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

We have carried out a prospective survey of 28 primary liver carcinomas over one year. Hepatocellular carcinoma is the commonest malignancy seen in Rhodesian blacks, which results in a high index of suspicion and accounts for the 96.4% positive diagnosis before death in this study. The age distribution was evenly spread through adult life with no definite peak incidence. Some were young and without evidence of chronic liver disease, but many had the stigmata of established hepatic disease. This contrasts with the common assertion that in areas of high incidence for primary liver cancer those affected are mainly young and lack signs of chronic liver disease. The commonest presenting symptoms were abdominal pain and swelling and weight loss. Hepatomegaly, often tender and nodular, was present in all but one. The incidence of alpha-feto protein, 46.5%, is low compared with other countries where primary liver cancer is common. Hepatitis B antigen was absent in all 28, suggesting that there is no association between the persistence of the antigen and hepatocellular carcinoma in Rhodesia. Liver function tests, although abnormal, were never diagnostic of primary liver cancer. We have confirmed the association of high alcohol consumption and cirrhosis with hepatocellular carcinoma.
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PMID:Hepatocellular carcinoma in the Rhodesian African. 6 99

Five colorectal cancer patients with nonresectable metastatic liver cancer underwent continuous intraarterial chemotherapy in our institute from January to December 1991. Patients included four rectal cancers and one colonic cancer. 5-fluorouracil (5-FU) was infused continuously through an Infuse-A-Port; 360 mg/m2/day for one week after operation, and 180 mg/m2/day for the following three weeks. Since the fifth week after operation, two weeks without infusion and two weeks of infusion (180 mg/m2/day) were alternated as long as possible. Total periods of 5-FU infusion therapy were from one to 11 months and total doses of 5-FU ranged from 8,750 mg to 25,650 mg. Three patients showed partial response (PR) and two patients progressive disease (PD) (response rate; 60%). In three cases of PR, lengths of infusion therapy and total doses of 5-FU before PR was first observed was 8 weeks, 10,750 mg, 6 weeks, 9,250 mg, and 4 weeks, 8,750 mg, respectively. Four patients presented nausea, appetite loss or abdominal pain, which were considered to be side effects of 5-FU. In one of these four patients, infusion could not be continued because symptoms were so severe. However, catheter troubles were not noticed among all cases.
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PMID:[Continuous intra-arterial infusion chemotherapy in colorectal cancer patients with nonresectable metastatic liver cancer]. 153 Feb 98

Regional hyperthermia with a radiofrequency capacitive heating apparatus in combination with hepatic arterial embolization with degradable starch microspheres (DSM) was performed in 20 primary and six metastatic liver cancer patients. Efficacy was assessed primarily with regard to the improvement in heating efficiency. An angiocatheter was inserted into the hepatic artery in order to determine the DSM dosage adequate to arrest blood flow. The temperature rise in the tumours after heating alone and after heating combined with DSM embolization was compared. The maximum temperature and initial temperature rise within tumours were significantly improved by the combination therapy. Local tumour response could be evaluated in 10 primary and three metastatic liver cancer patients and tumour reduction over 50% was obtained in 40% and 33% respectively. Abdominal pain, nausea and vomiting, presumably due to reflux of the DSM, were experienced by several patients. In three patients heating could not be continued. However, all the symptoms were transient and responsive to symptomatic treatment, and no significant late complications were observed. Hepatic arterial embolization with DSM for liver tumours is considered effective and safe when combined with regional hyperthermia.
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PMID:Combined effects of hepatic arterial embolization using degradable starch microspheres (DSM) in hyperthermia for liver cancer. 171 74

Five patients with hypersplenism associated with liver cirrhosis were treated by PSE and the changes of peripheral blood cells and liver function tests were observed. After PSE, all patients had a high fever and abdominal pain continued for a few weeks without severe complications. Peripheral blood cell counts improved soon after PSE and liver function tests (hepaplastin test and ICGR15) grew transiently worse, but they also improved within two months. During 4.5 to 10 months, the levels of albumin and total cholesterol of three patients increased, although the changes of bilirubin level and HPT were not shown. For other two patients, it was difficult to estimate the effect of PSE, because one patient was treated at the same time with lipiodol chemoembolization for HCC and another patient had a progress of nephrotic syndrome. On the other hand, ICG levels were stable after PSE but RI-uptake on liver scintigram increased in the liver. These results suggest that PSE may be able to improve not only hypersplenism but also liver function in the patients with compensated liver cirrhosis without severe complication.
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PMID:[The effect of partial splenic embolization (PSE) on liver function test in patients with liver cirrhosis]. 206 49

Clinicopathologic analysis of nine patients with inflammatory pseudotumor of the liver was reported. The age of the patients varied from 22 to 83 years old, with a male to female ratio of 8 to 1. They complained of intermittent fever and abdominal pain, and laboratory data on admission suggested an inflammatory process. The solitary or multiple, well-defined space-occupying lesions were displayed by recently advanced imaging techniques. Partial hepatectomy, laparotomy, needle biopsy, or autopsy was performed in all nine patients with diagnoses of hepatocellular carcinoma, metastatic liver tumor, or liver abscess. Histologically, these lesions were composed of dense hyalinized fibrosis and/or infiltrating inflammatory cells constituting large numbers of foamy histiocytes, lymphocytes, and plasma cells. Obliterating phlebitis of relatively large branches of the portal vein was found, thus providing a diagnostic clue to distinction from the primary hepatic cancer by imagings. Considering the clinicopathologic features and the patients' histories, in which four patients had been in the Southeast Asian countries or India, it is possible that infection of microorganisms through the portal vein could participate in these lesions as a cause. Two patients died of causes probably related to this lesion, indicating poor prognosis in some patients, in contrast to the generally fair prognosis of previously published cases.
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PMID:Inflammatory pseudotumor of the liver. Clinicopathologic study and review of the literature. 215 99

Intratumor injection of OK-432, a biological response modifier, in the treatment of small HCC was studied in 7 inoperable patients. After evaluation with ultrasound (US), computed tomography (CT), angiography and US-guided biopsy, implantation of a steel coil in the tumor, intratumor injection was performed under US guidance. After completion of the treatment, liver biopsy and image studies were again done to evaluate the extent of tumor necrosis. One patient was alive and well without recurrence 19 months after treatment. Four had recurrent tumors at different site of the liver 4 months, 9 months, 9 months and 8 months later. Two died of progressive malignancy 3 months and 8 months later. In the 6 patients with elevated serum alpha-fetoprotein (AFP) levels, 4 had decreased AFP after treatment, and the 2 mortalities had steadily increased AFP. The most common side effects are fever and chills. Transient abdominal pain with elevated transaminase activities, cough with hemoptysis, and vomiting were seen in 1 case each. After treatment, the biopsy specimens showed total necrosis of HCC. Although the T4/T8 ratio of peripheral blood was increased as compared with that before treatment in 4 cases, peritumoral cytotoxic T lymphocyte and monocyte infiltration were seen in one specimen only, and another 7 examined specimens showed negative staining with monoclonal antibodies of T cells. We conclude that intratumor injection of OK-432 is an alternative treatment for small HCC in inoperable cases. The effectiveness may be due to the direct tumoricidal mechanism of OK-432.
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PMID:Intratumor injection of OK-432 for the treatment of small hepatocellular carcinoma. 217 23

HCC occurs infrequently in Western countries, with recent increases being reported in California and parts of Europe. Southeast Asia, Japan, and South Africa continue to have a high incidence of this tumor with HBV, cirrhosis, and the ingestion of aflatoxins being identified as probable risk factors. Although the majority of patients present with abdominal pain or mass indicative of extensive tumor, asymptomatic, small HCCs are being detected with increasing frequency. Early detection in high-risk individuals is best accomplished by screening with serum AFP determinations and liver ultrasonography. CT and arteriography are valuable preoperatively in defining anatomy and determining resectability. Five-year survival following resection for cure of HCC ranges from 20 to 40 per cent, with improved survival reported for small asymptomatic tumors. Resection of metastatic liver tumors from colorectal primaries results in 48 per cent 2-year and 24 per cent 5-year survivals, with an additional 5 per cent dying of recurrent cancer after 5 years. Although patients with simultaneous and metachronous metastases do equally well after resection, the presence of four or more individual deposits adversely affects survival. Hepatic artery ligation or embolization can produce a significant palliative reduction in total tumor mass in patients with unresectable liver metastases. Regional chemotherapy using implantable hepatic artery drug infusion pumps is promising, with reports of prolonged survival compared with historical controls. Regional hyperthermia, laser vaporization of tumor, and cryosurgical techniques may prove to have useful roles in the selective treatment of liver cancer in the future. Orthotopic liver transplantation has been successful primarily in those in whom the malignancy is found incidentally in the chronically diseased liver.
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PMID:Malignant tumors of the liver. 242 9

As a broad generalization, there appears to be little intrinsic difference in the biological behaviour of the common malignant liver tumours in respect of presentation, clinical course, clinical features and prognosis. Whatever the tumour's origin, patients present with some combination of abdominal pain, hepatomegaly, weight-loss and general malaise and death occurs within 3 years of the onset of symptoms. It is the state of the non-tumorous liver (cirrhotic/non-cirrhotic) and the anatomical site of the tumour (as with hilar cholangiocarcinomas) that are responsible for any significant differences. Metastatic carcinoid tumours, epithelioid haemangioendotheliomas, stage IV-S neuroblastomas and the fibrolamellar variant of HCC are exceptions to this rule with a genuinely better prognosis.
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PMID:The clinical features and natural history of malignant liver tumours. 303 58

Intra-arterial CDDP-Lipiodol infusion chemotherapy using an implantable port was effective in 10 unresectable liver cancer patients, including 7 hepatocellular and 3 metastatic cases. CDDP-Lipiodol suspension (10 mg of CDDP/1 ml of Lipiodol) was administered at the dose of 25 mg/m2 of CDDP biweekly from 2 to 9 times. The clinical responses were defined as 4 PR (40%), 5 NC (50%), including 3 MR, and 1 PD (10%). The efficacy rate was 40%. The level of AFP and CEA was reduced in all PR and NC cases except one. Side effects were nausea (70%), low-grade pyrexia (50%), abdominal pain (30%), and liver dysfunction (20%), but they were tolerable and transient.
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PMID:[Intra-arterial infusion chemotherapy of cisplatin (CDDP)-lipiodol suspension using implantable injection port for unresectable liver cancer patients]. 769 May 35

The Japanese Ministry of Health and Welfare Research Committee on Aberrant Portal Blood Flow carried out an epidemiological survey and clinical study on Budd-Chiari syndrome in 1990. In the primary survey for determining the prevalence of the disease, a questionnaire was sent to all major hospitals throughout Japan and 160 cases seen in 1989 were compiled. More epidemiological details were obtained in 87 of these 160 cases. The number of patients with Budd-Chiari syndrome in this country was estimated to be about 300 (prevalence of 2.4/million) with about 20 new cases occurring every year. In the clinical study, 157 authentic cases of Budd-Chiari syndrome studied in 15 years (1975-89) were analyzed. There were 87 males (average age, 36.4 years) and 70 females (46.5 years), and the average period from the likely onset to the first medical consultation was 6.6 years, suggesting that these patients were mostly chronic cases. The main clinical features were hepatomegaly, leg edema, ascites and venous dilatation over the trunk. Abdominal pain was recorded in only four (2.5%). There were 16 (10.2%) with known identifiable etiologies. Of the patients 93% showed an obstructing lesion of various thickness in the hepatic portion of the inferior vena cava. Only nine (5.7%) had hepatic vein obstruction without caval lesions. Thus, the majority of Budd-Chiari syndrome patients in Japan are idiopathic, having an obstructing lesion in the inferior vena cava. The main causes of 33 deaths (21%) were liver failure, variceal bleeding and hepatocellular carcinoma. Hepatocellular carcinoma occurred in 10 (6.4%) in the 15-year period. However, the incidence of Budd-Chiari syndrome among all cases of hepatocellular carcinoma was less than 1% in the survey made by the Liver Cancer Study Group of Japan.
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PMID:Epidemiological and clinical features of Budd-Chiari syndrome in Japan. 775 74


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