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)

In 19 patients with gastrointestinal tumors the diagnosis was made by ultrasound. 7 patients were examined for further investigation of an abdominal mass; 12 patients, presented with symptoms suggesting malignants, e. g. weight loss, vomiting, fever, abdominal pain, and/or anaemia from bloodloss were first investigated by ultrasound. In 5 patients with colon tumors, diagnosed by ultrasound, a resection and anastomosis was possible. 13 cases were found to be inoperable during laparotomy, one patient had an ileocolitis Crohn with stenosis. Ultrasonic examination with real-time scanning technique proved to be a valuable method as a screening procedure for patients with suspected gastrointestinal tumors. During the same procedure local (mesenteric) or liver metastases can be detected. A normal abdominal ultrasonography does not exclude malignant intestinal lesions in any location during the early stage and in the region of cardia and rectum even in the more advanced stage.
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PMID:[The use of ultrasound in the diagnosis of gastrointestinal tumors (author's transl)]. 68 40

Casuistically is reported on two patients with an endocrine inactive ileum carcinoid, in whom the anamnesis with 5 weeks or 10 months was very short and atypical. Continuously increasing abdominal pain and gradual formation of a lower ileus of the small intestine or profuse watery diarrhoeas were the leading symptoms. Intraoperatively or autoptically in each case a very small (less than 1.5 cm) ileum carcinoid was found, which had led to a stenosing of high degree, there were no fibroses of the endocardium, no liver metastases--accordingly the secretion of serotonine metabolites (5-HIES) in the urine had been normal. The possibility of a so-called endocrine-nervous enteropathy in the female patient with the diarrhoea symptomatology and the necessity of a rapid diagnostic clarification in suspicion of a tumour in the lower small intestine are discussed, since such a suspicion in most cases corresponds to a carcinoid and thus there exists a great chance of cure.
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PMID:[Clinical aspects of the endocrinologically inactive small intestinal carcinoid]. 70 3

Breast liver metastases are uncommon and have not been well reported. We studied the clinical outcome of 47 patients who developed liver metastases out of 912 breast cancer patients treated between 1982 and 1987, an incidence of 5.2%. The median disease free interval prior to clinical liver metastases was 20.2 months (range 4-192 months). The most frequent clinical presentations were hepatomegaly (70%) and abdominal pain (34%). The diagnosis was confirmed on ultrasound scan in 72.7% patients. Thirty-one patients (70.5%) received specific treatment with both hormone and chemotherapy but only six showed any evidence of objective response, the majority of whom had metastases only in the liver. The median survival of treated patients was 4 months and absence of jaundice, response to treatment and liver metastases only were associated with significantly better survival. In conclusion breast liver metastases usually present as a manifestation of disseminated disease and have an appalling prognosis. When they occur as an initial site the prognosis is better but very few patients overall respond to conventional treatment.
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PMID:Breast liver metastases--incidence, diagnosis and outcome. 140 13

Twenty patients with histologically verified carcinoid liver metastases underwent a total of 24 liver artery embolizations by means of interventional radiologic techniques. There were no deaths. The postembolization syndrome, consisting of fever, abdominal pain, nausea, and vomiting, occurred in all the patients. Severe complications were rare, the most serious being multiple hepatic abscesses with septicemia in one patient, septicemia in another, and mild acute pancreatitis in a third. All these three patients recovered without any sequels from the embolization, and none required surgical intervention. The hepatic abscesses were drained percutaneously, guided by ultrasound. Hepatic artery embolization seems justified in patients with disabling symptoms from the carcinoid syndrome, as long as alternative therapy with the same benefit but fewer complications is not available.
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PMID:Side effects and complications after hepatic artery embolization in the carcinoid syndrome. 187 48

A 23-year-old man was admitted with progressively disturbed vision and easy fatigability. CT scans demonstrated an enhanced mass in the sellar region. Physical and endocrinological examinations revealed atrophy of both optic nerves, temporal field cuts in both eyes, and panhypopituitarism. Concentrations of human chorionic gonadotropin (HCG) in the serum and cerebrospinal fluid were 12 and 33IU/L, respectively. On November 11, 1987, the tumor was partially removed using the transsphenoidal approach. The histological diagnosis was germinoma with syncytiotrophoblastic giant cells. Following postoperative craniospinal irradiation (whole brain, 30Gy; local, 18Gy; spinal canal 28Gy), CT scans showed no residual tumor and the HCG levels decreased until they were undetectable. Eighteen months later, the patient complained of abdominal pain. His serum HCG level had increased to 2,554 IU/L. CT scans of the abdomen revealed multiple low density areas in the liver. Chest X-ray was negative. A Ga scintigram disclosed only liver metastasis. Administration of a chemotherapy was started on June 26, 1989. Cisplatin and etoposide in doses of 20mg and 40mg respectively were given for 5 consecutive days in one course. Following four courses of the combined chemotherapy, the tumor entirely disappeared on CT scans and the HCG level returned to normal. The patient is now able to work well without evidence of recurrence. Multiple liver metastases of an intracranial germ cell tumor had been fatal in previous reports. This may be the first case with liver metastases in which the victim is still alive. The present case indicates that combined chemotherapy with cisplatin and etoposide is effective for extraneural metastases of an intracranial germ cell tumor.
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PMID:[Multiple liver metastases of a suprasellar germ cell tumor treated with combined chemotherapy of cisplatin and etoposide]. 189 Oct 59

Transcatheter chemoembolization using degradable starch microspheres (DSM) was performed in 17 patients with liver metastases of colorectal cancer. DSM, 45 microns in diameter, which are easily degraded by serum amylase, and therefore obstruct arterial blood flow temporarily at the arteriolar capillary bed. DSM mixed with mitomycin C were administered through the catheter introduced by Seldinger's method in 13 cases, and through subcutaneously implanted drug delivery system (Port-A-Cath) in 4 cases. The treatment was repeated 5 times on the average at intervals of 2 to 4 weeks. The therapeutic effect of this chemoembolization was evaluated by the change in tumor size measured by angiography or computed tomography. Tumor regression of over 50% was observed in 9 of 17 cases (53%). Elevated serum CEA levels (greater than 10 ng/ml) decreased in 10 of 15 cases (67%). One-year survival rate was 48% in 17 cases, and among them it was 100% in 7 cases with the extent of several liver metastases (H2). Extrahepatic metastasis was observed in 3 of 17 cases (18%) before the treatment, and in 8 cases (47%) after the treatment. Abdominal pain occurred in 36% of the cases by the administration of DSM, but the pain disappeared within 2 hours. No major side effects such as bone marrow suppression or hepatotoxicity were observed. Our results suggest that chemoembolization using DSM is effective and safe in the treatment of liver metastases from colorectal cancer.
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PMID:[Chemoembolization with degradable starch microspheres for liver metastases of colorectal cancer]. 190 74

Ten patients, seven women and three men, ages 47 to 76 years (mean 58.6 years), treated for adrenal cortical carcinoma between 1971 and 1989, were reviewed. Three (30%) of the tumors were nonfunctioning. The remaining seven (70%) were functioning, six of them occurring in women. Common presenting features were hormonal excess, distant metastases, weight loss, and abdominal pain. The primary tumor was resected in all patients, only two of whom had disease confined to the adrenal gland. Tumor diameter ranged from 9 to 21 cm (mean 15.7 cm). Inferior vena caval or right atrial extension of tumor thrombus was present in two patients. Excluding two deaths from postoperative complications, seven patients died of their disease after a mean survival of 25 months (range 2 to 84 months). Of seven patients who received o,p'-DDD treatment for metastatic or recurrent tumor, three (43%) had an objective response. In two patients, tumor regression was complete and was associated with prolonged survival. The first patient underwent resection of recurrent tumor on two occasions in addition to receiving o,p'-DDD and survived 84 months. The second patient had complete regression of pulmonary and liver metastases confirmed at laparotomy and thoracotomy and remains free of disease at 78 months. None of the five patients treated with various combinations of cytotoxic chemotherapy had an observable response, and no measurable effect was seen in a single patient following abdominal radiotherapy. It is concluded that resection for local recurrence may prolong survival and that significant and lasting tumor regression is possible with o,p'-DDD administration. Beneficial results from cytotoxic agents, however, could not be demonstrated.
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PMID:Adrenocortical carcinoma. 192 92

Seven patients with severe pain caused by an advanced, incurable gynecologic malignancy were treated with an indwelling epidural catheter connected to an implantable subcutaneous port through which morphine was infused. There were few major complications associated with insertion or maintenance of the system. The average usage was 60 days, although the system functioned continuously for 6 months in one patient. Pain distribution in these women ranged from the upper abdomen to the lower extremities. All patients, including one with liver metastases, reported good to excellent pain control with the epidural narcotics. Two subjects with upper abdominal pain occasionally required supplemental oral oxycodone, but the other five patients had adequate pain relief with the epidural system alone. The indwelling epidural system provides excellent analgesia for patients with advanced, incurable gynecologic cancer.
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PMID:Indwelling epidural catheters for pain control in gynecologic cancer patients. 200 93

In an attempt to determine the natural history of ductal adenocarcinoma of the pancreas in patients under 40 years of age, we reviewed the surgical outcomes of all such patients seen at the Mayo Clinic from 1970 to 1985. Histologic sections were reviewed; islet cell tumors and cystadenocarcinomas were carefully excluded. Twenty-six patients were identified. Their mean age was 34 years, with only one patient less than 25 years old. Symptoms included primarily abdominal pain, weight loss, and jaundice. One third of patients had a recent or past history of pancreatic disease including pancreatitis, pseudocysts, benign cystadenoma, and choledochal cyst. The tumor was located in the head of the gland in 62% of patients. "Curative" resections were possible in only three patients (12%); the remaining patients underwent palliative bypass (38%), biopsy alone (42%), or a palliative resection (8%). The hospital mortality rate was 12%, with actual 1-, 2-, and 5-year survival rates of 19%, 8%, and 4%, respectively, with a median survival of 4 months. The only long-term survivor underwent biliary bypass at age 15 years for a large neoplasm in the head of the gland; despite biopsy-proved liver metastases at that time, she continues to do well 5 years later. Histologic review indicated this tumor to be a "solid and papillary neoplasm of the pancreas." Ductal adenocarcinoma of the pancreas in young patients is an aggressive tumor with a poor prognosis behaving much like ductal adenocarcinoma in older patients (greater than 40 years). In rare instances a more favorable outcome can be expected when a solid and papillary neoplasm is found.
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PMID:Nonendocrine cancer of the pancreas in patients under age forty years. 216 85

In 1947, a patient with metastatic islet cell tumor was treated for intractable ulcer disease at the University of Chicago Medical Center. Eight years later, in retrospect, it was recognized that he and another patient had the Zollinger-Ellison syndrome (ZE). From 1947 until the present, 30 patients with the ZE syndrome have been treated at this institution. Twenty-one (70%) were male and 9 (30%) were female. Their ages ranged from 24 to 76 years. Most (79%) had abdominal pain, however, melena (42%), hematemesis (33%), and severe diarrhea (35%) were prominent as well. Symptoms were present for a mean of 5.8 years before diagnosis. Over their entire clinical course, duodenal ulcers occurred in 96% of patients, gastric ulcers in 24%, jejunal ulcers in 29%, esophageal ulcers in 6%, and stomal ulcerations in 58%. Eleven (38%) of all gastrinomas were proved to occur in the duodenum; 10 (34%) were pancreatic in origin, including 3 with the MEN I syndrome; 3 (10%) were extrapancreatic and extraduodenal in origin, and no tumor was found in 5 (17%). Each of the 3 patients with MEN I developed a proven pancreatic islet cell carcinoma with metastases as well as hyperparathyroidism and a pituitary lesion. Of 27 patients who were explored for gastrinoma, tumor was found in 20 (74%). Excluding patients with MEN who had multiple lesions throughout the pancreas, all tumors were found in the "gastrinoma triangle." Total gastrectomy was performed in 10 (37%) of 27 of all patients who were explored, in 5 (71%) of 7 when no tumor was found, and in only 5 (25%) of 20 when tumor was present. Operative mortality was 15% (4 of 27) but no death has occurred since 1974. Long-term survival has followed both tumor resection or total gastrectomy in selected individuals (including 1 patient with known multiple liver metastases who is alive 18 years after liver biopsy and total gastrectomy); however, since malignant gastrinomas were present in 46% of all patients (or 57% in whom tumor was found) and since local metastases can sometimes be removed, we favor an aggressive approach to localization and resection when liver metastases or other distant metastases are not found. Duodenal gastrinomas are particularly favorable for resection for cure. They were malignant in only 36% and their metastases were nodal in each of 4 cases. The major problem is finding them since they are often small and "occult."(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Gastrinomas: a 42-year experience. 236 40


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