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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We have investigated the relationship between cholecystokinin levels and abdominal pain in patients with chronic pancreatitis. The baseline and postprandial cholecystokinin levels were measured in 15 patients with chronic pancreatitis (8 with and 7 without abdominal pain) and in a reference group of 8 healthy subjects. The baseline, 30 and 60 min postprandial plasma cholecystokinin levels were significantly (p less than 0.05) higher in the patients with pain as compared with the other two groups. No correlation was observed between increased cholecystokinin levels and impairment of the exocrine pancreatic function as assessed by the NBT-PABA test. The increased cholecystokinin levels might be an important factor in the genesis of pain in chronic pancreatitis.
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PMID:Basal and postprandial cholecystokinin values in chronic pancreatitis with and without abdominal pain. 191 33

This randomized double-blind trial examined the influence of the radical scavengers allopurinol (50 mg per rectum, four times per day) and dimethyl sulfoxide (500 mg per rectum, four times per day) on pancreatic pain treated with intramuscular pethidine hydrochloride (100 mg followed by 50 mg every 4 hours until complete pain relief) in patients given nothing orally and intravenously hydrated. Addition of allopurinol or dimethyl sulfoxide to the analgesic regimen significantly enhanced its efficacy, enabling at least 57% (13 patients receiving allopurinol and 12 patients receiving dimethyl sulfoxide) of 43 patients to be free of pain within 12 hours after admission compared with only four (17%) of 23 controls achieving the same effect. This advantage extended to all patients within 24 hours after admission, leaving 11 controls (48%) still in pain. Consequently, all patients given allopurinol or dimethyl sulfoxide were discharged 3 days after admission, a result realized in only five (22%) of the assessable controls who were discharged after 5 days of hospitalization. The results suggest that oxygen-derived free radicals are implicated in the mechanism of abdominal pain caused by alcohol-induced chronic pancreatitis and that removing them results in a beneficial therapeutic effect.
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PMID:Role of oxygen-derived free radical scavengers in the treatment of recurrent pain produced by chronic pancreatitis. A new approach. 192 42

The papilla of Vater and its sphincter of Oddi, lying at the confluence of the bile and pancreatic ducts in man, have long been suspected as a source of upper abdominal pain. Enlarging the opening of the transpapillary segment of the bile and major pancreatic ducts by using a transduodenal sphincteroplasty with transampullary septectomy resulted in death in a patient with a peripapillary diverticulum and pancreas divisum. Eight-six patients followed for 1 to 10 years experienced a 75% success rate. Thirty-six patients had a marked stenosis of their duct of Wirsung, suggesting that their pain was primarily from the pancreas. The remainder had either a generalized narrowing (40 patients) or a normal (7 patients) papilla. Pain was not satisfactorily resolved in patients with an associated pancreas divisum, chronic pancreatitis, and recurrent episodes of acute pancreatitis with alcoholism.
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PMID:Transduodenal sphincteroplasty with transampullary septectomy for stenosing papillitis. 199 Aug 74

Over the past 10 years, one of us (M.C.A.) has treated 92 patients who required operation for symptoms associated with alcohol-induced chronic fibrocalcific pancreatitis. Four of these patients had duodenal obstruction. All four had had lateral pancreaticojejunostomy to relieve pancreatic ductal obstruction and associated chronic abdominal pain; three of the four also required biliary diversion for stenosis of the intrapancreatic portion of the common bile duct. Each duodenal stricture required reoperation and gastrojejunostomy to bypass the site of obstruction. A review of the English language literature revealed that duodenal obstruction in patients with chronic fibrocalcific pancreatitis is uncommon, only 58 previous cases having been reported. All of those patients had pancreatic ductal obstruction, and more than half had concomitant distal biliary stenosis. Two thirds of the duodenal obstructions were treated by gastroenterostomy, and one third were resected. Duodenal obstruction in patients with chronic pancreatitis and biliary stricture appears to reflect an advanced form of the disease. Combined lateral pancreaticojejunostomy and biliary diversion has emerged as the preferred surgical procedure for this problem. Careful preoperative assessment for evidence of duodenal stenosis also is needed in this group of patients, and gastroenterostomy is indicated in appropriate cases.
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PMID:Duodenal stricture: a complication of chronic fibrocalcific pancreatitis. 200 May 20

A 50-year-old woman complained of upper abdominal pain for several weeks, getting worse and radiating towards the left shoulder in the 24 hours preceding her hospital admission. Plain X-ray film of the abdomen revealed plaque-like calcifications projecting onto the tail of the pancreas. Ultrasound imaging demonstrated splenic rupture with free intra-abdominal fluid. During an emergency laparotomy the spleen was removed. At first the postoperative course was uneventful. But epigastric pain recurred a few days after discharge. Serum amylase and lipase concentrations were elevated (280 U/l and 553 U/l, respectively). Endoscopic retrograde cholangiopancreatography revealed chronic pancreatitis with a 3 cm pseudocyst in the tail of the pancreas. A papillotomy was performed, after which the symptoms rapidly regressed and the pancreatic enzyme concentrations fell. This was thus a case of spontaneous splenic rupture associated with previously undiagnosed chronic pancreatitis with inflammatory papillary stenosis and pseudocyst in the pancreatic tail.
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PMID:[Spontaneous splenic rupture in chronic pancreatitis]. 200 88

A 50 year old man presented with abdominal pain and weight loss after a splenectomy performed 26 years ago for abdominal trauma. At laparotomy, a mass was found at the tail of the pancreas. Pathological examination showed this was a traumatic neuroma and revealed evidence of chronic pancreatitis. Traumatic neuroma may be a rare cause of a pancreatic mass, especially after previous surgery or trauma.
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PMID:Traumatic neuroma at the tail of the pancreas following splenectomy. 205 41

A case of gastric duplication communicating with the pancreatic duct system is reported. The clinical presentation consisted of abdominal pain with recurrent acute pancreatitis. The histopathological examination showed that the duplication was lined with normal pyloric mucosa. In the tubular structure, connecting the duplication to the pancreatic ducts, an increase in the number of serotonin-positive cells was found. The pancreas showed dilatation of the duct system and chronic pancreatitis.
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PMID:Gastric duplication communicating with a pancreatic duct. Report of a case. 213 36

A case is reported of pancreatic ascites in a 14-year-old girl who had acute and chronic pancreatitis associated with pancreatic duct stones and a ruptured pancreatic duct. Abdominal erythema ab igne was considered to be an important physical sign of genuine severe abdominal pain.
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PMID:Pancreatic ascites in childhood. 214 96

Cystic neoplasms are rare but in the last ten years more frequently detected tumors of the pancreas. The clinical symptoms as abdominal pain, abdominal mass, diarrhoea or weight loss are rather unspecific. There are no typical laboratory findings. Localization, size and cystic character of these tumors are well documented by ultrasound or abdominal computed tomography while typical features in CT as well as US-guided fine needle biopsy may contribute to further differentiation of the tumors. Exocrine and endocrine pancreatic function are frequently weakened which might falsly lead to the diagnosis of chronic pancreatitis. Because of their malignant potential mucinous cystadenoma should be treated by complete surgical resection while serous cystadenoma are exclusively benign and might therefore be treated conservatively in uncomplicated cases or high-risk patients. The prognosis of pancreatic cystadenocarcinoma is obviously better compared to adenocarcinoma of the pancreas.
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PMID:[Serous cystadenoma and mucinous cystadenoma/cystadenocarcinoma of the pancreas. Clinical manifestation, diagnostic procedure and therapeutic concept]. 220 72

A method has recently been developed for measuring serum pancreatic (P) isoamylase, using two monoclonal antibodies specific for salivary isoamylase. We performed this test on 67 healthy controls and 133 patients: 15 with acute pancreatitis, 53 with chronic pancreatitis (20 during painful relapse and 33 in clinical remission), 18 with pancreatic cancer, 41 with nonpancreatic disease with abdominal pain, five with macroamylasemia, and one with total pancreatectomy. Results were compared with those of a wheat germ inhibition method and with electrophoresis on cellulose acetate. A close correlation was found between the results of immunoinhibition assay and those of the other two tests. All patients with acute pancreatitis had abnormally high values in all three tests. In the group with chronic pancreatitis studied during painful relapse, 16 had an increase in P-isoamylase, as determined with the immunoinhibition assay, 13 with the wheat germ inhibition test, and 15 with electrophoresis. In the group with chronic pancreatitis in clinical remission, we found low values in one patient, by immunoinhibition assay, but found low values in 17 and 19 patients by wheat germ inhibition and electrophoresis, respectively. Low P-isoamylase values corresponded to a severe exocrine pancreatic insufficiency. In the group with pancreatic cancer, the three tests showed similar results, and the majority of the patients had normal values. In the patients with nonpancreatic diseases, abnormally high levels were found in five, by immunoassay, in four by electrophoresis, and in three by the wheat germ inhibition method. In the five cases with macroamylasemia, both inhibition assays erroneously demonstrated an abnormal P-isoamylase elevation. The results show that the three tests are equally useful for the diagnosis of acute pancreatitis, or chronic pancreatitis during an acute relapse. In these diseases, the immunoinhibition test would be the preferred assay because it is simple and rapidly performed.
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PMID:Comparison of a new immunoassay for determining serum pancreatic isoamylase with two standard techniques. 222 Jul 32


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