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

Pancreatic arteriovenous malformation (PAVM) is a rare condition that may cause duodenal ulcer. A36-yr-old man with PAVM associated with duodenal ulcer and H.Pylori infection is described. The patienthad recurrent episode of upper abdominal pain despite healed ulcer and H.Pylori eradication.The preoperative diagnosis was confirmed by computed tomography and the patient was treated with apancreatoduodenectomy. Histological examination of the resected pancreas revealed a pancreatic arteriovenousmalformation involving the adjacent duodenal wall.
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PMID:Pancreatic Arteriovenous Malformation Associated with Duodenal Ulcer and H.Pylori Infection. 1275 95

Surgical emergencies can be missed easily in children, who are not always able to volunteer relevant information. Awareness of the entities discussed in this review might help the EP uncover subtle clues to early diagnoses that might not be initially apparent. Ill-appearing children who have abdominal pain and vomiting should be considered to have ischemic or necrotic bowel until proven otherwise. Possible diagnoses include volvulus, intussusception, and necrotizing enterocolitis. Bilious vomiting, especially in a young infant, should be considered to be an indication of a high bowel obstruction such as midgut volvulus, which warrants immediate surgical consultation. Significant rectal bleeding with abdominal pain can result from intussusception, volvulus, or an inflamed Meckel's diverticulum. Rectal bleeding with unstable vital signs can result from an upper GI bleed (eg, peptic ulcer disease). Painless rectal bleeding can result from a Meckel's diverticulum, polyps, arteriovenous malformation, or a tumor. Examination of the genitalia is imperative, especially in boys, to exclude the possibility of an incarcerated hernia or testicular torsion.
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PMID:Abdominal surgical emergencies in infants and young children. 1470 13

Vascular tumors are rare in female genital tract (FGT). The aim of this study was to analyze the distribution of vascular tumors in FGT and to highlight their clinicopathologic features. As a retrospective study, clinical features including imaging studies, gross findings, and microscopic features of cases (ten) diagnosed as having vascular tumors of FGT over 4 years were reviewed. The age range of our cases was 12-52 years. The presenting complaint was abdominal pain/mass, postcoital bleeding, and vaginal and vulval mass. In most cases, duration of symptoms was 6 months to 2 years. Only one case had a long-standing history of 8 years. The vascular tumors occurred most commonly in ovary (six), followed by vulva (two), and one each in cervix and vagina. Clinical diagnoses ranged from cystadenoma in ovarian tumors to endocervical polyp in cervical tumor. Histologically, all were benign vascular neoplasms, ranging from hemangioma (five), lymphangioma (one), lymphangioma circumscriptum (one) to angiomatosis (two) and arteriovenous malformation (one). Thus, we conclude that vascular lesions in FGT can present with symptoms similar to epithelial malignancies and may lead to unwarranted radical surgery. Vascular lesions of cervix and vulvovaginal region pose special problem during pregnancy. Risk of Kasabach-Merritt coagulopathy has to be considered in larger vascular tumors. Most of these cases can be treated by surgery.
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PMID:Benign vascular tumors of female genital tract. 1680 6

A 50-year-old man had been treated for hemorrhagic duodenal ulcer. Although the patient was treated by proton pump inhibitors (PPI), the ulcer did not show any sign of improvement. Therefore, we also examined the pancreas, and obtained CT findings suggestive of arteriovenous malformation (AVM) from the head to the body of the pancreas. Pancreatic AVM was diagnosed based on angiography. He was readmitted for high fever and abdominal pain. On day 2, CT demonstrated a cystic lesion containing gas at the pancreatic head, and CT showed pneumobilia on day 15. The next day, pancreaticoduodenectomy was carried out and a common bile duct-duodenal fistula was confirmed. This report describes a rare case of pancreatic AVM complicated with a common bile duct-duodenal fistula.
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PMID:[A case of pancreatic arteriovenous malformation creating a common bile duct-duodenal fistula with the onset of hemorrhagic duodenal ulcer]. 2053 Sep 31

Intravascular papillary endothelial hyperplasia (IPEH), or Masson's tumor, a rare benign vascular lesion, occurs mainly in the head, neck, and hands in the human population. Aberrant tumor locations have been rarely reported. We present a case of a patient with chronic abdominal pain and melena of variable severity due to a Masson's tumor, with no apparent Masson's tumor-associated comorbidities, along with a comprehensive review of the literature. Using PubMed, a search engine provided by the U.S. National Library of Medicine and the National Institutes of Health, we searched for all reports of Masson's tumor limited within the abdominal cavity. Furthermore, keywords such as 'intravascular papillary endothelial hyperplasia', 'renal', 'gastrointestinal', 'hepatic' and 'intraabdominal' were used to facilitate the search. We thus found fourteen cases of intraabdominal Masson's tumors published. Six (42.9%) of these were located in the renal vein, 4 (28.6%) were reported in the gastrointestinal tract, 1 (7.1%) in the adrenal gland, 1 (7.1%) in the liver, and 1 (7.1%) instance with multiple lesion sites including the renal hilum and retroperitoneum. Among these patients, 9 (64.3%) were female and 5 (35.7%) male, with a mean age of 38.9 years (7-69). IPEH is a reactive process, having three subtypes, all involving the proliferation of epithelial cells around a thrombus in the setting of venous stasis. In its pure form, the organized thrombus is solely localized within the vascular lumen. Mixed-form IPEH is formed in preexisting vascular lesions (such as arteriovenous malformation, hemangioma, pyogenic granuloma, etc.). The rarest form is the extravascular variety, which arises in hematomas often from recent trauma to the area. In its pure form, IPEH has a zero recurrence rate when an R0 resection is performed; all mixed and extravascular forms show the highest recurrence rates. The exact histogenesis of these epithelial cells remains a mystery and multiple theories have been offered. Although difficult to distinguish from malignant angiosarcomas solely on presentation and radiologic work-up, Masson's tumors occur more frequently in women, demonstrate no local invasion, do not metastasize, are commonly located intravascularly, and are associated with a significantly more favorable prognosis than angiosarcomas. Only four Masson's tumors have been reported in the gastrointestinal tract, two of these cases were related to microvascular thrombosis secondary to paroxysmal nocturnal hemoglobinuria and two were formed secondary to arteriovenous malformations. Our case lacked solitary evidence of either of these comorbidities. An incidental finding of an enlarged ovary, which was removed during our exploratory laparoscopy, plus strong demographic statistics that suggest women have an increased prevalence of this lesion may help support a hormonal theory of pathogenesis.
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PMID:Intraabdominal Intravascular Papillary Endothelial Hyperplasia (Masson's Tumor): A Rare and Novel Cause of Gastrointestinal Bleeding. 2110 39

A 27-year-old male presented with recurrent abdominal pain and high volume hematochezia despite undergoing extensive testing and a right hemicolectomy 3 years prior for a linear bleeding ulceration in the ascending colon. Studies at the University of Michigan included esophagogastroduodenoscopy (EGD), colonoscopy and video capsule endoscopy (VCE), revealing an arteriovenous malformation (AVM) in the terminal ileum. He was hospitalized for recurrent symptoms. His presentation suggested a small bowel source of obscure-overt GI bleeding based on prior non-diagnostic colonoscopy and EGD and a bilious nasogastric lavage. Tagged red blood cell scan localized bleeding to the right lower quadrant. Colonoscopy showed fresh blood in the terminal ileum without a clear source. Angiography showed no evidence of bleeding or terminal ileal AVM. A novel Meckel's scan fused with SPECT imaging showed focal uptake in the terminal ileum. The patient underwent Meckel's diverticulectomy with sparing of adjacent bowel and has remained asymptomatic for 19 months. This case illustrates that patients with obscure-overt GI bleeding require a step-wise multi-modality diagnostic work-up. Because Meckel's scans are false-positive in 28% of adults, Meckel's scan fused with SPECT imaging may offer an approach to refine diagnostic accuracy of either scan alone, but requires further investigation. Exploratory laparotomy should be reserved as a last option and is best performed with intraoperative endoscopy.
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PMID:Possible Role of Meckel's Scan Fused with SPECT CT Imaging: Unraveling the Cause of Abdominal Pain and Obscure-Overt Gastrointestinal Bleeding. 2149 Aug 44

Arteriovenous malformation (AVM) of the pancreas is a rare condition. Most patients are asymptomatic or alternatively may present with a wide spectrum of symptoms. Traditionally, surgery has been considered the treatment of choice; however, alternative approaches, such as transcatheter embolization (TAE), may be proposed. We report a case of a 48-year-old man with a pancreatic head AVM, presenting with upper abdominal pain and slight anemia. The patient refused surgery and underwent TAE by means of ethylene-vinyl alcohol copolymer (EVOH). At 3 months follow-up, the patient was able to eat regularly, with no residual pain and no signs of anemia.
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PMID:Pancreatic arteriovenous malformation involving the duodenum embolized with ethylene-vinyl alcohol copolymer (Onyx). 2195 9

An unusual case of pancreatic arteriovenous malformation (P-AVM) combined with esophageal cancer is reported. A 59-year-old man was admitted with upper abdominal pain. Contrast-enhanced computed tomography showed numerous strongly enhanced abnormal vessels and a hypovascular lesion in the area of the pancreatic tail. Angiographic study of the celiac artery confirmed racemose vascular networks in the tail of the pancreas. Endoscopic retrograde pancreatography revealed narrowing and displacement of the main pancreatic duct in the tail of the pancreas. Screening esophagoscopy showed a 0-IIa+IIc type tumor in the lower thoracic esophagus. Histological examination of esophagoscopic biopsies showed squamous cell carcinoma. Based on these findings, P-AVM or pancreatic cancer and esophageal cancer were diagnosed. Video-assisted thoracoscopic esophagectomy and distal pancreatectomy were performed. Histological examination of the resected pancreas revealed abundant abnormal vessels with intravascular thrombi. In addition, rupture of a dilated pancreatic duct with pancreatic stones and both severe atrophy and fibrosis of the pancreatic parenchyma were observed. The final diagnoses were P-AVM consequent to severe chronic pancreatitis and esophageal carcinoma. The patient's postoperative course was relatively good.
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PMID:Pancreatic arteriovenous malformation. 2457 46

Arteriovenous malformation of the pancreas (PAVM) is a very rare entity, although it may be increasingly diagnosed with the expanding use of cross-sectional imaging of the abdomen. PAVM is characterized by a network of tangled vasculature within and surrounding all or part of the pancreas, resulting in the shunting of the arteries of the pancreas directly into the portal venous system. Here, we present a patient with chronic abdominal pain and pancreatitis found to have PAVM, based on the findings of computed tomography, magnetic resonance imaging, endoscopic retrograde cholangiopancreatography, and angiography. Differential considerations are discussed. Although PAVM is uncommon, it should be considered in the differential of patients with recurrent abdominal pain or gastrointestinal bleeding.
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PMID:Multimodality imaging of pancreatic arteriovenous malformation. 2526 88

Ovarian vein syndrome is defined as obstructive uropathy caused by dilated ovarian vein with or without thrombosis. This is seen in the puerperal period as an acute condition with abdominal pain and fever and in multipara women with chronic recurrent abdominal pain. We report an ovarian vein syndrome caused by a true vascular anomaly in an 8-year-old child. Laparoscopic ureterolysis was performed with ligation of the arteriovenous malformation during the first operation. As ureterolysis was not effective, the patient was reoperated and ureteroureterostomy was performed after 3 months, which emphasizes the importance of removing the diseased segment even if it looks normal.
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PMID:Arteriovenous malformation causing obstructive uropathy: A different dimension to ovarian vein syndrome. 2537 30


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