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)

A 3 6/12-year-old previously healthy girl had intermittent attacks of abdominal pain following a blunt abdominal trauma. At admission to the hospital, she had jaundice and hepatomegaly. Results of laboratory tests indicated an obstructive pattern, and ultrasonography revealed an intraluminal mass in the distal common bile duct. At surgery, the mass was confirmed as the cause of obstruction, and it was removed. Microscopic analysis indicated that the amorphous material was fungi infested. Growth cultures from bile and feces yielded Candida albicans. Postoperative treatment with T-tube drainage and antimycotic drugs led to an uneventful recovery. Clinical, biochemical, and ultrasonographic follow-up have shown no evidence of recurrence. A possible cause and effect relationship between the trauma and the development of biliary obstruction is suggested.
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PMID:Common bile duct obstruction due to an intraluminal mass of candidiasis in a previously healthy child. 352 Apr 70

Primary bile duct carcinoma is a malignancy with a poor prognosis, but recent diagnostic developments allow earlier detection and possibly improved chances for effective palliation or surgical cure. In order to increase the clinical understanding and awareness of this disorder, 43 patients with primary adenocarcinoma of the bile ducts were reviewed. The mean patient age was 63, and symptoms of nausea, abdominal pain, and pruritus were reported in a majority of patients. Documented weight loss, alcoholic stools, cutaneous icterus, and hepatomegaly were each present in a majority of patients. Serum bilirubin and alkaline phosphatase determinations were abnormal in 40 of 43 patients (93%), and cholangiography was the diagnostic study providing the most discriminating information. Locally invasive disease and biliary obstruction was the major cause of morbidity and mortality, and there was only one surgical cure. These data suggest that cholangiography and nonsurgical techniques for biliary drainage should be employed in most patients who are not optimal surgical candidates.
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PMID:Primary adenocarcinoma of the bile ducts. Clinical characteristics and natural history. 352 44

The efficacy of nasogastric (NG) suction was evaluated in a prospective, randomized trial in 60 patients with acute pancreatitis of mild to moderate severity. Group I, NG (29 patients) was treated with NG suction, and group II, no NG (31 patients) was treated without NG suction. The presentation, cause of pancreatitis, and clinical parameters at the time of admission of the two groups were similar. The use of NG suction had no discernible benefit during hospitalization. There were no differences in duration of abdominal pain, the interval until bowel sounds returned, the need for narcotic administration, or the length of time intravenous fluid therapy was needed. When compared with group II, no NG, patients in group I, NG tended to resume oral intake later (5.0 +/- 0.3 versus 3.9 +/- 0.5 days) and remain hospitalized longer (13.1 +/- 2.6 versus 10.7 +/- 2.0 days). The incidence of serious complications, such as pancreatic abscess, pseudocyst, biliary obstruction, or pulmonary failure, was no different between the groups. This study demonstrates that the routine use of NG suction in patients with acute pancreatitis of mild to moderate severity is of no benefit in altering the clinical course.
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PMID:Prospective, randomized trial of nasogastric suction in patients with acute pancreatitis. 352 10

Oriental cholangitis is a progressive hepatic disease characterized by episodic biliary obstruction and sepsis. This is the report of a case of Oriental cholangitis in a nine-year-old girl. Oriental cholangitis should be considered in the differential diagnosis of upper abdominal pain in the susceptible population.
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PMID:Oriental cholangitis. 373 37

Post-traumatic biliary obstruction caused by a penetrating foreign body is rare. Our patient appears to be the first case in which the diagnosis was established by endoscopic retrograde cholangiopancreatography. Even though this entity is uncommon, it should be considered in patients presenting with jaundice and abdominal pain years after penetrating abdominal trauma.
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PMID:Late post-traumatic obstructive jaundice secondary to a biliary tract foreign body. 707 93

We report a patient with cystadenoma of the liver who presented with jaundice and abdominal mass. Although cystadenoma of the liver is a rare neoplasm, the lesion was diagnosed preoperatively by gray scale ultrasonography, PTC and ERCP. Characteristically, cystadenoma shows a multiseptated cystic appearance. While the origin of a cystadenoma is unclear, theories of synchronous development from anomalous bile ducts, endodermal diverticula, and ectopic germ cell origins have been promoted. Approximately 85% of patients with hepatic cystadenoma are women, with an insidious onset of symptoms due to the slowly growing nature of this tumor. Common symptoms include right upper quadrant mass, abdominal distension, and dull abdominal pain. Jaundice is less common. Complications include biliary obstruction, infection, hemorrhage, and rupture. As hepatic cystadenoma tends to recur after inadequate excision, and has malignant transformation potential, hepatic lobectomy has been promoted as definitive treatment.
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PMID:Cystadenoma of the liver. 708 9

Four cases of cholelithiasis in horses were reviewed. Two horses were examined because of recurrent abdominal pain. Clinical laboratory data, results of physical examination, and history indicated biliary obstruction. In 1 case, B-mode ultrasonography aided in the diagnosis, which was confirmed at necropsy. In 2 horses, the biliary calculi were incidental necropsy findings.
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PMID:Cholelithiasis in four horses. 710 89

Seventy-five patients with abdominal pain in the right upper quadrant who were subsequently confirmed operatively and histologically to have acute or chronic cholecystitis underwent radionuclide imaging of the biliary tree, ultrasonography, and/or computerized tomography before operation. fifty-eight of the patients had acute cholecystitis and 17 had chronic cholecystitis and cholelithiasis. Analysis of our data indicates that ultrasonography is an accurate and better screening test than cholescintigraphy in the diagnosis of chronic cholecystitis and cholelithiasis, but it is less accurate in the detection of acute cholecystitis. On the other hand, radionuclide imaging is highly sensitive and specific in the early diagnosis of acute cholecystitis, but it is poor in the diagnosis of chronic cholecystitis and cholelithiasis unless the cystic duct is obstructed. CT scanning is more expensive than ultrasonography but may be extremely helpful in problematic cases such as the diagnosis of the cause in biliary obstruction or in imaging of the pancreas.
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PMID:Comparison of ultrasonography, computerized tomography, and radionuclide imaging in the diagnosis of acute and chronic cholecystitis. 714 26

Carcinoma of the pancreas has a poor prognosis with a short survival time. Despite diagnostic advances, diagnosis is often delayed because early symptoms are frequently vague and non-specific. Symptomatic treatment is the only possibility in the large majority of patients with pancreatic cancer since curative surgical excision of the tumor is only possible in few cases. Symptoms managed, in the aim to improve the quality of life, include weight loss and anorexia, abdominal pain, jaundice secondary to biliary compression and digestives consequences of pancreatic surgery. Anorexia is a frequent complaint in patients with pancreatic cancer, and contributes to decreased caloric intake, weight loss and malnutrition. Patients who are unable to eat, due to obstruction or dysfunctional gastrointestinal tract, may benefit from enteral or parenteral nutrition. Patients whose main reason to not obtain adequate food intake is anorexia may benefit from recently developed pharmacologic strategies. Megestrol acetate often produce an improvement in appetite and weight gain in patients with advanced cancer. Jaundice can be treated by surgical biliary drainage or better still by palliative biliary endoprosthesis. Percutaneous transhepatic or endocopic biliary drainage are now well established methods for decompressing malignant biliary obstruction. Pain occurs in 80-85% of patients with advanced disease. Abdominal pain should be treated by oral non-narcotic analgesics, or, if necessary, potent narcotic analgesics, and sometimes by percutaneous block of the celiac ganglion, splancnicectomy or abdominal radiotherapy. Celiac plexus block with alcohol is the most common and well described therapy for the specific pain from carcinoma of the pancreas. Digestive consequences of pancreatic surgery also require symptomatic treatment.
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PMID:[Tumor of the pancreas. Support treatment]. 753 90

Attempts have long been made to use the prostigmine-morphine provocation test for the selection of postcholecystectomy patients suffering from sphincter of Oddi (SO) dyskinesia. Since the whole procedure is based upon the evaluation of subjective complaints, this test has frequently been criticized. To improve the diagnostic value of this method, we have visualized SO spasms during prostigmine-morphine provocation by means of quantitative hepatobiliary scintigraphy (QHBS). Twenty-two cholecystectomized patients with typical postprandial biliary pain were included in this study. In the first series of studies, QHBS with technetium-99m 2,6-diethylphenylcarbamoylmethyl-diacetic acid was performed in each patient 2 days before prostigmine-morphine provocation. The time to peak activity (Tmax) and the half-time of excretion (T1/2) over the liver parenchyma (LP), hepatic hilum (HH) and common bile duct (CBD), and the duodenum appearance time (DAT), were determined and served as control values. In the second series of experiments, sphincter spasms were evoked by prostigmine-morphine administration and visualized by means of QHBS. The same parameters were evaluated and serum levels of aspartate aminotransferase (AST) were determined simultaneously at regular intervals. In 12 patients who responded to prostigmine-morphine provocation with typical biliary pain and a significant AST elevation (Nardi positive group) the hepatobiliary scintigram demonstrated a marked biliary obstruction. Tmax and T1/2 over the LP, HH and CBD were significantly increased, while DAT was significantly longer relative to the corresponding data obtained without provocation. Four of the remaining ten patients indicated atypical abdominal pain during prostigmine-morphine provocation, but the AST level remained unchanged in all ten (Nardi negative group).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Evaluation of results of the prostigmine-morphine test with quantitative hepatobiliary scintigraphy: a new method for the diagnosis of sphincter of Oddi dyskinesia. 778 95


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