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)

Case reports are presented that link the use of oral contraceptives (OCs) to liver disease, particularly to the Budd-Chiari syndrome. This syndrome is caused by occlusion of hepatic veins and although a causative relation between OC use and this syndrome is not proven, these facts support an association: 1) the known increased incidence of venous thrombosis in women using OCs; 2) data from a review of 164 cases of the syndrome showed that in 1959 men and women suffered the syndrome about equally, but since 1975 after the introduction of OCs another study reported women contracting the disease twice as often as men; 3) the syndrome is associated with pregnancy; and 4) since the 1975 study, association with the pill was found in 16 reported cases. Clinically, the average age of these 16 women with OC-associated Budd-Chiari syndrome was 32 years. Length of time before onset of symptoms after beginning OC therapy varied from 2 weeks to 8 years (mean 23.8 months). In most cases, abdominal pain, nausea, vomiting, and abdominal distension were present. Hepatomegaly and ascites were described in most cases and splenomegaly in less than half. Liver function abnormalities were nonspecific. Prognosis is not good, and management techniques for the syndrome have been largely unsuccessful. Metabolic alterations of steroids as they pass through the liver may account for the syndromes associated with OC use. 3 major diseases or effects are linked with OCs: hepatic dysfunction, cholestatic jaundice, and benign hepatic tumors and peliosis hepatis; these, however, are benigh complications compared with the severity of contracting Budd-Chiari syndrome, and the clinician should respect a woman's decision not to use the pill in the face of such disease-inducing possibilities.
 ...
PMID:Oral contraceptives and liver disease. 726 Aug 2

We recorded clinical information over a 12-month period on consecutive consultations to the gastroenterology service of the Durham VA Medical Center. Of 902 consultations, 789 were prospectively collected. Eighty-five percent of the patients were between 40 and 70 years old. Seventy-five percent of the referrals were from the internal medicine service. The most frequent reasons for consultation were abdominal pain (19%), GI bleeding (active, 16%; occult, 9%), abnormal results of liver tests (18%), and request for a procedure (11%). Diseases of the liver (32%) and "peptic diseases" (30%) were the most common diagnoses. One or more procedures were done in 71% of consultations. When these data are compared with those of a practicing gastroenterologist, using an identical instrument, it is apparent that trainees' experience with structurally identifiable gastroenterologic disease and with a variety of procedures was similar in scope. There were, however, differences in that the physicians at the VA saw substantially fewer patients with so-called "functional" illness. If these data are applicable to other VA Medical Centers, then the training of physicians in gastroenterology at a VA Medical Center should probably be broadened.
 ...
PMID:Analysis of patients referred to the gastroenterology service of a VA medical center. 729 53

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.
 ...
PMID:Hepatobiliary disease in cystic fibrosis patients with pancreatic sufficiency. 753 38

Thirteen patients with symptomatic polycystic liver disease who were selected for fenestration were reviewed. The main preoperative complaints that related to polycystic liver disease were severe abdominal pain, respiratory distress, clinical ascites, or leg edema. All symptoms disappeared after operation, and the number and size of the cysts were smaller. Five patients developed transient but massive ascites during the postoperative period, and long-term follow-up demonstrated a moderate recurrence of hepatomegaly in two patients. These postoperative complications and failures appeared to be at least partly related to a more extensive evolution of the disease in the patients in whom it developed.
 ...
PMID:Fenestration in the management of polycystic liver disease. 774 Aug 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.
 ...
PMID:Was Beethoven's cirrhosis due to hemochromatosis? 777 Jun 48

A prospective audit of the diagnostic yield and management benefit of laparoscopy was undertaken in 220 consecutive patients. The procedure was performed electively in 180 patients and as an emergency in 40. The indications for laparoscopy in the elective group were suspected hepatic disease, staging of intra-abdominal malignancy, diagnostic problems, and chronic abdominal pain. Emergency laparoscopy was performed in patients admitted with acute abdominal pain. Diagnostic benefit varied with the indication for the procedure: liver disease 71%, tumour staging 87%, uncertain diagnosis 74%, acute abdominal pain 100%, and chronic abdominal pain 41%. Clinical management was significantly influenced by laparoscopy in 15 of 21 (71%) patients with liver disease, 10 of 30 (33%) with intra-abdominal malignancy, 5 of 19 (26%) with uncertain diagnosis, 32 of 40 (80%) with acute abdominal pain, and 15 of 110 (23%) patients with chronic abdominal pain. A wrong assessment of the nature or stage of the disease was made by laparoscopy in 3 of 220 (1.0%). There was no morbidity or mortality attributed to laparoscopy in the study.
 ...
PMID:Diagnostic yield and management benefit of laparoscopy: a prospective audit. 782 84

Polycystic liver disease is commonly asymptomatic but may present with hepatomegaly, abdominal distension, and dull abdominal pain. Transudative ascites is a rare manifestation in these patients but may occur when portal hypertension is present resulting from associated hepatic fibrosis or after deroofing procedure of a cyst. Exudative ascites might suggest hepatic venous outflow obstruction. Four cases are described where hepatic venous outflow obstruction occurred in patients with polycystic liver disease. Three patients had orthotopic liver transplantation and one had a mesocaval shunt. Of the two patients that survived orthotopic liver transplantation both have shown considerable improvement in their symptoms. None of the patients had any confirmed procoagulant disorder. The mechanism of hepatic venous outflow obstruction in these patients seems to be mechanical compression of hepatic veins by the cysts and associated formation of thrombi in small hepatic vein tributaries. Patients with severe polycystic kidney/liver disease are at risk of hepatic venous outflow obstruction and the onset of this complication is heralded by tender hepatomegaly and presence of exudative ascites.
 ...
PMID:Hepatic venous outflow obstruction in patients with polycystic liver disease: pathogenesis and treatment. 789 Feb 19

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.
 ...
PMID:Spontaneous bacterial peritonitis in cystic fibrosis. 820 May 73

Protoporphyria is a genetic disorder characterized by a defect in the enzyme ferrochelatase, which catalyzes the chelation of iron to protoporphyrin. This causes excessive accumulation and excretion of protoporphyrin. The predominant clinical feature is photosensitivity. Progressive and fatal liver disease occurs in a small percentage of cases. We report our experience with eight patients with end-stage protoporphyric liver disease in whom a syndrome developed before transplantation that resembled the neurological crises of the acute porphyrias. This syndrome was characterized by abdominal pain, hypertension, tachycardia, extremity pain and weakness, constipation and nausea and vomiting. Erythrocyte and serum protoporphyrin levels were markedly increased in all patients. In one patient, profound hemolysis developed during the anhepatic phase of transplantation and continued over a period of 72 hr, causing an extreme increase in the serum protoporphyrin level. Progressive weakness deteriorated to paralysis in this patient. This phenomenon suggests that protoporphyrin may gain access to neural tissue when serum levels are markedly increased, causing neurotoxicity.
 ...
PMID:Evidence for neurological dysfunction in end-stage protoporphyric liver disease. 798 71

Diagnostic laparoscopy is rapidly becoming a procedure used by general surgeons in increasing numbers. Its use will follow the therapeutic procedures now being used by many fellow surgeons. As the procedure is generally performed under local anesthesia, new techniques must be learned. The indications include abdominal pain (acute and chronic), focal liver disease, ascites, preoperative evaluation of malignant disease, and second-look evaluations after medical therapy for malignant disease. The overall diagnostic rate is 99% for acute abdominal pain, 70% for chronic pain syndromes, 95% for focal liver disease, 95% for abdominal masses, 97% for ascites, and greater than 80% for retroperitoneal disease. Diagnostic laparoscopy should be used with increasing frequency when a tissue diagnosis is needed.
 ...
PMID:Diagnostic laparoscopy. 826 33


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