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

A middle-aged, obese, black woman complained of abdominal pain and tenderness in the left upper quadrant. An abdominal computerized tomographic (CT) scan revealed an encapsulated cystic mass in the tail region of the pancreas. Selective angiography confirmed mass and hypervascularity, definite encapsulation, and lack of capsular invasion. The diagnostic value of the CT scan, angiography, and special staining in classifying the excised pancreatic mass as an apudoma is discussed. Malignancy was excluded by the lack of capsular-vascular invasion and the absence of metastases. Nonfunctional status was determined by lack of hormone hypersecretion.
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PMID:Apudoma of the pancreas: benign or malignant? 274 81

60 patients with primary retroperitoneal tumor were reported. Among them, 26 cases were benign and 34 malignant. Abdominal mass was the most frequent presenting symptom (58.3%). The next was abdominal pain. The clinical course varied from 1 day to 22 years. Malignancy was predominant in patients with history less than one year. The size of tumor varied from 3 X 3 X 3 cm to 34 X 24 X 11 cm. Malignancy was more frequent in tumors larger than 10 cm in diameter. The location is decided mainly by displacement and compression of the gastrointestinal tract in barium meal examination and displacement or compression of the kidney or ureter and the presence of hydronephrosis in intravenous pyelography. The final diagnosis can only be established by pathological examination on celiotomy. All 60 patients were operated and the lesion of 43 was resectable. In the 20 with malignant tumor resected, only 8 patients are alive, while all the 26 patients with benign tumor are surviving, though 3 of them had unremovable lesions. The treatment is to resect the tumor as thorough as possible, including the adjacent invaded organs. Recurrence is likely for which resection should be reconsidered if possible. Radiotherapy or chemotherapy should be given to patients with lymphosarcoma, unremovable tumors and residual lesions after resection.
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PMID:[Primary retroperitoneal tumor]. 375 73

Hemangiopericytoma is an uncommon vascular tumor with variable malignant potential. The origin, structure and function of pericytes remains controversial. Intra-abdominal hemangiopericytomas are highly aggressive soft tissue tumors with a great propensity for malignant transformation. We report on a case of hemangiopericytoma of the pancreas in a 53-year-old female presenting with abdominal pain. Ultrasonography and CT scan revealed a cystic tumor of the head of the pancreas. The patient underwent successful pancreaticoduodenal resection and is alive with no signs of recurrence 25 months following surgery. Ultrastructural studies are necessary to differentiate hemangiopericytomas from other sarcomas. Malignancy may be ascertained only in the presence of metastases or local recurrence. Routine surveillance is advocated.
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PMID:Hemangiopericytoma of the pancreas: report of a case and review of the literature. 767 67

The case of a 50-year-old man with abdominal pain and abnormal liver test results is described. Endoscopic retrograde cholangiopancreatography with manometric studies showed biliary dilatation, poor ductal drainage, and sphincter of Oddi dysfunction. Clinical and radiographic clues suggested the possibility of an ampullary lesion; a small ampullary adenoma was detected after endoscopic sphincterotomy, and ampullary carcinoma was found in the operative specimen. Malignancy can cause sphincter dysfunction not only in the esophagus (as pseudoachalasia) but in the ampulla of Vater as well.
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PMID:Sphincter of Oddi dysfunction caused by an ampullary neoplasm. 780 47

A case of right lower quadrant pain in a 53-year-old postmenopausal female who underwent appendectomy 21 years previously is presented. Recurrent appendicitis with rupture was noted in the appendiceal stump on exploratory celiotomy after diagnosis by computed tomography scan. Although rare, pathology of the appendiceal stump, whether inverted or not, is a real entity that can be encountered on laparotomy. Malignancy and hemorrhage can also occur in the appendiceal remnant, but the large number of disorders that can cause acute right lower quadrant abdominal pain makes appendiceal stump pathology extremely difficult to detect preoperatively. Because of the extensive differential diagnosis, timely operative intervention for clinical peritonitis in this region should not be delayed.
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PMID:Delayed pathology of the appendiceal stump: a case report of stump appendicitis and review. 797 78

The aim of the study was to determine the aetiology of large and symptomatic pericardial effusions and to review the management and subsequent outcome. A survey was done on a consecutive cases of patients who had undergone percutaneous pericardiocentesis over a 10 year period in a city centre general hospital serving a multiethnic catchment population. In all, 46 patients (24 male, 22 female; age range 16 to 90 years, mean 54 years) underwent a total of 51 pericardial drainage procedures (or attempted pericardiocentesis) between 1989 and 1998. Malignancy (44%), tuberculosis (26%), idiopathic (11%), and post-cardiac surgery (9%) were the most common causes of pericardial effusion. The most common presenting symptoms were breathlessness (90%), chest pain (74%), cough (70%), abdominal pain (61%) (presumed to be related to hepatic congestion), and unexplained fever (28%). In the 12 cases of tuberculous pericarditis, nine occurred in patients of Indo-Asian origin, and three in patients of Afro-Caribbean origin. Fever, night sweats, and weight loss were common among these patients, occurring in over 80% of cases of tuberculous pericarditis. Pulsus paradoxus was the most specific sign (100%) for the presence of echocardiographic features of tamponade, with strongest positive predictive value (100%). Although malignancy remains the most common cause in developed countries, tuberculous disease should be considered in patients from areas where tuberculosis is endemic. Percutaneous pericardiocentesis remains an effective measure for the immediate relief of symptoms in patients with cardiac tamponade, although its diagnostic yield in tuberculous pericarditis is relatively low.
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PMID:Management of pericardial effusion by drainage: a survey of 10 years' experience in a city centre general hospital serving a multiracial population. 1108 87

Annular pancreas is a congenital anomaly resulting from malrotation of the pancreatic ventral bud. Although annular pancreas in the adult is rare, it may be recognized with increased frequency as a result of more liberal use of pancreatic imaging studies in patients with chronic abdominal pain and suspected chronic pancreatitis. Malignancy in the setting of annular pancreas is an uncommon event that has been reported previously but has almost always been related to the annular (ventral) segment. We report an interesting case in which pancreatic adenocarcinoma diffusely involving the dorsal (nonannular) segment presented in a middle-aged female patient. This unusual presentation points out the importance of considering neoplasia as part of the differential diagnosis and the possibility of pancreatic pathology in the dorsal, nonannular segment when there is no obvious duodenal or biliary obstruction involving the annular ventral segment.
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PMID:Diffuse pancreatic adenocarcinoma identified in an adult with annular pancreas. 1523 92

Adult intussusception is uncommon and requires a surgical approach. Malignancy is associated with 31% (43/137) of small bowel intussusception and 70% (74/106) of large bowel intussusception. Computerized tomography (CT) findings are pathognomonic for this condition. Often, the patient presents with long-standing, nonspecific complaints. A 63-year-old man presented with sudden onset of abdominal pain. CT demonstrated colonic inflammation. A laparoscopic right hemicolectomy for ileocecal intussusception was performed. The pathology report revealed a lipoma of the cecum. The postoperative course was uneventful, and he was discharged the fifth postoperative day. Despite a high incidence of malignancy, colonic or ileocecal intussusception can be successfully treated by laparoscopic resection. Review of the literature and treatment options are discussed.
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PMID:Ileocecal intussusception in an adult: the laparoscopic approach. 1688 31

The present patient was a 50-year-old male with sudden upper abdominal pain. The patient exhibited pallor, and physical examination revealed a rigid abdomen. Abdominal x-ray revealed free air, and emergency laparotomy was performed to confirm upper gastrointestinal tract perforation. A perforated lesion of approximately 1 cm in diameter was found on the anterior wall at the gastric angle. The area surrounding the lesion was tumor-like, and the posterior wall was fused invasively with the pancreas. Malignancy was suspected; however, considering the patient's general status, greater omentum grafts were opted for. The patient was diagnosed with type III gastric cancer by gastroendoscopy post-operatively, and TS-1/CDDP therapy was started on the 28th day after surgery. After three courses of treatment, the tumor was found to have smoothened, wall consolidation was improved, and a second surgery was performed. During laparotomy, a nodule in the round ligament of liver was found and removed; however, there were no other medical findings that raised suspicion of peritoneal dissemination or liver metastasis. It was concluded that radical surgery was possible, and distal gastrectomy (D 2) was performed. Pathological examination revealed that signet ring cell carcinoma was present on only part of the mucous membrane. The lower and muscle layers of the serous membrane and the nodule in the round ligament of liver were replaced by fibrous tissue, indicating the disappearance of cancer cells. Two years and three months after surgery, the patient exhibited no signs of recurrence.
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PMID:[A case of perforated gastric cancer in which complete response was confirmed with resection following TS-1/CDDP combined chemotherapy after omentopexy]. 1710 34

Ten cases of pheochromocytoma in horses were obtained from the literature and a computer search of medical records. The clinical, laboratory and pathological features of pheochromocytoma in horses were reviewed. Pheochromocytoma is a catecholamine secreting tumor which tends to occur in older horses without breed or sex predisposition. It is usually unilateral adrenal medullary in location and benign. Malignancy was present in one horse. The most common clinical signs were sweating, tachycardia, tachypnea, muscle tremor and anxiety; however the tumor may be asymptomatic. Clinical signs were nonspecific and could be confused with other diseases, especially abdominal pain. Hyperglycemia is a consistent finding. Venous norepinephrine levels were measured in normal horses. Norepinephrine measurements may prove to be a diagnostic aid in horses with pheochromocytoma.
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PMID:Pheochromocytoma in the horse and measurement of norepinephrine levels in horses. 1742 50


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