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

An unusual case of a ruptured abdominal aortic aneurysm is described. The patient presented with sudden abdominal pain and obstructive jaundice and was misdiagnosed as suffering from biliary colic. Two months later there was a pulsating mass in the abdomen palpated and the patient operated on. The only pathology which could explain the jaundice was an organized retroperitoneal hematoma extending from a small sealed rupture of the aneurysm towards the head of the pancreas and duodenum.
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PMID:Rupture of an aortic abdominal aneurysm presenting as painful obstructive jaundice. 722 93

We report a 3-year-old asymptomatic patient who had obstructive jaundice. Percutaneous transhepatic cholangiogram showed total obstruction of the distal common bile duct. At laparotomy, fibrosing pancreatitis was found. Sphincteroplasty and choledochoduodenostomy relieved his symptoms. A review of the literature disclosed ten patients, nine of whom had abdominal pain. Fibrosing pancreatitis should be considered in the differential diagnosis of obstructive jaundice in children, even in the absence of abdominal pain.
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PMID:Fibrosing pancreatitis--an obscure causes of painless obstructive jaundice: a case report and review of the literature. 724 23

Gastrointestinal endoscopy with flexible instruments is also a suitable method for pregnant women. Pregnancy is generally not a contraindication for use of the endoscopy, and additional special preparations are usually not necessary. In cases with unclear upper abdominal pain the esophagogastro-duodenoscopy with thin instruments is more suitable than X-ray examination. An indication for the coloscopy can occur in patients with relapsing peranal hemorrhage or diarrhea. For obstructive jaundice ERCP with PTC is the diagnostic method of choice.
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PMID:[Surgery in pregnancy from an endoscopy viewpoint]. 733 55

The "groove pancreatitis" is a special form of segmental chronic pancreatitis affecting the "groove" between pancreatic head, duodenum and common bile duct. This type of chronic pancreatitis was first described in 1973 and only few cases have been reported in literature. Unlike other forms of chronic pancreatitis, this is often preceded by peptic ulcers, gastric resections or biliary tract diseases; it could be associated with cysts of the duodenal wall and pancreatic cysts. Abdominal pain, vomiting due to duodenal stenosis, obstructive jaundice and weight loss are the most common presenting symptoms. The radiological features show a pancreatic mass similar to a pancreatic head carcinoma and the discrimination of groove pancreatitis from pancreatic carcinoma is often difficult or even impossible in some patients. We describe a case of groove pancreatitis treated with pancreatoduodenectomy, reviewing the clinical and radiological features. We remark that the groove pancreatitis is a disease that must be known and should be considered in the differential diagnosis of pancreatic carcinoma.
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PMID:[Groove pancreatitis. A case report of chronic focal pancreatitis]. 764 41

Between 1982 and 1991, 20 patients of median age 44 (range 22-76) years were treated for non-functioning neuroendocrine tumours of the pancreas. Presenting features were obstructive jaundice (seven patients), abdominal pain (seven), weight loss (six), abdominal mass (eight) and severe haemorrhage (four). Gut hormone profiles were normal except for one patient who had a raised pancreatic polypeptide level. Contrast-enhanced computed tomography localized the tumour in 17 patients and visceral angiography in 14 of 15; all but three tumours were highly vascular. Ten patients underwent curative resection, and the remainder were managed palliatively by resection (four), bypass procedures (three) or biopsy alone (three). There were two postoperative deaths and seven early complications. Seven of the remaining 18 patients have died from disease a median of 16 (range 4-30) months after presentation. The 11 survivors, eight of whom had curative resections, have been followed for a median of 42 (range 7-72) months. Ten patients are asymptomatic but only five are free from disease. These tumours are seldom curable by radical surgery, but patients may remain free from symptoms for many years.
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PMID:Management of non-functioning neuroendocrine tumours of the pancreas. 768 77

Many patients with acquired immune deficiency syndrome (AIDS) and abdominal pain are evaluated by the surgeon, and the majority have gastroenteritis, which can be treated with specific antimicrobials. There are some, however, who need more extensive investigation or who have an intra-abdominal infective process that requires surgical treatment. The one and a half decades of experience with human immunodeficiency virus (HIV) and AIDS has defined the role of the surgeon in treating patients with HIV. Major infective processes that may require surgical involvement include cytomegalovirus infection of the intestinal tract; appendicitis, which may be due to opportunistic infections; spontaneous bacterial peritonitis; cholecystitis; and obstructive jaundice with underlying sclerosis of the biliary tree. Early diagnosis and prompt surgical treatment are critical in the management of HIV-infected patients. For example, cytomegalovirus affecting the gastrointestinal tract may lead to perforation with the development of generalized fecal peritonitis; the clinical presentation of acute appendicitis in HIV patients may not include the usual rise in white blood cell count; and bacterial peritonitis in patients with AIDS may be caused by opportunistic pathogens or, as in the classical case, a single gram-negative bacillus or pneumococcus. This review article focuses on intra-abdominal infections in patients with HIV and AIDS.
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PMID:Surgical infections in AIDS patients. 775 66

This report presented a twelve-year experience from 1981 to 1992. Seventy-four cases of congenital biliary tract dilatation were at diagnosed an age of 6 days to 16 years. Twenty-two cases were infants. There were 54 females and 20 males. The ratio of female to male was 2.7:1. The classic triad of abdominal pain, jaundice and a palpable mass was seen in eleven cases (14.9%). Most children suffered from abdominal pain (50/74), vomiting (45/74), anorexia (42/74) and jaundice (34/74). Prolonged jaundice was the main symptom in infancy (15/22). A long common pancreatico-biliary channel was seen in six cases (6/47); the bile amylase level was elevated in five cases (5/20), one patient had a complex union with obstructive jaundice. All these cases were diagnosed by preoperative sonography accurately (100%). According to the Todani's classification, type Ia was the most common (40/74), followed by type IV-A (25/74) and type Ic (8/74). Cholelithiasis (13/74), perforation (9/74), and atresia/stenosis of distal choledochus (8/74) were the most common associated conditions. Cyst excision with biliary tract reconstruction was performed in all cases. Reoperation was needed in ten cases. Two cases died postoperatively due to sepsis and cholangitis induced hepatic failure.
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PMID:Congenital biliary tract dilatation in infancy and childhood--74 cases experience. 785 Jun 45

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

We report the use of a nasobiliary catheter in the management of a 55-yr-old female with autosomal dominant polycystic kidney disease who developed obstructive jaundice from a hepatic cyst. The patient presented with a 2-wk history of fatigue, jaundice, nausea, vomiting, and abdominal pain. Physical examination was remarkable for tender hepatomegaly. Computerized tomography revealed multiple hepatic cysts and dilated intrahepatic biliary radicles. Endoscopic stent placement failed to relieve the obstruction. Computerized tomography guided percutaneous aspiration of the obstructing hepatic cyst was successful with the aid of a nasobiliary cholangiogram allowing visualization of the biliary tree and identification of the obstructing hepatic cyst. However, the cyst rapidly accumulated fluid, and the obstruction recurred within 1 wk of simple aspiration. Relief of symptoms was maintained only after alcohol sclerosis of the obstructing hepatic cyst. Review of the literature shows that alcohol sclerotherapy is a safe and effective nonsurgical means of treating symptomatic hepatic cysts.
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PMID:Alcohol sclerosis for polycystic liver disease and obstructive jaundice: use of a nasobiliary catheter. 807 38

We report a case of granular cell tumor of the cystic duct. We have found only 47 such tumors of the biliary tract reported in the literature. Main symptoms at presentation are abdominal pain or obstructive jaundice. The clinical diagnosis is often difficult and the differential diagnosis is established with other more frequent conditions, including malignant neoplasms. Surgical excision is curative.
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PMID:[Granular cell tumor of the bile duct: an infrequent location]. 820 88


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