Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report new operative approaches to the treatment of hepatic vein occlusion due to malignant tumors in the liver and their results in four patients. Two patients had hepatoma, one had metastatic melanoma, and one had metastatic leiomyosarcoma. All of them had abdominal pain, abdominal distention secondary to ascites, and massive hepatomegaly. The right lobe and medial segment of the left lobe of the liver were involved in three patients, and the involvement was diffuse throughout the liver in one. Hepatic veins were occluded completely in one patient, and two of three veins were occluded in the others. Two patients were treated by hepatic resection and removal of tumor thrombus from the hepatic vein under isolation-perfusion technique. They lived 18 and six months, respectively, without recurrence of Budd-Chiari syndrome. Tumors in the other patients were diffuse and could not be resected. The hepatic artery was ligated and chemotherapy was given postoperatively. Ascites and abdominal pain disappeared completely in one, who survived 17 months. The other patient had significant palliation and lived nine months.
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PMID:Surgical management of hepatic vein occlusion by tumor: Budd-Chiari syndrome. 19 61

A case of metastatic melanoma of the stomach is reported with illustrative endoscopic and radiographic findings. Metastatic melanoma of the stomach may present with vague gastrointestinal symptoms, abdominal pain, or gastrointestinal bleeding. A history of melanoma may not be readily obtainable. When gastrointestinal symptoms occur in a patient with known melanoma, gastric metastases should be considered. Polypoid or target lesions are frequently seen on barium x-ray study. Small bowel roentgenograms should be obtained. Endoscopy, cytologic study, brushing, and biopsy may yield the diagnosis. The prognosis is poor. Surgery should be performed only to relieve significant symptoms.
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PMID:Metastatic melanoma of the stomach: the endoscopic and roentgenographic findings and review of the literature. 84 97

A 46-year-old woman presented with abdominal pain, nausea vomiting and abdominal distention. Small bowel x-rays and CT scan of the abdomen revealed small bowel obstruction due to malignant melanoma. The diagnosis of cutaneous melanoma was performed 8 years prior to admission on one lesion in the back. Patient received surgical treatment. Completed resection of an involved jejunal [correction of ileal] segment was performed. Three tumor masses were found at laparotomy. Metastasis from malignant melanoma at the gastrointestinal tract occurs frequently though rarely are these intestinal lesions symptomatic. The efficacy of surgical treatment for symptomatic metastatic melanoma is justified to relief symptoms and prolonged survival.
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PMID:[Symptomatic malignant melanoma of the small intestine]. 134 Nov 16

Melanoma frequently disseminates to the gastrointestinal tract, being found post-mortem in 60 per cent of patients with disseminated disease, while during life it is diagnosed in only 4 per cent. During the period 1981-87, 835 melanoma patients were referred and 30 developed complaints caused by gastrointestinal metastatic melanoma. Twenty-three patients were treated surgically. The interval between treatment of the primary melanoma and detection of intestinal involvement was a median of 34 months (range 2-87 months). In four patients recurrence in the gut was the first evidence of dissemination. Major complaints were nausea and vomiting, abdominal pain, signs of anaemia, and blood in the stools. Complications were bleeding (ten cases), ileus due to intussusception (five cases), bowel perforation (four cases) and cholecystitis (one case). The metastases, mainly localized in the small bowel, were removed by relatively simple procedures. Symptoms were reduced in 19 patients. Two patients died after operation: one from sepsis due to suture leakage, the other from pneumonia and a cerebrovascular accident. Of the remaining patients, 16 survived a median of 7.5 (range 0.7-32.0) months. Five patients are still alive 72, 72, 70, 7 and 2 months after the metastasectomy, three of whom are tumour-free. The actuarial 5-year survival of all patients is 19 per cent. These results support surgical intervention for patients with complaints and/or complications attributable to gastrointestinal metastatic melanoma.
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PMID:Surgery for melanoma metastatic to the gastrointestinal tract. 168 96

Sixteen patients with metastatic melanoma were treated with N-methylformamide (NMF), a polar-planar compound with in vitro cytotoxic and differentiating properties. Sixteen patients were evaluable for toxicity and 14 for response. The initial four patients received an intravenous bolus of NMF 800 mg/m2 daily for 5 consecutive days every 28 days. Because of excessive gastrointestinal toxicity, the dose was reduced to 700 mg/m2/day for the subsequent 12 patients. Two patients had immediate adverse effects from NMF; one had a grand mal seizure and the other developed severe abdominal pain. Nausea, vomiting and abdominal pain were dose-limiting. Transient elevation of liver function tests occurred in all patients. Myelosuppression was not observed. There were no objective responses among 14 evaluable patients (95% confidence limits 0-20%). One patient with pulmonary metastases had a minor response lasting 13 months. Median time to progression of disease was one month. NMF in these doses and schedule lacks clinical efficacy in the treatment of metastatic melanoma.
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PMID:Phase II trial of N-methylformamide in patients with metastatic melanoma. 202 91

Fifty-six patients with symptomatic metastatic melanoma of the gastrointestinal tract (GIT) treated surgically at the Sydney Melanoma Unit between 1974 and 1989 were reviewed. The majority of these patients presented with abdominal pain or symptoms of anemia. The small intestine was the site of metastasis in more than 80 per cent. The mean over-all survival time was 11.7 months (range of one to 60 months) after surgical treatment of a first metastasis to the GIT and 3.6 months (range of zero to 12 months) postoperatively for a second GIT metastasis. Forty-four of the patients reported complete relief of their symptoms postoperatively. The results suggest that an aggressive approach to symptomatic GIT metastases from malignant melanoma is justified both to relieve distressing symptoms and to prolong life.
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PMID:The justification for surgical treatment of metastatic melanoma of the gastrointestinal tract. 223 26

Between 1980 and 1992, 68 patients with clinical indications of involvement of the gastrointestinal (GI) tract with metastatic melanoma were treated at Roswell Park Cancer Institute. Presenting symptoms were anaemia, abdominal pain, nausea and vomiting. Sites commonly involved were the small bowel (75%), the large intestine (25%), and the stomach (16%). Twenty-one patients were considered unsuitable for surgery; their median survival after diagnosis of GI metastases was 2.9 months. Forty-seven patients underwent abdominal surgery; effective palliation was achieved in most of them. Complete resection of GI metastases was accomplished in 47% of patients. The median survival after operation was 27.6 months for patients with complete resection of GI metastasis and no other disease, 5.1 months for patients with resection of involved GI tract and other metastases present, and 1.9 months for patients who had a by-pass procedure only. The 5-year survival for patients with complete resection of GI metastases and no other evidence of disease was 28.3%. The other groups had only 1-year survivors. Surgical intervention is justified on the basis of these findings, and extended palliation can be achieved in patients with complete resection of metastatic disease.
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PMID:Gastrointestinal metastases from malignant melanoma. 755 Dec 58

We present herein the case of a 66-year-old woman with disseminated malignant melanoma in whom a metastasis in the ileal mesentery ruptured into the peritoneal cavity causing an acute abdomen. The patient suddenly developed lower abdominal pain and a computed tomography (CT) scan of the pelvis confirmed the presence of an intrapelvic abscess. At emergency laparotomy, a 10 x 10 cm ruptured metastatic melanoma was found in the ileal mesentery, which demonstrated no communication with the ileum itself. To our knowledge, no other case of an acute abdomen being caused by the rupture of mesenteric metastatic melanoma lacking any communication with the bowel lumen has ever been reported.
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PMID:Malignant melanoma with mesenteric metastasis causing an intrapelvic abscess: report of a case. 764 Apr 77

In a 16 year old patient a superficially spreading malignant melanoma had been excised from the left temple. Ten years later, she represented with lower abdominal pain. On examination cystic adnexal masses were found and median laparotomy was performed. Intraoperatively bilateral polycystic, dark-coloured ovarian tumors were found, each measuring about 10 x 10 x 10 cm. Hysterectomy with bilateral salpingo-oophorectomy and resection of the great omentum was performed. Uterus and ovaries weighed 3.480 g. At microscopic examination large metastases of a pigmented melanoblastoma were found in both ovaries. Two months after surgery she succumbed to multiple cerebral metastases. For primary ovarian melanoma radical surgery with lymphonodectomy is mandatory. The operation is to be followed by immuno- and chemotherapy. In case of metastatic melanoma of the ovaries individual decisions concerning the extent of the surgical procedure are to be made. In any case, however, bilateral salpingo-oophorectomy should be performed, preferably combined with hysterectomy.
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PMID:[Metastatic ovarian melanoma in a 26-year-old patient]. 794 11

Eighteen of 1420 patients with primary cutaneous melanoma presented with symptomatic small bowel metastases and were reviewed to establish the role and efficacy of surgical intervention. The median interval between treatment of the initial skin lesion and detection of the intestinal metastases was 4.4 years (range, 2 months to 15 years). Most patients presented with either anemia, abdominal pain, bowel obstruction, or intussusception. In six patients, small bowel involvement was the first sign of metastatic disease. Seventeen of the 18 patients underwent laparotomy, and all overt metastases were completely excised in 12. Three patients died postoperatively. Fourteen of the 17 patients had satisfactory palliation with complete symptomatic relief. Median survival after resection was 13 months (range, 2 days to 300 months). Median survival of the 12 patients in whom all macroscopic disease was resected was 44.5 months (range, 2-300 months), whereas the median survival in the four with incompletely resected tumors was 4 weeks (range, 2 days-24 weeks). Five of 12 patients who underwent complete resection of small bowel metastases survived more than 6 years, 3 of whom remain well and free of disease at 6, 14, and 25 years. These results justify active surgical intervention in patients with symptomatic small bowel metastatic melanoma, both for relief of symptoms and prolongation of life.
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PMID:Surgical treatment of metastatic melanoma of the small bowel. 871 64


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