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)

We report the first known case of syphilitic gastritis in an HIV-infected person. The presentation of nonspecific abdominal pain and weight loss in a 48-yr-old former intravenous drug user previously treated for asymptomatic syphilis led to a barium swallow which demonstrated linitis plastica. Upper endoscopy reinforced a suspicion of carcinoma, but biopsy made the diagnosis of syphilis by silver staining. Further testing revealed a positive serology for syphilis as well as HIV infection with a depressed CD-4 lymphocyte count. Treatment with parenteral penicillin led to a rapid resolution of symptoms. This case represents a rare complication of late syphilis, and is another example of the unusual manifestations of syphilis seen in the HIV-infected population.
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PMID:Syphilitic gastritis in an HIV-infected individual. 144 50

Two rare cases of a primary, diffusely infiltrating carcinoma (linitis plastica) of the colon are reported. Case 1: In a 54-year-old male complaining of constipation and bloody stool, stenosis in the lower rectum was detected. He was diagnosed as having rectal cancer and rectal amputation with R3 lymphadenectomy was performed. The histological diagnosis was a signet ring cell carcinoma (a2, n2(+), Ho, Po stage IV). The patient died of multiple metastasis on the 318th postoperative day. Case 2: In a 29-year-old male complaining of a lower left abdominal pain, a circular stenosis of 7.5 cm in length in the descending colon, with Schnitzler's metastasis, was found. In spite of the advanced stage, a palliative colectomy was performed. A circular thickness of the wall was noted macroscopically, and the histological diagnosis was signet ring cell carcinoma, (s, n4(+), Ho, Po, stage V). The patient died of multiple metastasis on the 25th postoperative day.
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PMID:[Two cases of primary, diffusely infiltrating carcinoma (linitis plastica) of the colon]. 215 8

A 59-year-old female with depressive tendencies was admitted suffering from hematemesis and abdominal pain, two hours after ingestion of an unknown amount of toilet bowl cleaner (hydrochloric acid, pH 1.0). A barium study 24 days after ingestion revealed rigid narrowing and granulation of the entire stomach. The esophagus and duodenum were normal. The radiographic results were similar to those obtained for linitis plastica carcinoma of the stomach, but biopsy specimens of the stomach revealed no cancer cells. A total gastrectomy was performed about two months after ingestion to relieve the persistent feeling of nausea. Specimens revealed a rigid and thickening lining and a denuded mucosal surface of the stomach. The cut surface of the specimen showed a remarkable fibrous thickening of the submucosal layer. Microscopic examination failed to reveal a normal mucosal layer except in a narrow area of the fornix, and remarkable fibrosis of the submucosal lining was noted. No cancer cells were found. Corrosive gastritis has a linitis plastica appearance with a predilection for the antrum. Radiological examination revealed the very rare manifestation of a rigid narrowing of the whole stomach mimicking linitis plastica type cancer.
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PMID:Corrosive gastritis mimicking linitis plastica carcinoma. 255 Mar 6

A 60-year-old woman had progressive lower abdominal pain, nonbloody diarrhea, and weight loss, followed by severe epigastric pain and dysphagia. Radiographic evaluation of the colon showed segmental strictures which were interpreted as Crohn's disease. Medical treatment was not helpful. Neither gross endoscopic appearance nor multiple biopsies of the esophagus, stomach, and colon were diagnostic. Finally, laparotomy with full-thickness biopsies of the stomach and colon revealed linitis plastica. The clinician should be alert to colonic metastases from gastric linitis plastica, for it can produce focal or segmental strictures, mimicking more common colonic diseases such as Crohn's disease. A full-thickness biopsy is often necessary for a firm diagnosis. We review the literature on this occurrence, highlighting the clinical and radiologic spectrum, as well as the organ systems most often affected when gastric linitis plastica metastasizes.
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PMID:Gastric linitis plastica with metastases to the colon: a mimic of Crohn's disease. 255 55

We report a case of metastasis to the uterine corpus revealing a primary gastric adenocarcinoma. A 26-year-old woman suffered from weight loss, vaginal bleeding, abdominal pain. An endometrial curettage showed apparently metastatic adenocarcinoma. The primary site of the tumour was gastric. The upper gastrointestinal endoscopy revealed an ulcus and aspect of linitis plastica in the fundus. Biopsies showed diffuse type adenocarcinoma. Because of extensive disease, laparotomy was not performed and exclusive palliative chemotherapy was started. The patient died 10 months after the diagnosis. Metastasis from primary gastric cancer to the female genital tract are rare and are usually observed in young premenopausal women with diffuse type gastric adenocarcinoma. This case report underlines the interest, for those patients of careful gynaecologic examination at the initial staging and after treatment.
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PMID:[Uterine metastasis revealing gastric adenocarcinoma]. 852 24

Primary linitis plastica carcinoma of the colon is rare. Most lesions are located on the left side of the colon and these tumors often involve the lymph nodes, peritoneum, and ovaries. We report a case of primary linitis plastica of the sigmoid colon in a 32-year-old Chinese woman who presented with a 7-month history of constipation and associated abdominal pain and tenesmus. Colonoscopy and barium-enema studies showed a stricture at the sigmoid colon. The patient underwent radical surgical resection and received adjuvant radiation therapy and chemotherapy. She died 12 months after the initial diagnosis. The poor prognosis seen with this tumor is due largely to a delay in diagnosis. With increasing familiarity with this tumor, it is hoped that earlier diagnosis and curative surgery will be possible, leading to improvement in survival.
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PMID:Primary linitis plastica carcinoma of the colon: a case report. 944 22

A 68-year-old Japanese man with a history of linitis plastica carcinoma of the stomach and subsequent gastrectomy 8 years previously presented with lower abdominal pain. Radiological and endoscopic examinations showed multiple submucosal nodular lesions similar to Crohn's disease in the ileocecal area. A firm diagnosis could not be made after initial multiple biopsies. Finally, a submucosal biopsy revealed adenocarcinoma. The ileocecal lesion was diagnosed as a recurrence because of the histological findings, which included mucosal preservation, a similarity with the histologic type of stomach carcinoma, and atypical immunoreactivity for primary colon carcinoma; the lesion was negative for both cytokeratin 7 and cytokeratin 20. In cases where metastatic carcinoma of the colon is suspected, we recommend early consideration of a submucosal biopsy.
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PMID:Metastatic carcinoma of the colon similar to Crohn's disease: a case report. 1555 60

Gastric tuberculosis is rare and usually presents as an ulcerated lesion or gastric outlet obstruction. Rarer presentations include massive gastrointestinal bleed and gastric perforation. A case of gastric tuberculosis presenting as linitis plastica is reported here. This is the first such case report. The patient was a young woman who presented with non-specific abdominal pain and significant weight loss. The gastric mucosa appeared oedematous and hyperaemic and there was spontaneous oozing of blood on upper gastrointestinal endoscopy. Computed tomography of the abdomen revealed diffuse thickening of the gastric wall. The diagnosis was confirmed by the presence of caseating granulomas with acid fast bacilli in the endoscopic biopsy specimen. The patient showed significant clinical improvement on four-drug anti-tuberculous treatment.
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PMID:Gastric tuberculosis presenting as linitis plastica: a case report and review of the literature. 1646 46

In some cases the diagnosis of gastric cancer is difficult and the endoscopic presentation may be misleading. Diffuse type gastric carcinoma with peritoneal metastasis may present primarily with abdominal pain, colonic infiltration and/or diarrhea, thus other differential diagnoses like Crohn's disease (CD) may be considered at first. Therefore intensive diagnostic work-up is important. We report two cases of gastric cancer with ascites due to peritoneal carcinomatosis who were first diagnosed as CD. The patients were hospitalized in different institutions for weight loss, abdominal pain and nausea. The first colonoscopy, upper endoscopy with multiple biopsies and ascites puncture were negative for malignant disease, but macroscopic lesions resembling CD were described. Both patients were released on a prednisolone-based treatment for suspected CD. They presented to our hospital for further evaluation due to persistent symptoms. Neither lower nor upper endoscopy were suggestive of CD and endoscopic ultrasound was suspicious of malignancy in one case. Histology was diagnostic and showed gastric infiltration by a poorly differentiated adenocarcinoma. Diffuse type gastric cancer (gastric linitis plastica) with peritoneal metastasis may mimic certain clinical, endoscopic and CT imaging features of CD. Repeated biopsies and endoscopic investigations are often necessary to confirm a malignant process, especially in case of an inconclusive clinical and endoscopic picture. Endoscopic ultrasound may be useful to evaluate the risk of malignancy in patients with macroscopic suspicion of malignancy and negative biopsies.
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PMID:Diffuse gastric cancer with peritoneal carcinomatosis can mimic Crohn's disease. 2318 52

We report a case of Krukenberg tumor of gastric origin with adnexal metastasis, in which ultrasonography (US) and contrast-enhanced US (CEUS) played a key diagnostic role. An 64-year-old female patient was referred to our department for abdominal pain, nausea and ascites. US examination was performed as first line diagnostic imaging approach, confirming the presence of ascites and detecting marked thickness of the gastric wall and a right adnexal mass. CEUS was immediately performed and showed arterial enhancement followed by wash-out in the venous phase of both the gastric wall and the adnexal mass, suggesting the diagnosis of gastric cancer with right adnexal metastasis (Krukenberg syndrome). The patient underwent US-guided paracentesis and esophagogastroduodenoscopy that showed linitis plastica. Cytologic examination of the peritoneal fluid revealed the presence of signet-ring cells, and histologic examination of the specimen obtained by endoscopic biopsy showed primary gastric mucus-producing adenocarcinoma with signet-ring cells. Although transvaginal US is undoubtedly the method of choice to evaluate ovarian tumors, abdominal US and CEUS can provide key diagnostic elements, supporting clinicians in the first steps of the diagnostic work-up of abdominal and pelvic masses.
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PMID:Role of ultrasonography and contrast-enhanced ultrasonography in a case of Krukenberg tumor. 2400 58


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