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)

The serum behavior of amylase, pancreatic isoamylase, lipase, trypsinogen, and elastase 1 was studied in 145 patients with pancreatic disease and in 66 patients with abdominal pain of nonpancreatic origin, for the purpose of evaluating the relative diagnostic utility of their assays. In 34 patients with acute pancreatitis, serum lipase, trypsinogen, and elastase 1 were elevated in all 34, pancreatic isoamylase in 33 (97%) and amylase in 30 (88%). Ten of these acute pancreatitis patients were followed sequentially for seven days: the variations in their serum enzyme levels were parallel, although the lipase, trypsinogen, and particularly the elastase 1 elevations persisted longer than did those of amylase and pancreatic isoamylase. Among the patients with chronic pancreatitis, either in painful relapse (N = 19) or with pancreatic cysts (N = 15), the respective percentages of enzymes elevations were: 79 and 80% for elastase 1, 68 and 67% for trypsinogen, 63 and 73% for pancreatic isoamylase, 58 and 60% for lipase, 53 and 60% for amylase. In the 52 chronic pancreatitis patients studied during clinical remission, serum enzyme behavior varied greatly, and a majority of the assays (60%) were normal; even in the case of severe pancreatic exocrine insufficiency, normal as well as abnormally high and low enzyme values were seen. Highly variable enzyme behavior was also seen in the 40 patients with pancreatic cancer, and elastase I was the most frequently (35%) elevated enzyme in this group as well. Among the patients with abdominal pain of nonpancreatic origin, abnormally high enzyme levels were present in percentages ranging from 6% for lipase to 21% for trypsinogen.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Role of serum pancreatic enzyme assays in diagnosis of pancreatic disease. 279 21

Fine needle aspiration biopsy guided by ultrasonography was performed in 39 patients with pancreatic cancer to evaluate the value of the technique for establishing a proved histologic diagnosis. Aspirated material suitable for cytologic evaluation of smear preparation was obtained from 33 patients (84.6%). Among the 33 patients, cytologic diagnosis of pancreatic cancer was possible in 28 patients (84.9%). There was mild abdominal pain only in one patient (2.6%). In conclusion, percutaneous fine needle aspiration biopsy guided by ultrasonography proved to be a safe and useful method for histologic diagnosis of pancreatic cancer.
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PMID:Percutaneous fine needle aspiration biopsy of pancreatic cancer guided by ultrasonography. 248 42

Sixteen patients with mesenteric venous thrombosis were reviewed retrospectively during a period from 1983 to 1987. Twelve patients had progressive abdominal pain, three had gastrointestinal bleeding, and one had general malaise. Seven of these 16 patients had previous deep-vein thrombosis. After negative routine gastrointestinal and hepatobiliary evaluation, 11 patients underwent an infusion computerized tomographic scan. Of these, 10 had superior mesenteric vein thrombosis; three of these 10 patients had portal vein thrombosis. Selective arteriography was done in two patients because of gastrointestinal bleeding, and a diagnosis of mesenteric vein thrombosis was made on the venous phase of the examination. The remaining four patients developed acute abdominal symptoms requiring surgical exploration, at which time mesenteric venous thrombosis was discovered. An identifiable coagulopathy was detected in nine patients (protein C deficiency in six, protein S deficiency in two, and factor IX deficiency treated with factor IX concentrate in one). No case of congenital antithrombin-III deficiency was identified. Six of these nine patients had a past history of deep venous thrombosis. Of five patients who underwent surgical exploration, all required bowel resection. In follow-up, two patients died of intestinal necrosis and a third died of associated pancreatic cancer. Thirteen patients were discharged from the hospital. Treatment of coagulopathy was by heparin in three patients and sodium warfarin (Coumadin) in four patients. Long-term anticoagulation was not instituted because of gastrointestinal bleeding in three and cirrhosis in three patients. Mesenteric venous thrombosis can occur without gangrenous bowel. Diagnosis should be suspected when acute abdominal symptoms develop in patients with prior thrombotic episodes and a coagulopathy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Mesenteric venous thrombosis. 172 86

Plasma concentrations of CA-50 antigen in samples from patients suffering from pancreatic cancer, chronic pancreatitis and abdominal pain of unknown origin were analysed by three different techniques, using the same monoclonal antibody, C-50 Mab. These methods include an inhibition assay, an immunoradiometric assay (IRMA), and a dissociation-enhanced lanthanide fluoro-immunoassay (DELFIA). Whereas all three methods had high sensitivities for cancer, they displayed different specificities. With respect to the differential diagnosis between pancreatic cancer and chronic pancreatitis, all three methods are of value, with slightly better discrimination for the inhibition test, and easier performance and better analytic ranges for the IRMA and DELFIA methods.
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PMID:CA-50 in patients with pancreatic disease--an evaluation of three different laboratory techniques. 307 Jul 17

A Phase I trial of intraperitoneally administered 5-FU and citrovorum factor was performed in eight patients with a variety of malignancies. Both drugs were given according to a single weekly dose schedule in a volume estimated to be 2000 cc, including residual ascites. Citrovorum factor 50 mg was given first, immediately followed by 5-FU 1000-3400 mg, according to a dose-escalating schedule. Myelosuppression proved to be the dose-limiting toxicity, though mucositis, diarrhea, nausea, and abdominal pain were also produced. Six patients failed to respond to therapy. One patient with malignant mesothelioma showed a significant decrease in the production of malignant ascites and a transient conversion of peritoneal fluid cytologies from positive to negative, while a second patient with pancreatic cancer showed conversion of peritoneal fluid cytologies from positive to negative and demonstrated an objective partial response of an hepatic metastasis. Dosage adjustment according to body surface area would seem indicated by the toxicity data, with a 5-FU dose of 1200 mg/m2 body surface area and citrovorum factor 50 mg/m2 being recommended for Phase II trials of this combination of drugs given according to this weekly schedule.
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PMID:Phase I trial of intraperitoneal chemotherapy with 5-fluorouracil and citrovorum factor. 348 98

Early pancreatic carcinoma is defined as a tumor of less than 2 cm in diameter, limited to the pancreas without extension to adjacent structures or organs and without lymph-node and distant metastasis (T1a, N0, M0). In analysing 693 pancreatic cancer patients seen at the Surgical Clinic of Erlangen since 1969 we found only 3 early lesions (0.4%). There is a variety of diagnostic signs like unexplained abdominal pain, the development of pancreatic insufficiency, weight loss in excess of 10%, sudden onset of diabetes and elevation of serum and urine amylase. These early symptoms should be clarified by special pancreatic screening tests (ERCP, CT, US, angiography). CT and US alterations may be missing, because of the small tumor size. The proof of a pancreatic duct stenosis indicates laparotomy and resection. One of three of our patients survived longer than 6 years without recurrence. As reported, the 5-year-survival rate of early pancreatic cancer is 86%.
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PMID:[Early cancer of the exocrine pancreas: diagnosis and prognosis]. 356 19

The aim of this study was to evaluate the endoscopic retrograde pancreatographic (ERP) findings in respect of alcohol intake. Two hundred eleven patients consecutively submitted to ERP for upper abdominal symptomatology, with suspected pancreatic disease (SPD; 79 patients) or without (NSPD; 132 subjects), were classified in 3 groups of different ethanol intake: 1 (0-40 g/day), 2 (41-80 g/day), 3 (more than 80 g/day). The following conclusions could be drawn: (1) the frequency of ERP changes increases with the increase of alcohol intake both in SPD (34.6-63.8%) and NSPD (8.2-29.8%); (2) the frequency of pancreatic cancer was not related to alcohol intake, but in NSPD it was about 2-fold that in SPD: 12/132 (9.1%) vs 4/79 (5.06%); (3) a pancreatic morphological assessment, by means of ERP or other imaging techniques, should be performed in every subject with upper abdominal pain of unknown origin both in alcoholics (for the high incidence of chronic pancreatitis) and in non-alcoholics (for the risk of pancreatic cancer, which approximates 10%).
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PMID:Frequency of pancreatographic changes in subjects with upper abdominal symptoms and its relationship with alcohol intake. 369 81

This report deals with the study of 25 patients with carcinoma of the pancreas without jaundice. Carcinoma of the pancreas is the fourth most common cause of death among men who suffer from cancer. The extremely high mortality associated with pancreatic cancer is due to failure of early diagnosis. Those cases associated with obstructive jaundice can be diagnosed much earlier than those in which jaundice is absent. In the absence of jaundice, symptoms and signs of pancreatic cancer are so vague that they may be confused with those of other conditions. Routine laboratory tests aid little in the definitive diagnosis of the disease. Sophisticated new modalities of diagnosis such as ultrasonography, endoscopic retrograde cholangiopancreatography (ERCP), and CT-scanning frequently will lead to a correct diagnosis, but these tests are seldom performed unless there is a strong suspicion that carcinoma of the body of the pancreas exists. When pancreatic carcinoma without jaundice is ultimately diagnosed, it is found to be less amenable to surgery than lesions located in the head where early jaundice is more often encountered. Most patients with cancer of the body of the pancreas suffer from persistent unexplained abdominal pain, marked anorexia, and weight loss. Such patients must be subjected to sophisticated diagnostic tests in order to arrive at an early diagnosis.
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PMID:Carcinoma of the pancreas in nonjaundiced patients. A silent disease. 388 16

Decision analysis is a valuable tool for studying diagnostic strategies in gastroenterology. Multiple comprehensive patient management strategies can be compared in hypothetical populations of patients with varying characteristics reflecting real clinical situations which could not be readily empirically studied. Measures of clinical outcome can be compared and cost effectiveness ratios calculated. Analyses of the diagnostic approaches to suspected obstructive jaundice and pancreatic cancer presenting as abdominal pain are discussed as examples. A useful decision analysis combines the best data available in a clinically relevant fashion. Although decision analysis cannot replace empiric research, it helps clarify reasons for the uncertainty so common in clinical practice and provides insight into the diagnostic process that might otherwise be elusive.
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PMID:Decision analysis for the practicing gastroenterologist. 2. Insights into the efficacy of diagnostic strategies using decision analysis. 389 May 24

During a 12 year period 42 patients underwent a pancreatoduodenectomy, on 35 occasions because of malignancy. Four patients (11%), all with pancreatic cancer, died in the postoperative period. Two of the seven patients with pancreatitis died (28%). No patient with pancreatic cancer survived one year. Seven of the 11 patients with distal common bile duct cancer survived one year and five out of seven patients with carcinoma of the ampulla of Vater survived one year. Local tumor recurrence occurred in at least 18 of 27 patients (67%), upper abdominal pain being the most important symptom. At long follow-up three patients had tumor recurrence in the laparotomy scar. In our experience resection offers the only chance of cure for patients with a tumor of the ampulla of Vater or the distal common bile duct. At present, however, resection is not the treatment of choice in patients with pancreatic cancer.
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PMID:Is there still a place for Whipple's operation? 402 19


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