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)

HCC occurs infrequently in Western countries, with recent increases being reported in California and parts of Europe. Southeast Asia, Japan, and South Africa continue to have a high incidence of this tumor with HBV, cirrhosis, and the ingestion of aflatoxins being identified as probable risk factors. Although the majority of patients present with abdominal pain or mass indicative of extensive tumor, asymptomatic, small HCCs are being detected with increasing frequency. Early detection in high-risk individuals is best accomplished by screening with serum AFP determinations and liver ultrasonography. CT and arteriography are valuable preoperatively in defining anatomy and determining resectability. Five-year survival following resection for cure of HCC ranges from 20 to 40 per cent, with improved survival reported for small asymptomatic tumors. Resection of metastatic liver tumors from colorectal primaries results in 48 per cent 2-year and 24 per cent 5-year survivals, with an additional 5 per cent dying of recurrent cancer after 5 years. Although patients with simultaneous and metachronous metastases do equally well after resection, the presence of four or more individual deposits adversely affects survival. Hepatic artery ligation or embolization can produce a significant palliative reduction in total tumor mass in patients with unresectable liver metastases. Regional chemotherapy using implantable hepatic artery drug infusion pumps is promising, with reports of prolonged survival compared with historical controls. Regional hyperthermia, laser vaporization of tumor, and cryosurgical techniques may prove to have useful roles in the selective treatment of liver cancer in the future. Orthotopic liver transplantation has been successful primarily in those in whom the malignancy is found incidentally in the chronically diseased liver.
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PMID:Malignant tumors of the liver. 242 9

Clinical, laboratory, and ultrasonographic features of 75 patients of primary hepatocellular carcinoma (PHC) living in the Gizan Area of Saudi Arabia and their follow-up, during a 2-year period, were characterized. Eighty-nine percent of the cases were defined histologically, whereas in the rest, ultrasonographic (US) evidence along with an alphafetoprotein (AFP) level exceeding 480 ng/ml were taken as the positive evidence for PHC. Eighty percent of the cases were male patients, with the peak incidence during the seventh decade. The most common clinical presentations were hepatic enlargement (91%), abdominal pain (76%), splenic enlargement (33%), and acites (33%), followed by bruit, fever, metastases, and varices. Alteration in a liver function test was manifest in 97% of the cases, AFP values greater than 480 ng/ml in 57%, and a hepatitis B virus surface antigen (HBsAg) positivity in 65% of the cases. There was no intersex variation in positivity for HBsAg, antibody to HBsAg (anti-HBs), antibody to hepatitis B virus core antigen (anti-HBc) among the 30 PHC cases studied. Positivity for HBsAg or the overall hepatitis B virus exposure in PHC cases was higher than the normal controls (P less than 0.001). In addition to histologic confirmation of PHC in 67 cases, there was histologic evidence of cirrhosis in 25%, or chronic active hepatitis in 19% of the cases. At the time of diagnosis, the average duration of the presenting illness was less than 2 months, while the mortality in the ensuing 2-month period was 73%. The average span of total illness in the vast majority of cases was 4 to 6 months. Two female patients (one with fibrolamellar carcinoma) however, survived for 2 years. Immunization against hepatitis B virus should be considered for all newborns in such hyperendemic communities. A continuous program should be started in such communities to screen and immunize all those yet unexposed to hepatitis B virus. The established HBsAg carriers should be periodically examined ultrasonographically along with an AFP estimation for initiating the chemotherapeutic and other measures against PHC in fairly early stages of malignancy.
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PMID:A profile of primary hepatocellular carcinoma patients in the Gizan Area of Saudi Arabia. 242 66

Mesenteric ischemia associated with carcinoid tumors often presents with nonspecific abdominal pain and is usually due to mesenteric branch artery occlusion caused by elastic vascular sclerosis. Mesenteric ischemia was defined by the operative findings of cyanosis or infarction. Eleven patients with intraabdominal metastatic carcinoid tumor were evaluated by angiography. Angiographic narrowing and occlusion of multiple peripheral jejunal and ileal intramesenteric branch arteries was present in 3 patients with mesenteric ischemia, but also occurred in 5 of 8 patients without mesenteric ischemia. Other angiographic abnormalities included staining of the primary tumor (5) or metastases (6), tenting of small mesenteric vessels (5), and occlusion of draining mesenteric veins (2). We conclude that in patients with midgut carcinoid tumors, angiographic narrowing and occlusion of peripheral mesenteric arteries most likely represents elastic vascular sclerosis, is indicative of mesenteric invasion of tumor, but correlates poorly with the presence of ischemia in the subtended bowel. Alternatively, a normal selective arteriogram should exclude mesenteric ischemia as the cause of abnormal pain.
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PMID:Limitations of angiography for mesenteric ischemia caused by midgut carcinoid tumors. 250 47

Chemoembolization by selective intra-arterial injection of lipiodol--chemotherapeutic agents (mitomycin and/or adriamycin)--followed by terminal embolization with gelfoam was performed on 20 inoperable patients with hepatic tumors: 13 hepatocellular carcinomas (HCC), 6 metastases from colorectal cancer, and one adenoma. A total of 29 embolizations were performed, 17 of them followed by gelfoam embolization. Significant decrease in tumor size or no tumor increase was shown in 8 patients--6 capsulated and well-limited HCC's, and 2 multinodular HCC's. Apart from occasional episodes of post-embolization syndrome (fever, vomit, abdominal pain), no significant complications were observed. Nine patients died at intervals ranging from 2 weeks to 37 months after the first embolization; in 6 patients the cause of death was not related to the advancing of the cancer, but to the complications of the underlying cirrhosis. In cirrhotic patients, damage to the rest of liver parenchyma can be limited by using superselective catheterization. Of the 6 patients with greater than 12 months follow-up, 4 are alive and 2 have died; 2 more patients are still alive 18 months after the first embolization. Finally, lipiodol was useful as radiopaque marker to detect lesion changes during the follow-up.
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PMID:[Therapy of hepatic carcinoma by the intra-arterial injection of lipiodol, antineoplastic agents and gelfoam]. 253 65

To define the course of malignant pancreatic islet cell tumors, 20 patients seen over 14 years with these neoplasms were reviewed. The 12 men and 8 women ranged in age from 22 to 76 years, with a mean of 52. Seven functional tumors included three insulinomas, two glucagonomas, one gastrinoma, and one somatostatinoma. One insulinoma was associated with a multiple endocrine neoplasia type I (MEN-I) syndrome. The 13 patients with nonfunctioning tumors had abdominal pain (3), jaundice (2), and steatorrhea (2). Seven had a palpable abdominal mass. Diagnosis of malignancy was based on local invasion (4), distant metastases (15), or both (1). One patient had percutaneous biopsy of a hepatic metastasis. All others had laparotomy for diagnosis and/or treatment. Each patient had a single tumor except the patient with MEN-I syndromes, who had multiple tumors throughout the pancreas. The head was involved in seven patients, the body in seven, and the tail in five. Operations included six curative and three palliative resections, five biliary diversions (two with concomitant enteric bypass), and five biopsies. Palliative resections were done for hormonal or local symptoms such as gastrointestinal (GI) bleeding and pain. Multiple chemotherapeutic agents were used, but the best results were obtained with DTIC (50% response). Four patients had radiation for liver, brain, or bone metastasis, with some improvement. Of five patients who had curative resections, four are alive 15 to 144 months, with a mean of 75 months. One died six years after diagnosis. Of the remaining 15 patients who had liver metastasis, seven patients are alive 8 to 168 months later, with a mean of 87 months.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Islet cell carcinoma of the pancreas. 254 52

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

This paper discusses the clinicopathological characteristics of colonic carcinomas arising from right side colon. Out of 214 cases of resected colonic carcinomas during the past 13 years, 36 cases of a right side colon carcinoma (in the cecum, in the ascending colon, or in the hepatic flexure) were encountered. Several characteristics have been associated with this type of cancer. They are as follows: 1) in half of these cases an abdominal pain but no anal bleeding, as has been noted in carcinomas of the sigmoid or rectum; 2) in histological type, poorly differentiated adenocarcinomas or mucinous carcinomas in 30.5% of these 36 cases, and associated with a far distant nodal involvement (n3, n4) in advanced carcinomas; and 3) although there was no difference in the 5-year survival rate between a right side colon carcinoma or a colon carcinoma at another site, the prognosis for those given a curative resection for a right side colon carcinoma was poor--only 22% due to hepatic metastases, indicating that colonic carcinomas of the right side has a poor prognosis due to the subsequent risk of highly potential malignancies.
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PMID:[A clinicopathological study on colonic carcinomas arising from right side colon]. 255 8

The clinical data, diagnostic procedures and survival are reported in 19 cases diagnosed as malignant peritoneal mesothelioma. All patients were men and 74% had an occupational exposure to asbestos, whereas in 26% no information about asbestos exposure was available. The median interval between asbestos exposure and the diagnosis appeared to be 44.7 years (range 18-49 years). The most common presenting symptoms were abdominal pain, weight loss and dysphagia. Most patients presented with a large amount of ascites. In the majority of patients no therapy except pain relief was given and the median survival from the time of diagnosis was 6 months (range: 0-29 months). Some patients received surgery or chemotherapy, which however did not prolong survival. Only in 2 patients survival exceeded 1 year, although these patients did not receive therapy. The autopsy findings of some patients showed that there were positive abdominal lymph nodes in 2 of them, while in no case positive thoracic lymph nodes were found. The relative short survival period from the time of the first diagnosis in contrast to malignant pleural mesotheliomas is probably the reason for the absence of distant metastases. In this series only in a minority of patients cytology of the ascites was positive and often a laparotomy had to be done. Since cytologic specimens are often negative, we suggest that in patients suspected of a malignant peritoneal mesothelioma, laparoscopy with directed biopsies is the diagnostic procedure of first choice.
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PMID:Malignant peritoneal mesothelioma: a series of 19 cases. 261 45

Six patients with retroperitoneal liposarcoma are reported. Their mean age was 58,66 years. There were four males and two females. The symptoms or signs at presentation were: abdominal mass (5 cases); abdominal pain (3 cases); sustained fever (2 cases), and lower limb edema (1 case). Abdominal computed tomography (CT) showed large masses with different density. Distant metastases were not documented. All patients underwent laparotomy, and the tumor was not resectable in 2 cases. In the histological study, liposarcoma was shown to be myxoid in 4 cases, pleomorphic in one and round cell type in the remaining case. In 3 patients local relapse was observed. The longest survival was 38 months and the shortest one 3 months. It was concluded that the leading cause for consultation in these patients was an abdominal mass. Remarkably, two patients had the uncommon feature of sustained tumoral fever. CT was shown to be the most useful diagnostic method. The good general condition of the patients with large tumoral masses was remarkable. The most common variety was myxoid, local relapse was frequent and the survival was poor.
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PMID:[Retroperitoneal liposarcoma. Clinico-pathological analysis of 6 cases]. 262 88

Of 359 patients with colorectal cancer admitted over a period of about 11 years, 17 (4.7%) were 40 years of age or younger (group 1) and 342 (group 2) were older. In group 1 at the time of diagnosis, there were 9 men and 8 women; the average age was 34.2 years. Abdominal pain and diarrhea were the most common presenting symptoms. The average delay between onset of symptoms and treatment was 8.2 months (7.2 in group 2). Tumor stage at the time of diagnosis or at laparotomy was not more advanced than in group 2, the incidence of Dukes C lesions being 17.6% and 24.8%, and distant metastasis 17.6% and 18.7%, respectively. Analysis of tumor according to the stage (Astler and Coller classification), pelvic fat involvement, lymph node metastases and grading revealed no statistically significant differences between the 2 groups. The age factor had no impact on survival. It is concluded that in the present series, colorectal cancer in young patients differs in no respect from the disease in older patients.
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PMID:Colorectal cancer in patients 40 years of age and younger. 262 89


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