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)

The selection of 200 consecutive patients who underwent liver biopsy as a day-case procedure and subsequent complications were reviewed, In 59 patients a diagnosis of cirrhosis was confirmed by histological examination. Six patients developed minor complications attributable to the procedure and had to stay longer in hospital, and another returned with abdominal pain the evening after the biopsy. With careful selection of patients, liver biopsy may be safely undertaken on a day-case basis.
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PMID:Liver biopsy as a day-case procedure: selection and complications in 200 consecutive patients. 743 88

Focal and multilobular biliary cirrhosis are considered pathognomonic of cystic fibrosis (CF) and almost invariably have been reported in patients with steatorrhea. In contrast, patients with pancreatic sufficiency and normal absorption are considered less likely to develop liver or biliary tract problems. The authors report three patients with CF and pancreatic sufficiency, presenting with recurrent abdominal pain (unrelated to pancreatitis). All had common bile duct disease, one with multilobular cirrhosis and portal hypertension. Pancreatic sufficiency was proven by quantitative pancreatic stimulation tests, 3-day fecal fat analyses, and serum pancreatic isoamylases. All three patients had mild lung disease. Two were homozygous for the common delta F508 mutation, and the other, a delta F508 compound heterozygote. Hepatobiliary structure and function were determined by serial hepatobiliary scintigraphy, percutaneous transhepatic cholecystography, and biochemical liver function tests. Patients 1 and 3 had mild hepatomegaly, normal liver biochemistry, and distal common bile duct strictures. Patient 2 had a firm nodular liver with splenomegaly, abnormal liver biochemistry, and a cholangiographic appearance of sclerosing cholangitis. All have undergone operative treatment for persistent abdominal pain. These cases confirm the occurrence of common bile duct pathology and liver disease in patients with CF and pancreatic sufficiency. They demonstrate that liver and biliary tract disease can occur independently of the underlying disease severity and the presence of steatorrhea. Further, they suggest that obstruction of the biliary tract may be an additional factor in the evolution of liver disease in CF.
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PMID:Hepatobiliary disease in cystic fibrosis patients with pancreatic sufficiency. 753 38

In Brazil, hepatocellular carcinoma (HCC) is not a common tumour. Virus B hepatitis and cirrhosis play an important role in the development of HCC. The authors described 14 cases of HCC registered in our service during the last 33 months. PURPOSE--Evaluate clinical and laboratory aspects of the hepatocarcinoma treated in our service. MATERIAL--Fourteen patients evaluated between 1990 and 1993 were described. Ten were men the median age was 53 years. RESULTS--The main symptoms were: abdominal pain, weight loss and jaundice. Among the fourteen patients, 42% percent were positive for HBsAg, 0.7% for anti HCV and 57% were cirrhotic. Eighty percent had an advanced disease and serum alphafeto-protein was elevated in 92%. The patients underwent different kinds of treatment. Systemic chemotherapy was started in 5 patients, however without any response. Surgery was done in three patients, one underwent partial resection of the tumour and in the others a total resection was carried out. CONCLUSION--The hepatocarcinoma is rare in our service, eighty percent had advanced disease and 42% were positive for HBsAg.
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PMID:[Hepatocarcinoma: analysis of 14 cases]. 763 6

Dr. Wagner's description of an advanced macronodular cirrhosis is compatible with end-stage liver disease due to a variety of causes. An alcoholic etiology seems more probable than chronic viral hepatitis since such a diagnosis might also account for the chronic pancreatitis, unless it was related to the cholelithiasis. However, Dr. Wagner's description favors a diagnosis of biliary pigment sludge related to hemolysis. Furthermore, the controversy over the extent of Beethoven's alcohol consumption and the absence of mention of pancreatic calcification weakens the case for an alcoholic etiology. On the other hand, Dr. Wagner's emphasis of bluish-green pigmentation of the liver, blackish pigmentation of the spleen, and an arteropathy of the hepatic vessels suggests the probability of hemochromatosis, which diagnosis is also in keeping with Beethoven's medical history. In this regard the composer's history of recurrent obscure abdominal pain, commencing in his third decade, is especially in keeping with hemochromatosis. As many as a third of patients present with recurrent abdominal pain, and eventually up to 40% of cases develop significant abdominal pain in the course of their disease. While some of these cases of abdominal pain have been attributed to hepatoma, ascites, pancreatitis, perisplenitis, or diabetic neuropathy, the majority remain ill-defined (32). Even so, the diagnosis of hemochromatosis remains unproved in the absence of a histological examination and measurement of hepatic iron concentration. It is proposed that the combined additive, toxic effects of alcohol and iron were the most likely cause of Beethoven's cirrhosis.
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PMID:Was Beethoven's cirrhosis due to hemochromatosis? 777 Jun 48

Fifty eight cases of SBP for the latest 20 years in Japan were reviewed. General symptoms due to SBP were ascites (100%), abdominal pain (93%), jaundice (86%), fever (57%) and rebound tenderness (55%), including male/female ratio of 2.6:1. Eighty eight per cent of SBP patients had cirrhosis. Although there was no difference between bacterial spieces causing SBP in the first ten years and latter ten years, survival of short period within 2 weeks was improved from 26.7% to 71.4%. However, long survival of 6 months was very poor yet. In patients with decompensated liver function, prophylactic and early treatment of SBP were recommended for improvement of long survival in SBP patients.
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PMID:[Spontaneous bacterial peritonitis--a review of Japanese case reports]. 811 77

A 55-year-old man with hepatic cirrhosis, gastroesophageal varices, ascites, slight abdominal pain, and transient encephalopathy experienced unexpected spontaneous relief of his symptoms during hospitalization. Percutaneous transhepatic portography showed an aneurysmal intrahepatic portosystemic venous shunt. Three years later, the shunt was still patent and had led to disappearance of the patient's varices and ascites. The patient remains stable 6 years later.
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PMID:Spontaneous aneurysmal intrahepatic portosystemic venous shunt. 818 34

Bacterial peritonitis presents with classic symptoms of fever and abdominal pain. Some patients, however, are completely asymptomatic. Death in the short term is considerable, especially in patients with alcoholic cirrhosis. Cystic fibrosis patients occasionally develop biliary cirrhosis and may have secondary hypersplenism, varices, and ascites. These patients should be at risk for spontaneous bacterial peritonitis. Spontaneous bacterial peritonitis is described in two patients with longstanding hepatic cirrhosis secondary to cystic fibrosis. Both had required splenectomy for complications of portal hypertension. This is a previously unreported, but potentially fatal, complication of cystic fibrosis liver disease. Early diagnostic paracentesis is essential so that appropriate acute management, including antimicrobial treatment can be started. In the long term, these patients deserve immediate paracentesis for any evidence of recurrence. Whether the patient is treated with chronic (continuous) antimicrobial prophylaxis or only receives antimicrobial treatment during periods when bacteraemia is possible (for example, dental work, bronchoscopy), it would seem reasonable in patients with cystic fibrosis to use a wide spectrum antimicrobial agent with activity against Pseudomonas aeruginosa, other common Gram negative organisms, and Staphylococcus aureus.
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PMID:Spontaneous bacterial peritonitis in cystic fibrosis. 820 May 73

A 50 year old man presented with sudden abdominal pain, abdominal distension and shock. At emergency laparotomy a large amount of blood was found in the peritoneal cavity. There was micronodular cirrhosis of the liver and the spleen was enlarged. The bleeding was traced to distended veins in the right paracolic gutter which were oversewn and the abdomen closed. A coagulopathy was diagnosed and treatment including high dose aprotinin commenced. However, he continued to bleed and at a second laparotomy the area of previous haemorrhage was packed. Further deterioration continued until death 12 hours later. Intraperitoneal haemorrhage from ectopic varices is a rare occurrence. There is a high mortality rate usually due to an advanced coagulopathy. This is the first report of aprotinin being used in an attempt to treat this. On the basis of this report aprotinin would not seem to be of benefit for this condition.
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PMID:Intraperitoneal rupture of ectopic varices--a rare complication of portal hypertension. 820 51

Twenty-five liver cirrhosis patients with endoscopically demonstrated gastro-duodenal mucosal damage (microhemorrhages, erosions, ulcers) were treated with misoprostol (prostaglandin E1) 400 mg/die. Eleven patients (44%) had abdominal pain and diarrhea and stopped treatment. Three months later, a new endoscopy was performed in the 11 patients that completed the study (3 patients were lost at follow up). Mucosal damage was stable in 5 patients (45%) and improved in 6 patients (55%), with complete absence of mucosal lesions in 2 patients (P = 0.027, Wilcoxon Ranks test). No case of worsening was observed and no patient had digestive bleeding during treatment. Digestive bleeding is a common complication of liver cirrhosis, originating in about 50% of cases from gastro-duodenal mucosal damage. Misoprostol suggests itself as a possible alternative therapy to the drugs usually utilized in these lesions (beta-blockers, H2-inhibitors), but individual intolerance is frequent and must be preliminary excluded.
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PMID:[The activity of misoprostol on the gastric and duodenal mucosal damage in patients with liver cirrhosis]. 825 66

Spontaneous bacterial peritonitis (SBP) is defined as infection of preexisting ascites without evidence for any intraabdominal source for secondary infection. SBP is now recognized with rising frequency and has mainly been reported in patients with alcohol-induced cirrhosis of the liver. We report SBP in a female dialysis patient whose ascites was not due to liver disease, but was possibly due to lupus erythematosus or represented 'nephrogenic ascites'. The patient had severe abdominal pain and a positive rebound phenomenon, fever and an elevated peripheral white cell count of 21,000 cells/microliters. Ascitic fluid analysis revealed an exudate with a protein concentration of 5.2 g/dl, 13,000 white cells/microliters with 94% neutrophils and positive cultures for Streptococcus morbillorum. Because of the dramatic clinical features the patient underwent laparotomy which did not reveal a source for secondary infection and in retrospect was unnecessary. The patient responded well to antibiotic therapy. This case report draws attention to SBP as a cause of acute abdomen in patients on chronic hemodialysis.
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PMID:Spontaneous bacterial peritonitis in a hemodialysis patient with systemic lupus erythematosus. 779 66


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