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

Nine patients with choledochal cyst have been reviewed. There was a 6:3 preponderance of females. Four patients presented in adulthood. Cholangiocarcinoma developed in three patients with an interval ranging from 2 to 35 years following surgery. The predominant complaint was of abdominal pain and symptoms had been present from weeks up to 28 years. Imaging by sonography may be all that is required in the paediatric age group, but in adults further confirmation of the choledochal cyst and the associated anomalous junction of the pancreatico-biliary duct (AJPB) by direct cholangiography is recommended.
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PMID:Choledochal cyst and congenital anomalies of the pancreatico-biliary junction: the clinical findings, radiology and outcome in nine cases. 133 94

Cholangiocarcinoma, a malignancy of the biliary duct system, tends to grow slowly and to infiltrate the walls of the ducts, dissecting along tissue planes and leading to biliary tract obstruction. In a retrospective case review, 62 cases diagnosed with cholangiocarcinoma between January 1997 and December 2001 at the King Chulalongkorn Memorial Hospital in Bangkok were studied. The most commonly observed clinical symptoms and signs were fever (96.8%), abdominal pain (87.1%) and malaise or weakness (83.9%). Fifty-one of the 62 tumours detected were distal extrahepatic (82.3%), seven perihilar (11.3%) and four intrahepatic (6.7%). There was a significant increase in serum bilirubin and marked elevation of serum alkaline phosphatase. Almost half (45.2%) of the patients presented with other pathological conditions, mostly cholangitis (19 cases) resulting from acute biliary tract obstruction and ascites (13 cases). The pathogens detected were similar in cases of cholangitis alone and cholangiocarcinoma. The major risk factor for this cancer in Thailand is believed to be exposure to liver fluke in insufficiently cooked traditional foods. As it is still endemic in Thailand, continuous prevention and surveillance of this public health problem are necessary.
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PMID:Clinical findings among 62 Thais with cholangiocarcinoma. 1263 12

Cholangiocarcinoma (CC) is a malignant neoplasm deriving from intra- and extrahepatic bile ducts. It affects both sexes, and is most prevalent at the age 50 to 70. Chronic nonspecific ulcerative colitis, primary sclerosing cholangitis, hepatolithiasis, congenital hepatic fibrosis, and Caroli's disease may lead to the increased incidence of CC. Recently, hepatic cirrhosis in the course of virus-associated chronic hepatitis has been suggested to be involved in the pathogenesis CC. Histologically, 90-95% of CC are well differentiated adenocarcinomas. Usually the tumor grows slowly and metastazes late locally and even less frequently extrahepaticly. CC often causes symptoms by blocking the bile ducts, abdominal pain, weight loss, signs of portal hypertension, rare ascites and thrombophlebitis. Serum chemistry was compatible with obstructive jaundice. The increased expression of CEA, Ca19-9, as well as loss or reduction of sialomucin/sulfomucin concentration in the biliary lining epithelium may be indicative of malignant changes. CC as usually non-vascularized nonencapsulated tumor with a large amount of fibrosis. It is isochogenic in classical USG, CT or MRI. MRCP-magnetic resonance cholangiopancreatography and virtual endoscopy are more helpful methods on the diagnostics of CC. Recently, FDG positron emission tomography has been suggested to be a sensitive technique in identifying small bile duct cancers. Surgical excision of the lesion confirmed localized CC. The adjuvant radio- and chemotherapy and transplantation are not satisfactory. Palliative therapy includes surgical biliary-intestinal bypass procedures as well as operative and nonoperative techniques for biliary intestinal drainage. Recently, the local treatment of CC by photodynamic therapy as a palliative strategy is very promising. Ordinary CC is reported as a neoplasm with a poor prognosis. Post resection 5-year survival is affirmed in about 25% of CC, whereas after palliative treatment only 1 year.
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PMID:[Cholangiocarcinoma--bile ducts cancer]. 1290 Dec 70

Cholangiocarcinoma (CCA) is an uncommon malignant tumor arising from the biliary epithelium. The incidence increases with age and usually affects individuals in their 6th or 7th decade of life. Those patients with underlying risk factors such as primary sclerosing cholangitis (PSC) and choledochal cysts generally present 2 decades earlier. Most patients clinically present with painless jaundice; however, other common symptoms include pruritus, weight loss, and abdominal pain. Although surgical resection offers the only hope for cure, most patients are found to have unresectable disease on initial presentation and have an extremely grim prognosis. This has led to an emphasis on the role of palliative care, with relief of biliary obstruction, in the management of these patients. Surgical bypass was once the primary means of palliation of jaundice in patients with unresectable cholangiocarcinoma but in the last 2 decades has been superseded by less invasive and less morbid nonsurgical procedures such as endoscopic and percutaneous biliary stent placement. Newer modalities of palliation such as endoscopic delivery of photodynamic therapy and high-intensity ultrasound therapy are emerging nonsurgical modalities that may result in improved survival and may play a future role as an adjunctive therapy to surgical resection.
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PMID:Endoscopic management of cholangiocarcinoma. 1519 89

Cholangiocarcinoma is a rare disease (0.15-0.16% in the general population). We present the case of a man, 64 years old, who was admitted to our clinic for emergency with intense jaundice, abdominal pain in the supra-umbilical region. Laboratory analysis revealed elevated total bilirubin (23.5 mg/dl), with predominant direct bilirubin and an increased serum level of alkaline phosphatase and GGT, AST, ALT. The abdominal CT shows an tumor infiltrating distal bile duct, with important dilatation of proximal biliary tree and enlarged retro pancreatic lymph node (8 mm). The first therapeutic procedure was an surgical exploration of the abdomen to asses the resectability of the tumor and an internal biliary drainage colecisto-gastrostomy to allow improving of patient's biological and clinical state and a latter radical operation, after remission of jaundice. After a month we performed cephalic duodenopancreatectomy. Pathology result: moderately differentiated adenocarcinoma of intestinal type (G2) pT2NOMO (stage II). The postoperative evolution was favorable encumbered by a small pancreatic fistula healed by conservative method.
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PMID:[Cholangiocarcinoma of the distal bile duct--case presentation]. 2054 Feb 47

Cholangiocarcinoma (CCa) is relatively resistant to chemotherapy as well as radiation therapy, and complete resection is the main curative therapy for these patients. The prognosis for patients with unresectable intrahepatic CCa (iCCa) is extremely poor. A 55-year-old woman presented at our hospital with abdominal pain. After evaluation, she was diagnosed to have multifocal iCCa. She did not opt for standard chemotherapy and therefore received oral metronomic therapy with a combination of celecoxib, etoposide, and cyclophosphamide for a total of 30 months. Presently, she is 57 months post diagnosis and 27 months post cessation of all treatment and continues to be in complete radiological remission. In the present report, we review the literature and discuss whether metronomic scheduling of biologic agents and anticancer drugs will be able to overcome chemoresistance and improve the outcome in cholangiocarcinoma. References for the review were identified through searches of Pubmed for the last 10 years as well as searches of the files of the authors themselves. The final list was generated on the basis of originality and relevance to this review.
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PMID:Can combination metronomic therapy overcome chemoresistance in cholangiocarcinoma? A literature review. 2397 7

Cholangiocarcinoma (CCA) poses a significant public health problem in Southeast Asia, with chronic Opisthorchis viverrini infection being the main risk factor. Epidemiological data on CCA is not available for Lao People Democratic Republic (Lao PDR), though there is a high prevalence of O. viverrini infection in the country. A hospital record-based retrospective study was carried out in six referral hospitals (four in the capital city, one in Savannakhet, one in Pakse) to assess the number of suspected CCA cases admitted between January 2006 and December 2010. In total, we identified 274 patients with liver lesions suggesting CCA, as diagnosed by ultrasound and CT scan. Male gender and age 50years and above were main characteristics of those identified. The majority were admitted to hospitals in the central (58.0%) and southern (29.6%) parts of Lao PDR. Abdominal pain (48.5%) and jaundice (14.2%) were the main symptoms leading to hospitalisation. Some 267 (97.4%) patients had dilated bile ducts; 40 (74.1%) had gallstone or intrahepatic stone, and 33 (12.0%) had a parasitologically confirmed O. viverrini infection. This study provides the first estimated numbers of suspected CCA cases admitted to selected hospitals in Lao PDR. Definitive diagnosis of CCA was not possible. Therefore, case diagnosis and registration of suspected CCA cases are warranted to gather evidence for a national burden estimate of CCA, to develop large-scale studies and adequate preventive and curative health services. A cancer registry would be a most useful tool.
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PMID:Suspected cases of cholangiocarcinoma seen in reference hospitals in Lao People's Democratic Republic. 2796 65

Cholangiocarcinomas are tumors that arise from the ductal epithelium of the intrahepatic or extra-hepatic bile ducts. Patients are usually asymptomatic or may present with weight loss, fatigue, loss of appetite and abdominal pain (intrahepatic cholangiocarcinomas) or jaundice (extra-hepatic cholangiocarcinomas). Subcapsular bile vessel rupture, due to intrahepatic cholangiocarcinoma, is an extremely rare clinical presentation, which is an emergent and potentially life-threatening complication. We report the case of a 79-year-old female patient suffering from an intrahepatic cholangiocarcinoma that completely obliterated the left main hepatic duct. This obstruction in intrahepatic bile flow had resulted in intraperitoneal rupture of subcapsular bile vessels (not infiltrated by the tumor) of the left liver lobe and formation of spontaneous biloma. The patient was admitted for acute abdominal pain. Computed tomography (CT) and Magnetic Resonance Imaging (MRI) revealed the tumor and an upper abdominal fluid collection. Since the patient was hemodynamically stable and afebrile, a CT-guided percutaneous aspiration of the collection was undertaken, showing a biloma. A left hepatectomy was performed two weeks later and today, sixty months since the incident, the patient enjoys good health, with no signs of local recurrence or distant metastases. Intraperitoneal rupture of bile ducts and subsequent spontaneous biloma formation, due to an intrahepatic cholangiocarcinoma which completely obstructed the left main hepatic duct, is a unique situation and this is the first time to be reported. Prompt surgical management can lead to successful treatment of this rare and difficult entity.
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PMID:Spontaneous biloma due to an intrahepatic cholangiocarcinoma: An extremely rare case report with long term survival and literature review. 2817 82

Tuberculosis (TB) isolated in Common Bile Duct (CBD) is very rare and its treatment is somewhat controversial. We report a case of distal CBD tuberculosis diagnosed as cholangiocarcinoma. A 40 year old man presented with obstructive jaundice without abdominal pain, fever or weight loss. Ultrasonography and Magnetic Resonance Cholangio-Pancreatography (MRCP) indicated a mass lesion in the Distal CBD, which caused structure of the distal common bile duct. As Cholangiocarcinoma was suspected, he underwent Whipple procedure (pancreaticoduodenectomy). Histological examination of resected specimen revealed typical features of tuberculosis in the distal CBD, pancreatic head and lymph nodes. The rest of the abdominal cavity was unremarkable. Anti-microbial therapy for tuberculosis is started for 12 month course and he is well.
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PMID:Distal Common Bile Duct Tuberculosis with Obstructive Jaundice: A Case Report. 2826 Jul 76

Cholangiocarcinoma is a rare form of gastrointestinal cancer with a poor prognosis. Patients often present with biliary obstruction or non-specific abdominal pain, and a high proportion of patients have advanced disease at initial diagnosis. The goal of this review is to discuss treatment options for patients with advanced bile duct tumours focusing on radioembolisation (RE) and its impact on overall survival. RE provides a therapeutic option for patients with unresectable cholangiocarcinoma. However, although systemic chemotherapy has demonstrated a survival benefit in randomised controlled trials, there is limited supporting evidence for the use of RE in this setting. Studies are mostly limited to single-centre, small cohorts with variable outcome measures. Additionally, patients included in these studies received a variety of previous therapies including chemotherapy, surgery or alternative intra-arterial therapy; therefore, a true assessment of overall survival benefit is difficult.
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PMID:Update on Treatment Options for Advanced Bile Duct Tumours: Radioembolisation for Advanced Cholangiocarcinoma. 2865 2


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