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 patient developed delayed life-threatening hemobilia after apparently uncomplicated percutaneous needle liver biopsy. An arteriobiliary fistula demonstrated by arteriography was successfully treated by selective transcatheter arterial embolization, with Gelfoam and a Gianturco coil. The diagnosis of liver biopsy-induced hemobilia should be suspected when a postprocedure fall in hematocrit is associated with abdominal pain, hyperbilirubinemia, or unexplained gastrointestinal bleeding. A review of the diagnosis and management of liver biopsy-related hemobilia is presented.
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PMID:Delayed massive hemobilia following percutaneous liver biopsy: treatment by embolotherapy. 144 53

Sixty patients with primary hepatic carcinoma (PHC) were treated with transcatheter hepatic artery infusion chemotherapy (TAI) and embolization (TAE) from June 1988 to December 1989. There were 54 males and 6 females. Their age ranged from 22 to 72 years with an average of 52. Course of disease ranged from 1/2 to 12 months. In these 60 cases, 31 had Stage II and 29 Stage III lesions. Using Seldinger's method per femoral artery, conventional hepatic angiography was performed. Afterwards, adriamycin or cisplatin infusion was carried out, followed by chemoembolization therapy of tumor vessels using mixture of ethiodized oil or iophendylate and mitomycin C. Finally, gelatin sponge block was used for proximal arterial embolization. After the treatment procedure, abdominal pain was relieved, tumor reduced in size, AFP, r-GT, AKP and LDH declined to various degrees and the survival time was prolonged. The 3-, 6- and 12-month survival rates were 93.3% (56/60), 67.3% (37/49) and 33.3% (9/27), respectively. It is indicated that TAI and TAE, being safe and effective, is the treatment of choice for patients with unresectable PHC.
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PMID:[Transcatheter hepatic artery infusion chemotherapy and embolization for 60 patients with primary hepatic carcinoma]. 165 88

To clarify the influence of Transcatheter Arterial Embolization (TAE) on the stomach, endoscopic examination was carried out before and after TAE. Forty-six TAE were performed in 27 patients with primary hepatoma. New gastric lesions, erosions and ulcers, were developed in 25 of 46 TAE. There was no significant relationship between the incidence of the lesions in the cases with esophageal varices (15/24) and the cases without (10/22) and there was no significant relationship between the incidence of the lesions after the first TAE (12/22) and after the second TAE (5/14). Period between the first and the second TAE had no statistical influence on the lesions after the second TAE. Hepatic functions (Child's classification; Rmax, K, R15 of ICG; serum total protein; serum albumin; total bilirubin; prothrombin time; hepaplastin test) before TAE were not statistically related to the appearance of the gastric lesions following TAE (Table 1). On the other hand, the cases which showed apparent effects of TAE including 0.2 time decrease of AFP had the more gastric lesions (P less than 0.05) (Table 2). The cases with upper abdominal pain after TAE had more gastric lesions (24/38) than the cases without (2/8) (P less than 0.05). But the cases undergone TAE with high possibility of the influx of gelatin sponge pieces, lipiodol or anticancer agents into the supplying vessels for the stomach did not exhibit significant incidence of the lesions (Table 3). Thus, when TAE is followed by a 0.2 time decrease in AFP, it is necessary to pay more attention to the gastric lesions. The prophylactic administration of H2 antagonist before or just after TAE did not seem useful to prevent the gastric lesions. These findings suggest that the influx of gelatin sponge pieces, lipiodol or anticancer agents to the stomach does not always cause gastric ulcer or erosion.
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PMID:[Factors of gastric lesions following after transcatheter arterial embolization for primary hepatoma]. 169 2

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

We examined the quality of life in the arterial infusion chemotherapy of hepatocellular carcinoma patients using a questionnaire. The questionnaire used a category scale method of five grades. The questions about the quality of life covered ten areas for investigation (appetite, discomfort pain, nausea, daily activities, sleep, fatigue, time with family and friends, thinking about illness and confidence in the treatment). We added up scale points after one week and those after two weeks after the treatment. Patients after one-shot infusion showed aggravated scale points of anorexia and discomfort. Patients after transcatheter arterial embolization showed scale points of abdominal pain, general fatigue and discouragement about illness. Scale points in matters of thinking about illness and confidence in the treatment informed us about confidence in the course of treatment and comprehension of illness by cancer patients. How do we measure the quality of our care? This is difficult, but we thought the rate of being at home in survival might furnish us with much information in respect to the treatment and the quality of our care. In 36 patients with hepatocellular carcinoma treated with transcatheter arterial infusion and embolization, the arithmetic mean survival time after treatment was 412.1 days and time at home was 305.6 days. The rate of being at home doing survival time was 74.2% after the arterial infusion chemotherapy in 39 patients. The rate of being at home in 9 cases with one-shot infusion of Adriamycin was 43.5% (111 days); that in 9 cases with infusion of Mitomycin C microcapsules was 86.6% (716 days); that in 17 cases with transcatheter arterial embolization using spongel was 72.0% (234 days),; and that in 4 cases with infusion using implantable reservoir was 84.6% (220 days). In non-resected patients with chemotherapy, the rate of being at home was 20.3% for 61 cases of gastric cancer patients, 30.7% for 11 cases of colon cancer, 9.6% for 14 cases of gallbladder cancer and 39.8% for 112 cases of lung cancer. The arterial infusion and embolization of hepatocellular carcinoma has made it possible to lengthen the time that patients may stay home and thereby assure good quality of life.
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PMID:[Evaluation of quality of life in arterial infusion chemotherapy of hepatocellular carcinoma]. 216 36

Transcatheter arterial embolization (TAE) has now been widely accepted in the treatment of hepatocellular carcinoma (HCC). Forty-five patients with tissue proven HCC received TAE and were followed up for more than 6 months; 28 of them were followed for more than one year and 13 for 2 years. The embolic materials used were Lipiodol 0.1-0.2 ml/cm2 (tumor area of its maximal diameter), which was prepared by pumping with contrast agent at a ratio of 1:2 and mixed with anticancer drugs (Mitomycin C: 8-10 mg or Adriamycin 40-50 mg), gelform particles 1-2 mm in size were subsequently embolized. The postembolization syndrome: abdominal pain, fever, nausea and vomiting usually subsided within 1-3 weeks. The overall cumulative half-year, 1-year and 2-year survival rates were 77.8%, 57.1% and 46.2%, respectively. Cases with regular follow-up and those with massive type without satellites, esp. when tumor size less than 5 cm, had better survival rates. In contrast, portal vein thrombosis and big tumors (especially with satellites) indicated poor prognosis. In addition, actively treated coexisting peptic ulcer and/or esophageal varices in HCC patients also improved TAE results.
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PMID:The outcome of hepatocellular carcinoma treated with transcatheter arterial chemoembolization. 217 16

Transcatheter arterial embolization (TAE) with the concurrent use of caerulein was assessed for the purpose of preventing gallbladder complications often seen after TAE of hepatic carcinoma. Ninety-six cases with primary hepatic carcinoma, who had undergone TAE in the right hepatic arterial region over the past 4 years, were divided into three groups: 22 cases for which embolization was possible on a selective basis by passing the catheter to the peripheral side beyond the bifurcated region of the cystic artery; 40 cases who had undergone TAE in which caerulein was not administered, from the central side of the bifurcated region of the cystic artery; and 34 cases given 20 micrograms caerulein 15-30 min before TAE. A comparison was made using the abdominal pain, pyrexia, rate of leukocytosis and the US findings of the gallbladder as the indices of the gallbladder complications. As a result, it became evident that it was possible to prevent or alleviate gallbladder complications if caerulein were administered before TAE in cases where the embolizing substances were infused in the right hepatic artery from the central side of the bifurcated region of the cystic artery. It was conclusively shown that the gallbladder blood flow decreases if the organ is contracted by caerulein, which in turn causes a decrease in the inflow of the embolizing substances whereby complications are alleviated.
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PMID:Alleviation of gallbladder complications by treatment of hepatic arterial embolization with caerulein. 253 68

There are few reports of the radiologic diagnosis of ruptured hepatic tumors. In a patient with right upper abdominal pain and impending shock, angiography demonstrated a hypervascular hepatic tumor, and CT imaged an extrahepatic mass suggestive of a hematoma. Following transcatheter arterial embolization with Lipiodol Ultrafluide and gelatin-sponge, multiple contiguous CT sections revealed numerous lipiodol droplets adjacent to a lipiodol-containing hepatic tumor, clearly outside the liver. These findings were indicative of a ruptured hepatic tumor. After embolization, the patient's condition improved and he was discharged.
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PMID:CT manifestations of a ruptured hepatic tumor after transcatheter arterial embolization. 255 46

Twenty patients with primary hepatic carcinoma (PHC) treated by hepatic arterial embolization in our department from Dec. 1986 to Mar. 1987 are reported. There were 15 males and 5 females. The ages ranged from 34 to 75 years with an average of 50.7. Preoperative diagnosis and localization of the tumor were done by AFP, B-us, CT and angiography (right lobe 15 cases, left lobe 1 case, both lobes 4 cases). Celiac and superior mesenteric angiography was carried out by femoral artery approach and then highly selective hepatic catheterization was utilized for hepatic arterial embolization. Antitumor agent (5-Fu, adriamycin), iophendylate and foamy gel sponge were used for peripheral and proximal embolization. Manifestations were improved in most of the patients after embolization, such as relief of abdominal pain, improvement of appetite, decrease of tumor size. Total necrosis of the tumor was found in 2 patients who underwent surgery 1 month after embolization. The side effects of the posthepatic embolization such as, nausea, vomiting, abdominal pain and fever could be relieved by symptomatic treatment. No severe complications, such as gangrene of the gall bladder, hepatic failure, liver abscess, intestinal necrosis or pulmonary embolization were found except 3 patients who died of renal failure after the procedure. The liver dys-function returned to normal within 2 weeks. Hepatic arterial embolization provides an alternative treatment for the patients with PHC who has compensated liver function without severe systemic diseases, especially renal endocrine problems and severe portal hypertension. They should have patent portal system as proved by angiography. The authors considered that this therapeutic embolization with hepatic chemotherapy infusion is safe and effective in the management of PHC. It may increase the resectability and provide palliative means for the advanced and terminal cases.
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PMID:[Hepatic artery embolization for primary hepatic carcinoma]. 255 66

We report on a 25-year-old patient diagnosed as having Bourneville tuberous sclerosis with a giant angiomyolipoma 16 X 12 cm. in diameter, and two small angiomyolipomas in the left kidney, multiple asymptomatic angiomas in the right kidney and two 1 cm. diameter angiomas in the liver. The presenting features were intense left-sided abdominal pain of sudden onset, frank hematuria, acute anemic syndrome, nausea and vomiting. Patient work up included x-ray of chest, abdomen, and skull, bilateral renal arteriography and ultrasound were diagnostic of Bourneville tuberous sclerosis with multiple bilateral renal angiomyolipomas. The hematologic and hemodynamic compromise and the almost completely absent intact parenchyma in her left kidney did not permit a conservative surgical procedure and the patient was submitted to a left nephrectomy. The patient had the following characteristic features of Bourneville's disease: epilepsy, intracranial calcifications on CT, sebaceous adenomas on face, fibromas under nails of left hand and foot, bony lesions in the form osteosclerosis and chylous pleural effusion. Her intelligence level was normal and no optic nerve phakomas were observed. The literature on angiomyolipoma and Bourneville's tuberous sclerosis is reviewed. The importance of using ultrasound and CT in combination to diagnose and follow up renal angiomyolipomas is highlighted. Treatment of angiomyolipomas must be based on two parameters: symptoms and size. Symptomatic angiomyolipomas warrant angiographic work up and selective arterial embolization or the most conservative surgical procedure possible (enucleation, partial nephrectomy). Asymptomatic angiomyolipomas warrant CT and/or ultrasound examination every 6 or 12 months depending on size.
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PMID:[Bilateral angiomyolipomas of the kidney in Bourneville's tuberous sclerosis]. 268 46


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