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

A rare case of anomalous arrangement of the pancreaticobiliary ductal system without dilatation of the biliary tract (AAPBDS without DBT) associated with mucosal dysplasia of the biliary duct is described herein. A 53 year old male with a long history of diarrhea and right upper abdominal pain was diagnosed as having AAPBDS without DBT by endoscopic retrograde cholangiopancreatography and other examinations. Excision of the gallbladder and biliary duct with a Roux-en-Y hepatico-jejunostomy was performed and subsequent pathological examination of the surgical specimens showed mucosal hyperplasia of the gall-bladder and mucosal dysplasia of the biliary duct. Considering the dysplastic changes of the biliary duct as seen in our case, and the high incidence of AAPBDS without DBT developing into carcinoma of the biliary duct, being 12.2 per cent, we suggest that pancreaticobiliary ductal diversion with excision of the gallbladder and biliary duct should also be performed for AAPBDS without DBT. However, further pathological investigations concerning the excised biliary duct in AAPBDS without DBT will be need to be carried out.
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PMID:Anomalous arrangement of the pancreaticobiliary ductal system without dilatation of the biliary tract. 139 35

Focal idiopathic renal arterial dissection (RAD) is a rare event. Nevertheless, a RAD should always be considered in the differential diagnosis in patients with flank pain or acute abdomen, since only an immediate diagnosis and correction can guarantee the maintenance of kidney function. Early operation is also necessary because other clinical pictures with a similarly dramatic clinical course and similar symptoms can likewise only be treated surgically. These include a renal arterial aneurysm with endo-aneurysmatic thrombus and poststenotic dilatation in fibromuscular dysplasia. We describe the case of an isolated idiopathic RAD which could only be diagnosed in the context of abdominal pain symptoms. Clinical, pathophysiological and therapeutic aspects of RAD are discussed with reference to the case report and the international specialist literature.
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PMID:[Spontaneous renal artery dissection. Case report and review of the literature]. 152 39

We report on a patient with a microcystic adenoma of the head of the pancreas. Cystic neoplasms of the pancreas comprise only about 2% of all exocrine tumours. They can be divided into two distinct groups with different prognoses: the microcystic glycogen containing tumours, which are always benign and the mucinous cystic tumours, the majority of which shows malignant dysplasia. Clinically they manifest as a palpable abdominal mass with unspecific upper abdominal pain. Preoperative diagnosis is difficult to achieve. Computer-tomography and ultrasound are the main radiological facilities that allow some degree of differentiation. During operation a frozen section is mandatory to differentiate between a pseudocyst and a real cyst with epithelial wall. Resection of the tumour is the therapy of choice. The prognosis of the microcystic adenoma is good, the prognosis of the mucinous cystadenoma-cystadenocarcinoma is much better than the prognosis of the adenocarcinoma of the pancreas.
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PMID:[Cystadenoma of the pancreas]. 222 88

Findings at coloscopy were analysed retrospectively for 4109 patients (2257 women, 1852 men; mean age 62.3 [5-100] years) who had undergone a high coloscopy between 1982 and 1987. The aim was to determine the site of colorectal adenomas and carcinomas, as well as the relationship between adenoma and carcinoma. Main indications for the coloscopy were polyps at previous ambulatory endoscopy (15.4%), abdominal pain (11.3%) and changed bowel habits (11.2%). In 752 patients 1273 adenomas were detected and in 354 patients there were 374 carcinomas (333 solitary, 21 multiple). 21.6% of the adenomas and 21.4% of the carcinomas were proximal to the right flexure. In 75 of 177 patients (42.4%) with both adenoma and carcinoma both tumours occurred in the same intestinal segment. The severity of the dysplasia increased with increasing size of the adenoma. 52 adenomas (4.1%) already had evidence of malignant degeneration. But 7.7% of the adenocarcinomas were only 5-10 mm in diameter. The increasing incidence of right-sided tumour (right shift) compared with the hitherto known distribution pattern argues for total coloscopy as the primary procedure in the diagnosis of colorectal tumour.
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PMID:[The incidence and localization of colorectal adenomas and carcinomas in 4109 patients]. 224 63

Although fibromuscular dysplasia (FMD) rarely occurs, it is the most common cause of renal artery disease in children. Aneurysm formation in FMD is well documented in adults. However, it was rarely described in children, partly because medial fibroplasia with a tendency to aneurysm formation is relatively rare. This report describes a 7-year-old girl with very unusual sets of abnormalities involving the left renal artery. Intimal fibroplasia with multiple small saccular aneurysms was seen. She presented with recent-onset renovascular hypertension, headache and intermittent severe colicky abdominal pain. Angiography revealed multifocal stenosis with multiple aneurysms of the left renal artery. Renal vein renin was twice as high on the involved side than on the contralateral side. After nephrectomy, the hypertension was under control without medication.
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PMID:Primary intimal fibroplasia with multiple aneurysms of renal artery in childhood. 235 68

A case of aortic valve dysplasia in a 6 year old male cocker spaniel is described. The dog was presented to the veterinarian because of strong dyspnea and frequent coughing. Clinical examination, EKG, radiographs and angiocardiography all pointed towards a tentative diagnosis of aortic insufficiency. Four months after the first appointment the dog was presented again with congestive heart failure, neural symptoms and strong abdominal pain. Electrocardiography and concentrations of LDH and CK were typical of myocardial infarction. Autopsy revealed a narrowing of the aortic valves in combination with a subaortic stenosis and several infarctions localized in the left ventricle as well as a recent infarction in the left kidney.
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PMID:[Aortic valvular dysplasia in a dog]. 276 90

Progressive anemia, melena, and sudden massive upper gastrointestinal bleeding in a man with cutaneous neurofibromatosis (von Recklinghausen's disease) since childhood prompted endoscopic demonstration of multiple gastric neurofibromas. One source of gastric bleeding removed by endoscopic electrosurgery proved to be a malignant schwannoma (spindle cell sarcoma). A pulmonary schwannoma, multifocal intracerebral spindle cell sarcomas, an extra-adrenal pheochromocytoma, and ocular neurofibromas were other features of this neuroectodermal dysplasia. Neurogenic tumors of the gastrointestinal tract are rare, commonly present with dyspepsia, abdominal pain, anemia, or hemorrhage, and should be suspect in the clinical setting of cutaneous neurofibromatosis. In the patient with systemic neurofibromatosis, endoscopic removal represents a safe method of diagnosis and treatment of bleeding neoplasms in the stomach or duodenum.
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PMID:Gastrointestinal neurofibromatosis. 643 77

The authors have reviewed 80 cases of ectopic ureter in 74 patients (62 women and 12 men). In most cases the abnormality involved the upper part of a double ureter system, and the extravesical openings were not only ectopic (located within or, most commonly, below the vesical sphincter in women), but also malformed with stenosis and/or reflux. The kidneys drained were damaged by dysplasia and/or interstitial nephritis. The presenting symptoms were fever, abdominal pain and disorders of micturition; incontinence, exclusively found in women, took only second rank. The purulent urine discharged could pass for leucorrhoea. Diagnosis was made by intravenous urography and by clinical or endoscopic finding of the ectopic opening.
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PMID:[Extravesical openings of ectopic ureters: diagnostic problems (author's transl)]. 707 36

Patients with multicystic kidneys that remained undetected for many years are currently our best source of information on the long-term fate of this type of renal dysplasia. We review 24 cases with adequate data reported in the literature and add 3 personal cases. Significant problems that were encountered and were related to these retained multicystic kidneys include abdominal pain, erroneous diagnosis of renal agenesis leading to repeated unrewarding medical studies for abdominal pain, abdominal mass and renal neoplasm arising in the dysplastic kidney.
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PMID:Unilateral multicystic renal disease in adults. 710 12

The records of all patients with solitary renal artery aneurysms seen between January 1968 and December 1978 were reviewed. Patients with fibromuscular dysplasia were excluded from analysis. Of the 67 patients seen, 34 had the diagnosis made on the basis of arteriography, 31 on the basis of abdominal roentgenography, and 2 at surgery. The ages of the 67 patients (34 men and 33 women) ranged from 21 to 90 years, with a mean of 61 years. Only five patients (8%) were symptomatic; all five presented with abdominal pain. Forty-six patients (69%) had associated hypertension. Five patients underwent surgical repair when initially seen. Only one patient had preoperative abdominal pain that was considered to be related to the aneurysm. The aneurysm sizes ranged from 0.3 to 4.0 cm, with a mean of 1.5 cm. In 45 patients (67%) the aneurysm was calcified. Follow-up ranged from 1 to 17 years, with a mean 5.7 and a median of 8.0 years. During follow-up, all aneurysms remained clinically silent. No aneurysms were subsequently repaired, no new cases of hypertension developed, no nephrectomies had to be performed, and no ruptures occurred. Eight patients (12%) died; no death was related to a complication of the aneurysm. This study supports the view that patients with asymptomatic solitary saccular renal artery aneurysm may be safely observed without surgical intervention.
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PMID:Solitary renal artery aneurysm. 742 76


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