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

Villous neoplasms of the main pancreatic duct are uncommon. Two cases of neoplasm of the main cephalic pancreatic duct in 61- and 42-year-old patients presenting with long standing (10 and 12 years) history of abdominal pain are reported. In both cases, duodenal fistula was present and mucus was observed by endoscopy at the fistula and major papilla levels. Endoscopic retrograde pancreatography showed a stricture of the main pancreatic duct in the pancreatic head. In one case, with incomplete stricture, pancreatic ducts disclosed typical features of chronic obstructive pancreatitis and contained mucus casts. Histologic examination of total and proximal duodenopancreatectomy showed a villous neoplastic pattern with focal malignant changes within the main pancreatic duct. The adjacent pancreatic tissue showed signs of stromal invasion without lymph node or nervous infiltration. Glandular parenchyma was atrophic in the pancreatic body and tail, with extensive fibrosis, and the pancreatic duct depicted signs of nonpapillary hyperplasia. Histochemical study disclosed a predominant sialomucin secretion by villous adenoma and sulfomucin secretion by epithelial cells lining the accessory or main caudal pancreatic ducts. These results lead us to suggest a possible relationship between villous adenoma of ducts and pancreatic adenocarcinoma.
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PMID:[Villous tumors of the Wirsung's duct and pancreatic intraductal adenocarcinoma: interrelation or accidental association?]. 136 60

This report deals with two cases of villous adenoma of the Wirsung duct. The two patients presented with upper abdominal pain, diarrhea, and weight loss. Duodenal intubation showed a complete failure of exocrine pancreatic function. Ultrasound scan, computed tomography, and endoscopic retrograde cholangiopancreatography disclosed marked dilatation of the head portion of the main pancreatic duct. A proximal duodenopancreatectomy was performed. Pathological examination revealed a papillary polyp expanding the pancreatic head and filling the main duct lumen. Histological pattern consisted of a villous adenoma without any feature of malignant change. Previously reported cases exhibit many similarities to our two cases. The putative likelihood of malignant change and the relationship between villous tumors of the Wirsung duct and of other origin remain unclear.
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PMID:Villous adenoma of the main pancreatic duct: a potentially malignant tumor? 218 92

Recently a patient with ulcerative colitis developed abdominal pain and a left upper quadrant mass. A 67Ga-citrate scintiscan showed increased activity over the mass. A barium enema demonstrated retrograde obstruction at the splenic flexure and intraluminal multilobulated tissue masses. The total abdominal colectomy specimen showed localized giant pseudopolyposis at the splenic flexure. This condition is a rare local complication of both ulcerative and granulomatous colitis. It resembles a villous adenoma on barium enema and, although inflammatory, may simulate a colonic carcinoma. When symptomatic, local resection may be sufficient treatment.
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PMID:Localized giant pseudopolyposis of the colon in ulcerative colitis. 738 23

Villous adenomas of the upper gastrointestinal tract, although rare, are difficult to diagnose and treat because of their location, invasiveness, and association with adenocarcinoma. Two patients with duodenal villous adenoma and upper abdominal pain as the presenting symptoms are described. Endoscopy is important for early diagnosis. The recommended treatment is simple excision with biopsy, or pancreaticoduodenectomy if adenocarcinoma is present.
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PMID:Duodenal villous adenoma. 743 42

Thirty-seven cases of colorectal cancer in patients aged 30 years or younger have been treated at the University of Virginia Health Sciences Center from 1957 through 1992. The present series, comprising patients treated from 1978 through 1992, updates a series presented from our institution comprising patients treated from 1957 through 1977. For the 36-year series, 24 patients (65%) were female, and 13 (35%) were male. Sixteen patients (43%) were black, and 21 patients (57%) were white. Sites of tumor and their frequency were rectosigmoid, 14 (38%), left colon, five (14%), splenic flexure, two (5%), transverse colon, three (9%), hepatic flexure, two (5%), right colon, two (5%), and cecum, six (16%). Twenty-two patients (59%) presented with abdominal pain, whereas 15 (41%) presented with hematochezia or hemoccult positive stools. The average time of onset of symptoms to diagnosis was 2.3 months. Thirty-four of 37 patients (92%) presented with advanced stage disease. Only four patients had precancerous conditions: one each with Gardner's Syndrome, Turcot's Syndrome, ulcerative colitis, and villous adenoma. Twenty-five patients (68%) underwent surgery for cure, and ten (27%) received palliative procedures. Nothing could be done for two patients (5%). Twenty-one patients (57%) had mucinous histology, 13 (35%) had typical adenocarcinoma, one (3%) had small cell carcinoma, and histology was unavailable in two (6%). Nodes were negative in only 10 (27%) patients, of which only three had mucinous histology. There have been five 5-year survivors and three patients alive and disease free at last follow up, ranging from 30 months to 48 months.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Colorectal carcinoma in patients 30 years of age and younger. 783 88

We describe the case of a 78 year old woman with a severely dysplastic villous adenoma of the duct of Wirsung presenting with abdominal pain, emesis, weight loss, and hyperamylasemia. Abdominal ultrasound, computed tomography, and endoscopic retrograde cholangiopancreatography suggested an intraductal lesion in the head of the pancreas with a dilated distal duct. The patient underwent uncomplicated pancreaticoduodenectomy and has done well. A review of the literature on benign and malignant neoplasms of the main pancreatic duct allows formulation of the typical clinical syndrome, appropriate diagnostic work-up, treatment, and prognosis of patients with these rare lesions. The pancreatic ductal epithelium can present the full spectrum of lesions along the pathogenetic route to malignancy. This is evidence for the presence of an adenoma-to-carcinoma sequence in the pancreas analogous to that which exists in the colon.
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PMID:Villous adenoma of the main pancreatic duct: a clue to the pathogenesis of pancreatic malignancy. 783 11

A 49-year-old diabetic patient with abdominal pain was found upon ultrasonography and computed tomography to have a cystic mass in the head of the pancreas with dilation of the main pancreatic duct. The head of the pancreas and duodenum were removed surgically. Examination of the operative specimen showed chronic pancreatitis, dilation of the main pancreatic duct, and impacted mucus in the secondary ducts with villous proliferation of the ductal epithelium, establishing the diagnosis of intraductal adenomatosis. There was no evidence of malignancy. The resection margin was involved, and consequently the remainder of the pancreas was removed six months after the initial surgical procedure. A review of the literature showed that intraductal adenomatosis tends to spread and carries a high risk of malignant transformation. Surgery is required because of the risk of pancreatic duct obstruction and pancreatic cancer. Intraductal adenomatosis of the pancreas shares many characteristics with other adenomatous proliferations of the gastrointestinal tract (colorectal villous adenoma, bile duct adenomatosis), including presence of villous structures with increased mucus production, a tendency to spread massively, and a high risk of malignant transformation.
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PMID:[Intraductal pancreatic adenomatosis. Apropos of a new case]. 866 4

Villous adenoma of the appendix is a rare pathologic entity, the treatment is controversial. We describe the case of a patient complaining of abdominal pain that was diagnosed as acute appendicitis. Pathological examination of the surgical specimen revealed a villous adenoma of the appendix. We comment the therapeutic options and we review the literature about this pathological entity.
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PMID:[Villous adenoma of the appendix caused acute appendicitis]. 875 26

A 76-year-old female with villous adenoma of the gallbladder is herein reported. She presented complaining of upper abdominal pain for some months prior to admission. No tumor mass could be detected by transabdominal ultrasonography, but CT scan demonstrated a sessile tumor measuring some 2 cm in diameter. A simple cholecystectomy was thus performed. The resected gallbladder was filled with mucinous material, and showed a sessile tumor with finger-like processes in the fundus. Both the macro- and microscopical findings of the lesion were almost identical to a typical villous adenoma of the colon. Little information is available on villous adenoma of the gallbladder, because such cases are extremely rare. In this paper, is described e a rare villous adenoma lesion while paying special attention to the morphological findings.
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PMID:Villous adenoma of the gallbladder: a case report. 922 71

Appendiceal intussusception is an uncommon pathologic condition; however, villous adenoma of the appendix is a distinctly rare entity. We report herein a case of appendiceal intussusception induced by tubulovillous adenoma with carcinoma in situ. A 67-year-old man was admitted to our hospital with a 1-year history of lower abdominal pain for investigation. Barium enema showed a filling defect with an irregular surface in the cecum, and colonoscopy revealed a cecal tumor with a granular surface. Pathological examination of biopsy samples revealed tubulovillous adenoma with well-differentiated adenocarcinoma, and a diagnosis of cecal cancer in tubulovillous adenoma was made. Surgery was performed and the resected specimen was found to contain a tumor arising from the appendix. The tumor was 5.5 x 4.5 cm in size in the cecal cavity, and the appendix had invaginated into the cecum at its base. The cut surface of the appendix showed the villous tumor filling the appendiceal lumen and projecting into the cecal cavity. Microscopic examination revealed well-differentiated adenocarcinoma in tubulovillous adenoma. To the best of our knowledge, this is the first report of appendiceal intussusception caused by tubulovillous adenoma with carcinoma of the appendix.
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PMID:Appendiceal intussusception induced by tubulovillous adenoma with carcinoma in situ: report of a case. 1081 82


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