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

A 36-year-old man was admitted for persistent abdominal pain and weight loss. He had had significant exposure to asbestos, as he had been active in cleanup after the World Trade Center attack. A CT scan of his abdomen was initially read as peritoneal carcinomatosis without evidence of ascites. Infectious etiology was subsequently ruled out and diagnostic laparoscopy was performed for tissue diagnosis revealing noncaseating granulomas consistent with peritoneal sarcoidosis. Of note, he had an elevated CA-125 level on admission, which is unique in males with peritoneal sarcoidosis.
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PMID:A rare case of peritoneal sarcoidosis in a 36-year-old construction worker. 2149 Aug 71

Peritoneal involvement continues to be a rare manifestation of sarcoidosis: its involvement is not always isolated and sarcoid granulomas are also found elsewhere. Peritoneal diseases tend to have an increased incidence in women. Peritoneal involvement presents as ascites, as peritoneal thickening and multiple soft tissue nodules, and can often simulate peritoneal carcinomatosis. We describe a case of a man presenting abdominal pain, nausea, vomiting and a clinical picture of intestinal obstruction, with peritoneal sarcoidosis and abdominal findings suggesting peritoneal carcinomatosis. The diagnosis of sarcoidosis was confirmed by biopsy of the peritoneum during surgical laparotomy. Peritoneal involvement is a rare manifestation of sarcoidosis (less than 30 cases described in English medical literature): to our knowledge this is the first reported case of the disease presenting with an acute abdominal obstruction treated with surgery.
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PMID:Peritoneal sarcoidosis: an unusual presentation and a brief review of the literature. 2193 98

Intraabdominal fat is a metabolically active tissue that may undergo necrosis through a number of mechanisms. Fat necrosis is a common finding at abdominal cross-sectional imaging, and it may cause abdominal pain, mimic findings of acute abdomen, or be asymptomatic and accompany other pathophysiologic processes. Common processes that are present in fat necrosis include torsion of an epiploic appendage, infarction of the greater omentum, and fat necrosis related to trauma or pancreatitis. In addition, other pathologic processes that involve fat may be visualized at computed tomography, including focal lipohypertrophy, pathologic fat paucity (lipodystrophies), and malignancies such as liposarcoma, which may mimic benign causes of fat stranding. Because fat necrosis and malignant processes such as liposarcoma and peritoneal carcinomatosis may mimic one another, knowledge of a patient's clinical history and prior imaging studies is essential for accurate diagnosis.
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PMID:Imaging manifestations of abdominal fat necrosis and its mimics. 2208 85

Burkitt's lymphoma is a form of Non-Hodgkin's B-cell lymphoma. We report a case of Burkitt's lymphoma mimicking peritoneal carcinomatosis. We will discuss the imaging and clinical findings that differentiate between peritoneal carcinomatosis and Burkitt's lymphoma. A 26-year-old man presented with nonspecific abdominal pain, vomiting and diarrhea associated with significant amount of loss of weight. Computed tomography images showed extensive peritoneal and mesenteric mass associated generalized lymphadenopathy. Core biopsy of the mass confirmed Burkitt's lymphoma. CT scan features are helpful indicator to differentiate Burkitt's lymphoma and peritoneal carcinomatosis. Focal or diffuse nodular thickening of the bowel wall with extensive lymphadenopathy are likely to be lymphomatosis over carcinomatosis. However, final and confirmatory diagnosis is histopathology examination.
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PMID:Diffuse peritoneal lymphomatosis simulating peritoneal carcinomatosis. 2211 59

We report the case of an African American male with no significant past medical history presenting with recurrent, rapidly relapsing episodes of thrombotic thrombocytopenic purpura (TTP) despite aggressive treatment with several lines of treatment. Incidentally, these episodes were associated with severe abdominal pain which eventually developed into acute abdomen and prompted exploratory laparotomy, revealing diffuse carcinomatosis with a tumor located on the left pelvis that was encasing the distal sigmoid colon. Pathology made a final diagnosis of peritoneal mesothelioma. TTP-like syndrome (TTP-LS) has been described as a paraneoplastic phenomenon in several malignancies but never before in the setting of malignant mesothelioma. Paraneoplastic TTP-like syndrome has historically been associated with a dismal prognosis and particular clinical and laboratory abnormalities described in this paper. It is of utmost importance to make a prompt determination whether TTP is idiopathic or secondary to an underlying condition because of significant differences in their prognosis, treatment, and response. This paper also reviews the current literature regarding this challenging condition.
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PMID:Recurrent thrombotic thrombocytopenic purpura-like syndrome as a paraneoplastic phenomenon in malignant peritoneal mesothelioma: a case report and review of the literature. 2308 61

In some cases the diagnosis of gastric cancer is difficult and the endoscopic presentation may be misleading. Diffuse type gastric carcinoma with peritoneal metastasis may present primarily with abdominal pain, colonic infiltration and/or diarrhea, thus other differential diagnoses like Crohn's disease (CD) may be considered at first. Therefore intensive diagnostic work-up is important. We report two cases of gastric cancer with ascites due to peritoneal carcinomatosis who were first diagnosed as CD. The patients were hospitalized in different institutions for weight loss, abdominal pain and nausea. The first colonoscopy, upper endoscopy with multiple biopsies and ascites puncture were negative for malignant disease, but macroscopic lesions resembling CD were described. Both patients were released on a prednisolone-based treatment for suspected CD. They presented to our hospital for further evaluation due to persistent symptoms. Neither lower nor upper endoscopy were suggestive of CD and endoscopic ultrasound was suspicious of malignancy in one case. Histology was diagnostic and showed gastric infiltration by a poorly differentiated adenocarcinoma. Diffuse type gastric cancer (gastric linitis plastica) with peritoneal metastasis may mimic certain clinical, endoscopic and CT imaging features of CD. Repeated biopsies and endoscopic investigations are often necessary to confirm a malignant process, especially in case of an inconclusive clinical and endoscopic picture. Endoscopic ultrasound may be useful to evaluate the risk of malignancy in patients with macroscopic suspicion of malignancy and negative biopsies.
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PMID:Diffuse gastric cancer with peritoneal carcinomatosis can mimic Crohn's disease. 2318 52

Self expandable metal stent can be used both as palliative treatment for malignant colorectal obstruction and as a bridge to surgery in patients with potentially resectable colorectal cancer. Here, we report a case of successful relief of malignant stomal obstruction using a metal stent. A 56-year-old man underwent loop ileostomy and was given palliative chemotherapy for ascending colon cancer with peritoneal carcinomatosis. Eight months after the surgery, he complained of abdominal pain and decreased fecal output. Computed tomography and endoscopy revealed malignant stomal obstruction. Due to his poor clinical condition, we inserted the stent at the stomal orifice, instead of additional surgery, and his obstructive symptoms were successfully relieved. Stent insertion is thought to be a good alternative treatment for malignant stomal obstruction, instead of surgery.
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PMID:Insertion of self expandable metal stent for malignant stomal obstruction in a patient with advanced colon cancer. 2325 99

Multiple nontraumatic peritoneal and mesenteric emergencies are encountered at imaging of patients in the emergency department. Peritoneal and mesenteric emergencies are usually detected in patients in the emergency department during evaluation of nonspecific abdominal pain. A high index of suspicion is required for the establishment of early diagnosis and aversion of life-threatening complications in cases of peritoneal carcinomatosis, nontraumatic hemoperitoneum, and peritonitis. A correct diagnosis of omental infarction, mesenteric adenitis, and mesenteric panniculitis helps patients primarily by avoiding unnecessary surgery. In this review article, we illustrate the cross-sectional imaging appearance of various nontraumatic peritoneal and mesenteric emergencies by emphasizing the role of the emergency radiologist in detecting and managing these entities.
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PMID:Cross-sectional imaging of nontraumatic peritoneal and mesenteric emergencies. 2352 85

A 64-year-old man with sudden upper abdominal pain and emesis was admitted to our hospital. Forty years ago, he had undergone distal gastrectomy and reconstruction by Billroth II anastomosis for gastric cancer. Abdominal computed tomography revealed a dilated afferent loop and anastomotic tumor. Gastrofiberscopy showed crookedness and edematization of the afferent loop anastomosis. A biopsy revealed a poorly differentiated adenocarcinoma. He was operated on under the diagnosis of remnant gastric cancer. Left upper exenteration was performed because the transverse colon, lateral segment of the liver, pancreas, and left renal hilus were involved. Liver metastasis and abdominal dissemination were not observed. Histopathological findings revealed severe invasion of poorly differentiated adenocarcinoma to other organs, and intraoperative peritoneal lavage cytology was positive. He was discharged from our hospital; however, adjuvant chemotherapy was impossible because of his poor condition. Four months after the operation, he died from peritoneal carcinomatosis. Remnant gastric cancer with afferent loop syndrome has a poor prognosis. Therefore, it is necessary to select surgical resection or palliative care after immediate chemotherapy, considering each patient's condition and cancer stage.
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PMID:[A case of remnant gastric cancer with afferent loop syndrome treated by left upper exenteration]. 2439 50

This report describes the case of a patient with peritoneal carcinomatosis due to recurrent adenocarcinoma of the ureter who was chemo-sensitive to weekly paclitaxel. A 73-year-old man was admitted to our hospital for pain in the right back in September 2009. Drip infusion pyelography(DIP)showed right hydronephrosis. Cytologic examination of the urine revealed many carcinoma cells in the urothelial tract. The patient underwent right nephroureterectomy, and examination of the resected specimen revealed a primary enteric-type adenocarcinoma of the ureter. Six months after surgery, he visited our hospital because of abdominal pain and distension. Abdominal computed tomography(CT)showed massive ascites. Cytologic examination of the ascitic fluid revealed many adenocarcinoma cells resembling those of the primary lesion. The patient received chemotherapy with S-1 as first-line treatment; however, he experienced severe anorexia and diarrhea. Subsequently, the patient received chemotherapy with uracil/tegafur(UFT)but abdominal distension worsened. Next, he received chemotherapy with weekly paclitaxel(80mg/m2 on days 1, 8, and 15, every 4 weeks). Thereafter, the ascitic fluid disappeared rapidly. After 6 courses of treatment with paclitaxel, abdominal CT revealed no ascitic fluid collection. The treatment was discontinued because of sensory neuropathy. Approximately 10 months later, the patient experienced massive ascites again. At 25 months after recurrence, he died of peritoneal carcinomatosis.
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PMID:[A case of peritoneal carcinomatosis due to recurrence of primary adenocarcinoma of the ureter treated with weekly paclitaxel]. 2442 66


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