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)

Obstructive jaundice due to benign, nonparasitic hepatic cysts is rare, with only 11 previously reported cases. We report a case in which relief of jaundice was obtained by percutaneous cyst aspiration. For the elderly, infirm, or high-risk patient, percutaneous aspiration is recommended to relieve obstructive jaundice. Immense size and porta hepatis proximity are major risk factors for developing jaundice from simple hepatic cysts. Abdominal pain of recent onset and rising alkaline phosphatase are warning signs that this complication is developing. In these situations, treatment prior to developing jaundice is recommended.
 ...
PMID:Obstructive jaundice from benign, nonparasitic hepatic cysts: identification of risk factors and percutaneous aspiration for diagnosis and treatment. 327 52

Idiopathic fibrosing pancreatitis is a chronic process of unknown etiology characterized by extensive infiltration of the pancreatic parenchyma by fibrous tissue. This disease process is uncommon in the pediatric patient and is consequently rarely considered in the differential diagnosis of abdominal pain and jaundice in the child. The sonographic demonstration of a dilated biliary tree and common bile duct compressed by an enlarged pancreas may be the first suggestion of this entity. Two patients with idiopathic fibrosing pancreatitis and obstructive jaundice are reported with a review of the clinical, radiographic, and pathologic findings.
 ...
PMID:Idiopathic fibrosing pancreatitis: a cause of obstructive jaundice in childhood. 327 37

Fifteen patients were evaluated because of highly symptomatic adult polycystic liver disease. All of them had abdominal pain, two patients had obstructive jaundice, one had ascites and a large right-sided pleural effusion, and one had oesophageal varices. In 4 patients percutaneous aspiration of the largest cysts was performed, but this form of treatment only provided temporary relief. In 9 patients a fenestration operation was carried out. One of these patients died per-operatively due to irreversible shock. The abdominal complaints disappeared post-operatively in 7 of the other 8 patients, although a decrease of the liver span was uncommon. In the two patients with obstructive jaundice the serum bilirubin level normalized after the operation, and in the patient with oesophageal varices this abnormality disappeared post-operatively. Biochemical analysis of cyst fluid was performed in 7 of the cases. The mean ratios of the levels of most of the non-protein-bound inorganic ions and other small molecules in cyst fluid and serum were about 1, whereas those of all proteins and protein-bound constituents were generally far below 1.
 ...
PMID:Highly symptomatic adult polycystic disease of the liver. A report of fifteen cases. 365 7

A patient is presented with a bleeding intrahepatic artery saccular aneurysm. The patient had for years complained of intermittent abdominal pain and was admitted with acute colicky pain in the left upper abdomen, followed by acute severe anemia. She survived after ligation of the right hepatic artery and partial resection of the right liver lobe. The postoperative course was uneventful. These lesions are rare and the diagnosis and best methods of treatment are complicated. The classic triad-pain, obstructive jaundice and bleeding-occurs only in 33 percent of cases and is in general caused by trauma. Bleeding intrahepatic saccular aneurysms cause pain and anemia as primary symptoms. The success rate of operation is still low. A possible alternative to surgery is given by selective trans-catheter embolization.
 ...
PMID:Saccular intrahepatic artery aneurysm. 368 49

This report deals with the study of 25 patients with carcinoma of the pancreas without jaundice. Carcinoma of the pancreas is the fourth most common cause of death among men who suffer from cancer. The extremely high mortality associated with pancreatic cancer is due to failure of early diagnosis. Those cases associated with obstructive jaundice can be diagnosed much earlier than those in which jaundice is absent. In the absence of jaundice, symptoms and signs of pancreatic cancer are so vague that they may be confused with those of other conditions. Routine laboratory tests aid little in the definitive diagnosis of the disease. Sophisticated new modalities of diagnosis such as ultrasonography, endoscopic retrograde cholangiopancreatography (ERCP), and CT-scanning frequently will lead to a correct diagnosis, but these tests are seldom performed unless there is a strong suspicion that carcinoma of the body of the pancreas exists. When pancreatic carcinoma without jaundice is ultimately diagnosed, it is found to be less amenable to surgery than lesions located in the head where early jaundice is more often encountered. Most patients with cancer of the body of the pancreas suffer from persistent unexplained abdominal pain, marked anorexia, and weight loss. Such patients must be subjected to sophisticated diagnostic tests in order to arrive at an early diagnosis.
 ...
PMID:Carcinoma of the pancreas in nonjaundiced patients. A silent disease. 388 16

Decision analysis is a valuable tool for studying diagnostic strategies in gastroenterology. Multiple comprehensive patient management strategies can be compared in hypothetical populations of patients with varying characteristics reflecting real clinical situations which could not be readily empirically studied. Measures of clinical outcome can be compared and cost effectiveness ratios calculated. Analyses of the diagnostic approaches to suspected obstructive jaundice and pancreatic cancer presenting as abdominal pain are discussed as examples. A useful decision analysis combines the best data available in a clinically relevant fashion. Although decision analysis cannot replace empiric research, it helps clarify reasons for the uncertainty so common in clinical practice and provides insight into the diagnostic process that might otherwise be elusive.
 ...
PMID:Decision analysis for the practicing gastroenterologist. 2. Insights into the efficacy of diagnostic strategies using decision analysis. 389 May 24

After a two-year history of recurrent abdominal pain, an 84-year-old man presented with acute pancreatitis and obstructive jaundice. An endoscopic retrograde cholangiogram demonstrated two filling defects approximately 1.0 cm in diameter, in a dilated common bile duct. Endoscopic papillotomy was performed which resulted in a polypoid tumour delivering itself into the wound followed by a free flow of bile. In addition, a single 1.0 cm gallstone was removed from the common bile duct, above the tumour, using a Dormia basket. The patient recovered completely. Histological examination of biopsies of the tumour taken on three subsequent occasions showed it to consist only of inflammatory tissue (an inflammatory polyp) and later, regenerating bile duct mucosa. After six months this tumour had completely regressed.
 ...
PMID:Extrahepatic biliary obstruction by a common bile duct inflammatory polyp in association with a gallstone, and treatment by endoscopic sphincterotomy. 395 41

A retrospective analysis was performed to evaluate the clinical symptoms and abnormal test findings in small pancreatic carcinoma. Five hundred and thirty-six cases of pancreatic carcinoma with the histology of duct cell carcinoma were collected from 14 medical centers in Japan. In 440 of the cases, tumor size was measured at the time of laparotomy or from the resected specimen. Three hundred and seventy-seven patients (86%) had a carcinoma larger than 3.0 cm; only 30% of these were resectable. Sixty-three patients (14%) had a carcinoma of 3.0 cm or less, with resectability of 97%. Detecting a tumor of "3 cm or less" with a high probability of resectability is the objective of early diagnosis with the resulting possibility of a cure. In most cases these small carcinomas were found easily when obstructive jaundice was present (73%). However, the estimated occurrence of obstructive jaundice associated with carcinomas of 3 cm or less was only 10% among the total cases of pancreatic carcinoma studied. Therefore, it is necessary for early diagnosis to detect carcinomas of 3 cm or less presenting without jaundice. The symptoms of small carcinoma without jaundice are weight loss, anorexia, upper abdominal pain, back pain and a palpable abdominal mass. Among the various available examinations, endoscopic retrograde cholangiopancreatography, computerized tomography and ultrasonography were valuable in diagnosing these small carcinomas.
 ...
PMID:Diagnosis of small pancreatic carcinoma. 398 9

The incidence of periampullary carcinoma is increased in patients with familial polyposis coli or the Gardner syndrome. Patients with familial polyposis coli and ampullary tumors usually present with obstructive jaundice or abdominal pain. We report the case of a 41-year-old woman with the Gardner syndrome in whom relapsing acute pancreatitis was the presenting manifestation of an ampullary neoplasm. A diagnosis of ampullary neoplasm should be considered in any patient with familial polyposis coli or the Gardner syndrome and pancreatitis, even in cases of relapsing acute pancreatitis.
 ...
PMID:Relapsing acute pancreatitis as the presenting manifestation of an ampullary neoplasm in a patient with familial polyposis coli. 402 80

Analysis of 56 patients with obstructive jaundice due to carcinoma of the pancreas or extrahepatic biliary tree showed that unexpected features were present in 25%. Presentation with painless jaundice was uncommon, and the symptoms were more often non-specific, with malaise, anorexia, and vomiting. Abdominal pain was frequent, and the condition was found in young patients. One-fifth presented with serum alkaline phosphatase levels of less than 30 K.A. units. Some had high serum aspartate aminotransferase levels, more characteristic of hepatocellular jaundice. A mathematical model may be helpful in correctly weighting these various criteria.
 ...
PMID:Pitfalls in the diagnosis of jaundice due to carcinoma of the pancreas or biliary tree. 451 75


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