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)

Of a series of 130 patients undergoing operation for peptic ulcer disease at the Vancouver General Hospital, seven patients with personality defects had a disastrous outcome after operation.THE MAIN FEATURES OF THIS POSTGASTRECTOMY SYNDROME WERE REMARKABLY SIMILAR: persistent abdominal pain without demonstrable cause, intermittent and inexplicable nausea and vomiting, continued analgesic drug dependence and marked nutritional deficiencies. The high incidence was surprising and was not confined to any particular socioeconomic group. Such patients fall into three groups: those with true ulcer disease, those with salicylate addiction, and those without positive signs of ulcer but with chronic complaints. A history of a personality defect should warn the surgeon, and operation should be performed only for the complications of true ulcer disease. Though operation may cure the ulcer, the patient is worse off because the resulting physiologic derangements cannot be accepted or handled by him. These patients continue to haunt the surgeon, and the syndrome has been named the "albatross" syndrome.
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PMID:Post-gastrectomy problems in patients with personality defects: the "albatross" syndrome. 602 43

To determine the relative frequency of different diseases and of functional gastrointestinal disorders among patients referred by general practitioners to a gastroenterology clinic, 2000 patients referred over a five-year period were studied. 980 had organic diseases, of which peptic ulcer, oesophagitis, and inflammatory bowel disease accounted for about half. 888 patients had functional disorders of the gastrointestinal tract, without any disease. Among these, various syndromes could be distinguished; abdominal pain with altered bowel habit (irritable bowel syndrome, spastic colon type) accounted for about half of these patients. More attention could profitably be directed towards understanding these common functional syndromes so that they can be more readily diagnosed and better managed.
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PMID:Organic and functional disorders in 2000 gastroenterology outpatients. 613 8

Forty five cases of chronic pancreatitis have been diagnosed between January 1966 to July 1983 in the Hospital A. Posadas. The diagnosis was confirmed by the presence of one or more of the following data: pancreatic calcifications positive in 35, abnormal secretin test 37, ultrasonography and computed tomography pathological findings 10. Surgical operations were carried out in 25 patients and biopsy taken in 5. Thirty nine (86.6%) were males, 6 (13.3%) females, the mean age in each group was 47.4 and 39.8 years. Chronic alcoholism was certain in 41 (91.9) patients, in the remainder 4 no other etiologic factors were found. The main clinical data were: Weight loss 38 (84.4%) diabetes 34 (75.5%) pain 33 (73.3% in 7 as acute pancreatitis) Steatorrhea 23 (51.1%) jaundice 16 (35.5%- 11 by extrahepatic biliary tree obstruction, 5 by hepatic cirrhosis) pseudocysts 12 (26.6%). The more common associated diseases were: hepatic cirrhosis 6, fatty liver 2 (17.7%) gastroduodenal ulcer 6 (13.3%) cancer 4 (8.8%--gastric 1, pancreatic 3). In order to study the frequency of the clinical data the patients were grouped according to the presence or absence of calcifications and the etiologic factor Symptoms and signs were matched and statistic analysis (coefficient association phi) was made. Only a moderate association between acute pancreatitis in no calcified group and diabetes in calcified group were found. The chronologic study of certains clinical data shows that acute pancreatitis, jaundice, pseudo-cyst and surgical operations were significative more frequent in the first five years while diabetes has little more frequency in the second five year period. Twenty six surgical operations were carried out in 25 patients; 20 (76.9%) due to complications, 6 (23.1%) secondary to pain (pancreatic resection 3, pancreatoyeyunostomy 2, exploration 1). Twenty three patients were lost to follow-up, 12 died and 10 are still alive. This last group was followed at regular period, 8 remained asymptomatic and 2 have intermittent abdominal pain related to alcoholic ingestion.
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PMID:[Chronic calcified pancreatitis. Our experience]. 639 6

With the intent of cost containment, we conducted a survey of cimetidine usage in the Ambulatory Care Service of our Veterans Administration Medical Center. During a period of six months, this drug was prescribed for 132 patients. Only about 20% received cimetidine for FDA approved conditions. Treated conditions not approved by the FDA (unlabeled) included undiagnosed abdominal pain, past peptic ulcer disease, reflux esophagitis, and a variety of other conditions. Fourteen percent of the patients had demanded the drug. Irrespective of whether a confirmed diagnosis was present or not, most patients taking cimetidine had symptomatic relief. It is unclear whether more regulations or improved physician education would be the better method to control improper and unnecessary use of a drug that is generally safe but has potentially serious side effects.
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PMID:Cimetidine usage for unlabeled conditions in an ambulatory care service. 648 50

We report a retrospective review of peptic ulcer disease (PUD) in children seen at Children's Hospital of Michigan, over 10 years (1971-1980). Of the 61 included, 31 had primary ulcers and 30 had stress ulcers. The diagnosis was made by either barium meal or endoscopy, at surgery, or at autopsy. Stress ulcers were commoner in children less than 4 years of age and were precipitated by various conditions leading to shock. The majority of these patients required surgery for perforation or bleeding. Primary ulcers were more common in children older than 4 years. The most common presenting symptoms in this group were abdominal pain and gastrointestinal bleeding. The majority of patients with primary PUD received medical therapy in the form of antacids and/or cimetidine. In one-third of these patients, surgery was necessary for complications such as intractable pain, perforation, or massive recurrent hemorrhage.
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PMID:Peptic ulcer disease in children and adolescents. A ten-year experience. 661 45

The presentation of peptic ulcer in 132 elderly patients is compared with that in 67 younger patients. Abdominal pain was not present in one third of the elderly group. Absence of pain was associated with the older age group to a highly significant degree (P less than 0.001).
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PMID:Absence of abdominal pain in elderly patients with peptic ulcer. 673 Nov 66

A 45-year-old man who was admitted with nausea, vomiting, and abdominal pain was found to have severe metabolic alkalosis, with a PaCO2 of 11.4kPa (85.5 mm Hg), PaO2 of 5.8 kPa (43.5 mm Hg), pH of 7.61, and plasma bicarbonate concentration of 82.0 mmol/l. He was treated with oxygen, intravenous physiological saline, and phenytoin and improved within 48 hours. Radiographs showed gastric outlet obstruction secondary to peptic ulcer, which was treated by surgery. Though sever, the rise in carbon dioxide concentration in this patient was probably lifesaving. The PaCO2 was therefore allowed to fall gradually as the alkalosis was treated. The return of both PaCO2 and plasma bicarbonate values to normal in parallel suggests that hypoventilation compensated for the metabolic alkalosis and emphasises the importance of conservative treatment in cases of metabolic alkalosis.
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PMID:Severe metabolic alkalosis: a case report. 679 44

Seventy two patients admitted to a medical department with dyspepsia but without a previous diagnosis of peptic ulcer disease or chronic pancreatitis were studied consecutively. A pancreatic function test (Lundh meal test) and an upper endoscopy was made in all patients. There was no difference in age, sex ratio, occurrence of upper abdominal pain or chronic alcoholism between the groups of patients with reduced pancreatic function (20) and the group with normal function (52). Seven duodenal ulcers were found, two in patients with normal pancreatic function (2/52 = 3.8%; 95% conf lim: 0.5-13.2) and five in patients with reduced pancreatic function (5/20 = 25%; 95% conf lim: 8.7-49.1). This difference was statistically significant (p less than 0.01). Duodenitis occurred with equal frequency in the two groups.
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PMID:Association between duodenal bulb ulceration and reduced exocrine pancreatic function. 688 16

The study and clinical assessment of enterogastric bile reflux has been restricted for want of a simple non-invasive test for its detection and quantification. This paper describes such a test in which biliary excretion scintigraphy has been combined and a mild meal provocation. Two of 10 healthy volunteers studied showed probable reflux of approximately 5 per cent of total initial abdominal field activity. Among 73 patients studied, 37 patients showed definite reflux of up to 47 per cent. Reflux occurred in 19 of 22 post-gastric surgery patients and in 7 of 22 patients with peptic ulcer disease, gastritis or gastro-oesophageal reflux. None of 7 patients with 'non-specific' abdominal pain showed any reflux, but 11 of 22 patients with gallstone disease or previous cholecystectomy showed reflux of up to 35 per cent, including 9 of 11 patients with loss of gallbladder reservoir function.
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PMID:Milk 99Tcm-EHIDA test for enterogastric bile reflux. 689 57

A 64-year-old woman presented with atypical abdominal pain, weight loss, melena and hematemesis. Reactivation of a peptic ulcer was diagnosed and she was treated with antacids and cimetidine. When her symptoms recurred 4 months later, a perforated duodenal ulcer was noted on roentgenograms. At laparotomy this proved to be a perforated, localized lymphoma of the duodenum. This case highlights an important consideration in the management of duodenal ulcers. Patients who present with a previously diagnosed peptic ulcer, who demonstrate atypical symptoms and remain refractory to treatment should undergo endoscopic examination and biopsy to rule out an occult localized duodenal lymphoma.
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PMID:Localized duodenal lymphoma masquerading as a duodenal ulcer. 706 86


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