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)

Hepatic artery aneurysm rupture is a rare condition that requires urgent diagnosis and treatment in order to avoid a potentially fatal outcome. The clinical presentation is often non-specific. The classic triad of abdominal pain, gastrointestinal hemorrhage, and obstructive jaundice occurs in less than one-third of cases. Physical examination is rarely helpful since bruits, masses or pulsations are infrequent. Radiologic imaging provides the best tool to early diagnosis. Angiography has historically been the gold standard of diagnosis and is needed prior to radiologic intervention. Computerized tomography, doppler ultrasound and even magnetic resonance imaging have all demonstrated visceral artery aneurysms with success. Conventional treatment has included surgical ligation and resection. More recently transcatheter embolization or even percutaneous transhepatic injection of thrombin has been successfully performed by the interventional radiologist. This article discusses the clinical presentation, imaging findings, and review of the literature of this elusive entity.
 ...
PMID:Hepatic artery aneurysm rupture: case report, imaging findings, and literature review. 983 Mar 29

Only 34 cases of primary cystic duct carcinoma have previously been published in the literature. Most of these cases presented with upper abdominal pain and a palpable mass in the right upper quadrant due to gallbladder hydrops or cholecystitis. We report a case of cystic duct carcinoma with the clinical presentation of obstructive jaundice. The patient was treated by cholecystectomy, resection of the common bile duct and a Roux-en-Y hepaticojejunostomy. An extended lymph node dissection was not performed. Fourteen months after the operation the patient died with local carcinoma recurrence. A literature review comparing clinical signs, surgical treatment, and outcome of 14 Japanese and 21 reported Western cases, including ours, was performed. Extended lymph node dissection in addition to combined resection of the gallbladder and ductus hepaticocholedochus appears to offer a better prognosis and larger survival, including the chance of potential cure.
 ...
PMID:Carcinoma of the cystic duct leading to obstructive jaundice. A case report and review of the literature. 984 18

A 21-year-old man was admitted with vomiting and abdominal pain 3 days after sustaining blunt abdominal trauma by being tackled in a game of American football. A diagnosis of intramural hematoma of the duodenum was made using computed tomography and upper gastrointestinal tract contrast radiography. The hematoma caused obstructive jaundice by compressing the common bile duct. The contents of the hematoma were laparoscopically drained. A small perforation was then found in the duodenal wall. The patient underwent laparotomy and repair of the injury. Laparoscopic surgery can be used as definitive therapy in this type of abdominal trauma.
 ...
PMID:Laparoscopic drainage of an intramural duodenal hematoma. 1020 21

The incidence of pancreatic cancer continues to increase and, although improving of diagnostic techniques, the prognosis is very poor with 5-year survival less than 5% and high mortality cancer rate. Neural and lymphatic micrometastases appear in early stages and curative resection is possible in few selected cases; in these patients there is a high local recurrence rate and a low median survival. Most patients with pancreatic cancer need palliative care of the obstructive jaundice (90%), duodenal stenosis and abdominal pain; endoscopic procedures have an important role in the treatment of these patients. Endoscopic placement of plastic biliary stents is a safe and efficient technique to perform a biliary drainage with a short hospital stay. The use of metal stent, instead of plastic prosthesis, improve median patency of the prosthesis with a low incidence of cholangitis, but they should be used only in patients with a life expectancy of more than six months, because of their high costs. Laparoscopic gastro-entero-anastomosis is a valid alternative to laparotomic procedure in the treatment of the duodenal stenosis, with a shorter hospital stay and a lower morbidity rate. The endoscopic treatment of abdominal pain with pancreatic endoprosthesis placement or with endosonography-guided celiac plexus neurolysis is an alternative approach to radiotherapy and analgesic drugs.
 ...
PMID:[Role of endoscopy in the palliative therapy of pancreatic cancer]. 1023 83

Endoscopic ultrasound (EUS) is proving to be a useful tool for evaluation of clinically suspected pancreatic masses unsatisfactorily evaluated by other means of imaging. We reviewed the records of 19 patients who had CT and EUS performed for clinically suspected pancreatic masses. Each patient had subsequent surgical exploration. Nineteen patients (11 females and 8 males) presenting with symptoms (11 with obstructive jaundice, 6 with abdominal pain and weight loss) or incidental CT findings suspicious for pancreatic carcinoma underwent EUS for further pancreatic evaluation. All of these patients had exploratory laparotomies, with 13 pancreaticoduodenectomies, 3 distal pancreatectomies and splenectomies, 1 bypass procedure, 1 open pancreatic and hepatic biopsy showing metastatic disease, and 1 open exploration with negative fine-needle aspiration biopsy. EUS correctly identified pancreatic neoplasms in 17 of 19 cases, with two false positives. The tumors included 15 adenocarcinomas, 1 microcystic adenoma, and 1 lymphoma. Node status was correctly predicted in 9 of 12 specimens. Nine of 12 tumors had accurate tumor staging by EUS. Absence of vascular invasion was accurately predicted in 13 of 14 cases. Two patients had metastatic disease discovered at laparotomy. All 19 patients had preoperative abdominal CT scans, with six of these negative for pancreatic masses. EUS is more sensitive than CT in detecting pancreatic masses and is more accurate than CT in locally staging pancreatic tumors. This higher sensitivity is important because those patients with earlier stage tumors are the most likely to benefit from resection.
 ...
PMID:Endoscopic ultrasound for diagnosis and staging of pancreatic tumors. 1039 76

Isolated pancreatic tuberculosis (TB) is very rare and its treatment somewhat controversial. We report a case of pancreatic TB diagnosed as pancreatic carcinoma. An 82-yr-old man presented with right upper abdominal pain and obstructive jaundice, without fever or weight loss. Ultrasonography, computed tomography, and endoscopic retrograde cholangiopancreatography showed a mass lesion in the pancreatic head, which caused stricturing of the distal common bile duct and pancreatic duct in the head of the gland. As malignancy was suspected, he underwent a Whipple procedure (pancreaticoduodenectomy). Histological examination of the resection specimen disclosed typical features of tuberculosis in the pancreatic head, lymph nodes, and at the ampulla of Vater. The rest of the abdominal cavity was unremarkable. After receiving antimicrobial therapy for tuberculosis for 6 months, he remains well, without jaundice or a recurrent mass visible by ultrasound.
 ...
PMID:Pancreatic tuberculosis with obstructive jaundice--a case report. 1048 20

We report a case of adenomyoma in the common bile duct accompanied by obstructive jaundice. A 64-year-old woman presented with abdominal pain, fever, appetite loss and jaundice. Endoscopic retrograde cholangiopancreatography revealed possible stenosis in the distal common bile duct. We could not distinguish whether the tumor was benign or malignant based on the clinical presentation, or biochemical, radiographic, or endoscopic investigations. Pancreatoduodenectomy was performed. The histological diagnosis was adenomyoma. The natural history of and optimal treatment for, adenomyoma have not been established.
 ...
PMID:Adenomyoma of the common bile duct: report of a case. 1069 May 95

This study evaluates the incidence of biliary leakage following T-tube removal from the common bile duct (CBD) in 97 patients who underwent open CBD exploration. In 93 patients, this was following exploration for CBD stones, in two patient it was for obstructive jaundice due to hydatid disease and in a further two patients it was following CBD injury. T-tube cholangiography (TTC) was carried out 7-10 days postoperatively and, if the examination was normal, the T-tube was removed 12-14 days postoperatively (2 months for the CBD injury patients). Following T-tube removal, six patients developed severe abdominal pain, sweating and tachycardia. They were treated with antibiotics, parenteral fluids, and analgesia. Three patients settled with this management. Two patients developed sub-hepatic collections and required open drainage. One patient developed a small pelvic collection, which was aspirated transvaginally. A seventh patient was re-admitted 2 weeks following T-tube removal and laparotomy revealed biliary peritonitis. The patient died the following day. Biliary leakage following removal of a T-tube is not uncommon. It has a significant morbidity and mortality. Our experience and that of the reviewed literature suggests that the aetiology is multifactorial. The management and outcome of this complication is discussed.
 ...
PMID:Biliary leakage following T-tube removal. 1081 34

Splanchnic artery aneurysms are among the most infrequent aneurysms that affect the arterial circulation. Aneurysms of the gastroduodenal artery are the rarest splanchnic artery aneurysms, comprising fewer than 10 per cent of all such lesions. The most typical presentations include abdominal pain and acute gastrointestinal bleeding. However, the diagnosis is often missed preoperatively. We report the successful surgical management of a patient with a gastroduodenal artery aneurysm who presented with isolated obstructive jaundice and review the literature on this unusual finding.
 ...
PMID:Aneurysm of the gastroduodenal artery: an unusual cause of obstructive jaundice. 1091 86

Rupture of an abdominal aortic aneurysm often presents with an abdominal pain, hypotension and a pulsatile abdominal mass. In the last years same clinical reports describe patients with less apparent clinical signs who were found later in their evaluation to have a contained rupture of an abdominal aortic aneurysm. The diagnosis may be delayed by consideration of other disease causing similar symptoms (herniated disc, renal colic). In these patients with confusing abdominal symptoms CT scan provides a rapid and noninvasive diagnosis. We report three cases of contained rupture of an abdominal aortic aneurysm evaluated by computed tomography with different clinical presentation: back pain for erosion into the lumbar vertebral bodies, lower extremity neuropathy and obstructive jaundice. All patients were operated on within 24 hours on admission; there was no operative mortality and survival was 100% at one year.
 ...
PMID:[Chronic rupture of abdominal aortic aneurysms. (Report of 3 cases)]. 1092 Apr 98


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