyncratic injury appears variable, some cases having features of a hypersensitivity reaction, most being more suggestive of a toxic metabolic effect. Light microscopy shows a nonspecific hepatitis with portal and lobular activity, and focal hepatocellular injury that may progress to zonal or massive necrosis. The ultrastructural features in our case are typical of drug or toxin injury. This may be of value in distinguishing this entity from other forms of hepatitis, which is important in view of the frequent reversibility of this potentially lethal form of injury.
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PMID:Reversible hepatitis associated with diclofenac. 203 30

In order to study the clinical picture of non A, non B hepatitis in the elderly, a retrospective study was carried out in the two main hospitals in Jerusalem. Thirty-six patients with acute viral hepatitis, older than 65, have been hospitalized between the years 1982-1988. Seventy-two percent were diagnosed as non A, non B hepatitis. All patients were symptomatic and the main symptoms were abdominal pain, fever and jaundice. Thirty percent of the patients had marked cholestasis, while the disease was uneventful in 96% of the cases. Non A, non B hepatitis is the main type of viral hepatitis in the aged and should be suspected in patients with abdominal pain, fever and cholestasis.
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PMID:Non A, non B hepatitis in the aged. 212 Jun 87

Halothane hepatitis is now a well-recognized distinct entity in adults, but there prevails an often-taught "axiom" that halothane hepatitis "does not occur" in children. We describe 2 children who developed cholestatic hepatitis following halothane anesthesia. The first patient had no antecedent liver disease, and presented with anorexia, abdominal pain and delayed onset of jaundice after multiple halothane exposures. Halothane-specific antibodies were positive, and liver tests resolved completely. The second patient had antecedent liver disease and presented with delayed onset of unexplained high fevers for 10 days following a single halothane exposure. Gradually increasing cholestasis ensued in the absence of other causes of liver disease. Halothane antibodies were negative. These cases illustrate different clinical presentations of halothane hepatitis, such as delayed onset of jaundice or fever following halothane exposure. The difficulties in making a definitive diagnosis and the need to exclude other causes of liver disease are detailed. Risk factors and other presentations are discussed. While halothane hepatitis appears to be an uncommon entity in children, it does occur, and may present with manifestations less than fulminant hepatic failure. A high index of suspicion and a detailed history of the time sequence of events are necessary as the diagnosis is primarily clinical. Halothane-specific antibodies are helpful if positive. In any child developing unexplained jaundice or high fevers following halothane anesthesia, further exposures should be avoided and halothane-specific antibodies obtained.
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PMID:Halothane hepatitis in children. 178 63

Long-term use of corticosteroids (CSs) may result in an increased risk of disseminated varicella. Concurrent administration of troleandomycin (Tao) to treat CS-dependent asthmatics can potentiate steroid effects. We present the first case of fatal varicella in a patient concurrently receiving methylprednisolone and Tao therapy. At the time of her death she had been receiving CSs for 2 years and Tao for 1 year. She had a 2-day history of fever, lower back and abdominal pain, dysuria, and constipation. Later, when pox lesions were evident, it was learned she had been exposed to varicella 2 weeks previously. While hospitalized she developed hepatitis, gastrointestinal hemorrhage, disseminated intravascular coagulopathy, and pneumonitis, resulting in respiratory failure. She succumbed despite treatment with stress doses of steroids, intravenous acyclovir, fresh frozen plasma, and ventilatory support. Autopsy findings revealed evidence consistent with disseminated varicella. This case suggests that concurrent therapy with CSs and Tao may increase the risk for disseminated varicella, possibly by enhancing CS-induced immunosuppressive effects. We suggest that other immunologic parameters in addition to serum varicella titers might be helpful in identifying those CS-dependent patients at risk. Any CS-dependent asthmatic, whether or not receiving Tao, should receive varicella-zoster immune globulin within 96 hours of exposure and acyclovir once varicella is clinically apparent. Varicella vaccine should be considered for those not yet exposed.
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PMID:Fatal varicella in a corticosteroid-dependent asthmatic receiving troleandomycin. 233 42

A patient with systemic lupus erythematosus presenting abdominal pain, nausea, vomiting and severe mucocutaneous vasculitis had significant elevation of serum amylase and hepatic enzymes levels during a flare-up of the disease. Clinical and laboratory alterations disappeared after therapeutic increase of corticosteroids given to the patient a fact that suggested etiologic correlation between systemic lupus erythematosus, hepatitis and pancreatitis.
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PMID:[Pancreatitis and hepatitis associated with systemic lupus erythematosus]. 248 88

The aim of the present study was to define and characterize the occurrence of a hepatitis outbreak. A hepatitis outbreak developed from November 1987 and June 1988 in a peripheral district of the city of Granada. Sixty cases were diagnosed (59 confirmed and 1 probable). An increase in the incidence was observed during October, November and December. There were no sex differences in the specific attack rates and the mean age of cases was 7.14 years; the specific rates in the different age groups were higher in the 0-5 years and 6-10 years groups. The most common symptoms and signs were choluria, abdominal pain and jaundice. Anti-HVA IgM was positive in 83.3% of cases. Only 5 children required hospital admission, and the outcome of 83.3% of cases was known and favorable. The strategies adopted against the outbreak were to recommend hygienic measures in the households and school where cases had developed and to give nonspecific human immunoglobulins before or after exposure in the closed contacts of cases. We do not feel that these strategies have had a sizeable effect on the course of the outbreak.
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PMID:[A hepatitis A outbreak in a Granada district]. 251 88


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