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)

The postcholecystectomy syndrome in its chronic form is characterized by severe episodes of upper abdominal pain that may or may not be accompanied by hepatic or pancreatic dysfunction or ductal dilation. Endoscopic retrograde cholangiopancreatography is the most definitive way to identify anatomic defects. Transendoscopic papillary manometry is a promising new diagnostic technique. A surgical approach should be used only after persistence of symptoms without apparent cause and a prolonged trial of medical therapy. The operation should include exploration of the contents of the peritoneal cavity and transduodenal examination of the papilla of Vater. An extended papilloplasty should be performed to include a 1- to 2-cm anterior sphincteroplasty and an excision of the transampullary septum. Approximately 75 percent of patients with chronic pain after cholecystectomy will gain long-term relief of their symptoms.
 ...
PMID:Postcholecystectomy syndromes. 354 8

Four hundred and fifty-four consecutive patients who had had their gallbladder removed were interviewed to determine the presence of upper abdominal pain, increased serum alkaline phosphatase and/or serum amylase activity. Patients with unexplained upper abdominal pain and/or enzyme abnormalities were offered endoscopic retrograde cholangiopancreatography (ERCP) and manometric evaluations. Dysfunction of the sphincter of Oddi diagnosed by ERCP manometry may account for the abdominal pain seen in 14% of the patients with postcholecystectomy syndrome. It may rarely be the cause of an elevated serum alkaline phosphatase and/or amylase when abdominal pain is not present. Papillary dysfunction is seen in less than 1% of the patients who have had their gallbladders removed. ERCP manometry is recommended in cholecystectomized patients with unexplained abdominal pain suggesting pancreaticobiliary origin.
 ...
PMID:Frequency of papillary dysfunction among cholecystectomized patients. 620 Apr 20

The purpose of this study was to evaluate the usefulness of endoscopic pancreatocholangiography in a group of patients having undergone surgical operations on bile ducts. This is a retrospective study including 64 patients in whom cholocystectomy was performed both with or without previous exploration of bile ducts. Forty five of these patients were jaundiced and 20 had abdominal pain as main symptoms. Forty nine were females and 15 males, their ages ranging between 18 and 80 years. The canulation of Vate's ampulla and the adequate darkening of the bile ducts was achieved in every case and the cholangiography showed recidual or recurring lithiasis in 75 per cent of the cases; in 67 per cent there was postsurgical stenosis of bile ducts; remnant cystic duct in 74.8 per cent; stenosis of Oddi's sphincter in 50.9 per cent, and in 13.3 a diagnosis of cholestasis was established. This procedure was quite useful in order to establish the correct diagnosis in this group of patients having a postcholecystectomy syndrome.
 ...
PMID:[Endoscopic cholangiography in the postcholecystectomy syndrome]. 732 87

A 66-year old woman had had intermittent anterior chest pain and upper abdominal pain for 15 years. Angina pectoris was diagnosed at the age of 51 years, as she had typical anginal pain that was relieved by nitroglycerine, although coronary arteriography was normal and the ergonovine provocative test was negative. She had undergone cholecystectomy at the age of 38 years. Her bile duct pressure increased markedly after morphine injection and severe pain with the aforementioned distribution was produced. Postcholecystectomy syndrome due to sphincter of Oddi spasm was diagnosed and her pain was relieved by endoscopic sphincterotomy.
 ...
PMID:Postcholecystectomy syndrome mimicking angina pectoris detected by the morphine provocation test. 771 81

A simple scheme for the examination of patients for identifying the causes of the so-called postcholecystectomy syndrome (PCES) is suggested from experience in the examination of 1,712 patients with this syndrome. Three groups of patients are distinguished. First group--individuals with an external biliary fistula. Second group--patients with jaundice or with signs of jaundice suffered in the past after an operation. Third group--patients with abdominal pain and dyspeptic disorders after removal of the gallbladder but without an external biliary fistula and jaundice. The author gives a clinical evaluation and recommendations for using in establishing the diagnosis ultrasonic examination, cholefistulography, intravenous cholegraphy, percutaneous transhepatic cholangiography, retrograde cholangiopancreaticography, and computerized tomography conformably to the distinguished groups. After the examination was completed, the need for a repeated operation or active treatment (endoscopic papillotomy, removal of stones through the fistula) occurred in 98.7% of patients of the first group, in 73.8% of those in the second group, and in 15.7% of patients of the third group.
 ...
PMID:[The causes of the so-called post-cholecystectomy syndrome and the possibilities of its timely recognition]. 829 89

A 42-year-old man presented with acute right upper quadrant abdominal pain 2 years after open cholecystectomy. Evaluation revealed cholecystitis in a second gallbladder and a second cholecystectomy was performed. Acute right upper quadrant abdominal pain after cholecystectomy presents a wide differential diagnosis, including the often idiopathic and difficult to manage postcholecystectomy syndrome. Emergency physicians should be aware of the most common causes of pain in these patients. Previously unrecognized congenital abnormalities of the biliary system should be considered when the diagnosis is not clear, as highlighted by this case report.
 ...
PMID:Duplicate gallbladder cholecystitis after open cholecystectomy. 1021 37

This study was undertaken to evaluate the outcome of diagnostic endoscopic retrograde cholangiopancreatography and to increase the awareness of physicians practicing in Ethiopia about the procedure. Between April 1993 and October 1997, 47 patients underwent endoscopic retrograde cholangiopancreatography at Tikur Anbessa Hospital, Addis Ababa. Cholestasis, postcholecystectomy syndrome and abdominal pain with intermittent jaundice accounted for 91% of the indications. The success rate of endoscopic retrograde cholangiopancreatography was 81%. Cholestasis provided the highest diagnostic yield followed by postcholecystectomy syndrome and abdominal pain with intermittent jaundice. The endoscopic retrograde cholangiopancreatography finding was normal in 18% of cases. The commonest abnormal findings were gall stones (45%), biliary strictures (16%) and pancreatic carcinomas (11%). Using ultrasonography and endoscopic retrograde cholangiopancreatography, choledocholithiasis was diagnosed in three (21%) and 13 (93%) cases, respectively. The endoscopic retrograde cholangiopancreatography diagnosis of choledocholithiasis was confirmed at surgery in all but one patient. Acute cholangitis and asymptomatic elevation of serum amylase and/or lipase were noted in three (6%) and four (9%) cases, respectively. Endoscopic retrograde cholangiopancreatography is generally a safe diagnostic modality and should be used more frequently for the diagnosis of biliary and pancreatic diseases.
 ...
PMID:Preliminary experience with endoscopic retrograde cholangiopancreatography in Ethiopia. 1195 9

sWe describe the management of a cystic duct remnant calculus in a 45-year-old male patient who had undergone a laparoscopic cholecystectomy and re-presented with abdominal pain and jaundice. Magnetic resonance cholangiopancreatography was utilized to confirm the diagnosis of an impacted calculus within the remnant cystic duct along with several small retained common bile duct stones. Four sequential endoscopic procedures successfully removed all retained common bile duct calculi to alleviate the biliary obstruction; however, we were unable to treat the cystic duct remnant calculus endoscopically. The patient finally underwent successful laparoscopic excision of a 2.5-cm cystic duct remnant containing its impacted calculus. It remains unclear if cystic duct remnant calculi may become more prevalent as a cause of postcholecystectomy syndrome in future due to the large numbers of laparoscopic cholecystectomies performed in the past 2 decades.
 ...
PMID:Postcholecystectomy syndrome in the laparoscopic era. 1700 73

The term postcholecystectomy syndrome (PCS) comprises a heterogeneous group of symptoms and findings in patients who have previously undergone cholecystectomy. Although rare, these patients may present with abdominal pain, jaundice or dyspeptic symptoms. Many of these complaints can be attributed to complications including bile duct injury, biliary leak, biliary fistula and retained bile duct stones. Late sequelae include recurrent bile duct stones and bile duct strictures. With the number of cholecystectomies being performed increasing in the laparoscopic era the number of patients presenting with PCS is also likely to increase. We briefly explore the syndrome and its main aetiological theories.
 ...
PMID:Postcholecystectomy syndrome (PCS). 1985 10

Post-cholecystectomy syndrome (PCS) is defined as a complex of heterogeneous symptoms, consisting of upper abdominal pain and dyspepsia, which recur and/or persist after cholecystectomy. Nevertheless, this term is inaccurate, as it encompasses biliary and non-biliary disorders, possibly unrelated to cholecystectomy. Biliary manifestations of PCS may occur early in the post-operative period, usually because of incomplete surgery (retained calculi in the cystic duct remnant or in the common bile duct) or operative complications, such as bile duct injury and/or bile leakage. A later onset is commonly caused by inflammatory scarring strictures involving the sphincter of Oddi or the common bile duct, recurrent calculi or biliary dyskinesia. The traditional imaging approach for PCS has involved ultrasound and/or CT followed by direct cholangiography, whereas manometry of the sphincter of Oddi and biliary scintigraphy have been reserved for cases of biliary dyskinesia. Because of its capability to provide non-invasive high-quality visualisation of the biliary tract, magnetic resonance cholangiopancreatography (MRCP) has been advocated as a reliable imaging tool for assessing patients with suspected PCS and for guiding management decisions. This paper illustrates the rationale for using MRCP, together with the main MRCP biliary findings and diagnostic pitfalls.
 ...
PMID:Post-cholecystectomy syndrome: spectrum of biliary findings at magnetic resonance cholangiopancreatography. 2033 41


1 2 Next >>