Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Although restricted transhepatic portal flow is necessary for development of generalized portal hypertension (GPH), increased splanchnic arterial inflow also contributes to GPH and its clinical sequelae. In this context, we describe 7 male and 6 female patients (mean age 48 years) in whom the lesser splanchnic (gastrosplenic) system played a key role in the signs and symptoms of GPH. These 13 patients (9 with hepatic cirrhosis, 3 with primary myeloproliferative disorder, and 1 with extrahepatic portal block) shared common features of massive splenomegaly, huge splenofundic gastric varices, often with a prominent natural shunt to the left renal vein. Total or near total splenectomy alone or combined where appropriate with coronary vein ligation was effective in controlling varix hemorrhage (10 patients), ascites (3), or complications of an enlarged spleen-anorexia and abdominal pain (3), hemolytic anemia (1) and profound thrombocytopenia with severe epistaxis (1). Intraoperative jejunal portal venography was crucial in operative management in order to establish definitively the presence or absence of coronary venous collaterals, and when present, to verify their operative ligation. These distinctive patients illustrate: 1) GPH is a heterogeneous syndrome of divergent splanchnic circulatory patterns, a feature which should be taken into account in selecting operative treatment; 2) one well-defined subgroup displays prominent hyperdynamic lesser splanchnic and specifically, splenic blood flow as a major contributor to clinical complications; and 3) within this subgroup, splenectomy combined with documented absence or surgical interruption of coronary venous collaterals as corroborated by intraoperative portography is effective alternative treatment.
 ...
PMID:Preeminence of lesser splanchnic blood flow in selected patients with generalized portal hypertension. 227 22

A 60-year-old man with primary splenic hemangiosarcoma (PSH) presented with weakness, weight loss, abdominal pain, and anemia. Physical examination revealed hepatomegaly, ascites, and firm, huge splenomegaly. Ultrasonography showed many nodular structures characterized by hypoechogenic and hyperechogenic areas. The patient also had portal hypertension, which was confirmed by physical findings and by measurement of portal vein pressure during operation. A liver-spleen scan using Tc-99m sulfur colloid and Tc-99m labeled heat denatured erythrocytes failed to demonstrate any splenic uptake, a reliable feature of functional asplenia. Although on a total body scan with Ga-67 citrate there was no splenic uptake, there was gallium uptake in the liver, where the presence of the metastatic lesion was histopathologically verified and confirmed by operation. There was also uptake in the middle zones of the lungs. Ga-67 citrate imaging appears to be helpful in the diagnosis of metastasis of PSH, and PSH can rarely cause portal hypertension.
 ...
PMID:Functional asplenia and portal hypertension in a patient with primary splenic hemangiosarcoma. 234 Jun 75

A study of morbidity and side effects of treatment with praziquantel in relation to intensity of infection with Schistosoma mansoni was conducted in 406 infected individuals from a newly-settled village in Metekel, north-western Ethiopia. Each subject was submitted to a standardized medical history and abdominal palpation. The frequencies of hepatomegaly and splenomegaly were low, 2% and 3%, respectively. A positive association was found between egg load and a history of blood in the stool. Interviews on side effects were conducted on the day following treatment with praziquantel (40 mg/kg body weight). Positive correlations with egg load were found for several side effects, including abdominal pain, diarrhoea, headache, back pain, and vomiting. Unusual side effects involving swelling of various parts of the body confirm 2 previous reports from a different region in Ethiopia and should be investigated further.
 ...
PMID:Schistosoma mansoni infection in a new settlement in Metekel district, north-western Ethiopia: morbidity and side effects of treatment with praziquantel in relation to intensity of infection. 251 35

Gastrointestinal manifestations of brucellosis in 340 Saudi Arabian patients are reported. Sixty seven per cent of patients presented with gastrointestinal disturbances. The most frequent symptoms were anorexia (40%), abdominal pain (16%), vomiting (11%), and diarrhoea (6%). Hepatomegaly (32%), splenomegaly (29%) and abdominal tenderness (15%) were major abnormalities on physical examination. In endemic areas for brucellosis, gastrointestinal disturbances in the presence of fever of obscure etiology, should raise the possibility of brucellosis.
 ...
PMID:Gastrointestinal manifestations of brucellosis in Saudi Arabian patients. 262 79

Traumatic rupture of the spleen has been well described in the medical literature and is found in approximately 30% of patients undergoing surgery for blunt abdominal injury. Atraumatic splenic rupture is described much less often. A case of atraumatic rupture of an enlarged spleen is described. The etiology of spontaneous rupture of the spleen in this case could not be determined. The patient was seen and discharged twice from the emergency department; the diagnosis was made at emergency laparotomy three days after subsequent admission. This case should remind the emergency physician that nontraumatic splenic rupture should be considered in the differential diagnosis of unexplained acute left upper quadrant abdominal pain.
 ...
PMID:Spontaneous rupture of the spleen: a case report and literature review. 264 58

Infectious mononucleosis is an acute viral illness associated with a high incidence of splenomegaly, although the incidence of splenic rupture is low. When rupture occurs, the mortality has been significant, presumably, because a history of trauma is not present. The spleen may be vulnerable to injury due to the histopathologic changes that occur as a result of this illness. Essentially all patients with spontaneous rupture related to infectious mononucleosis have epigastric or upper abdominal pain. The diagnosis of splenic rupture may be confirmed in a variety of ways. In those patients who are hemodynamically stable, CT scan, ultrasound, or radionuclide scan may aid in establishing the diagnosis. Selective splenic angiography is very accurate but has been largely abandoned because of the invasive nature of the study. Peritoneal lavage is efficacious in establishing the diagnosis in hemodynamically unstable patients. The treatment of choice, at this time, is splenectomy. Current interest in splenic salvage has resulted in reports of nonoperative therapy in stable patients and splenorrhaphy in one instance. Due to the extent of the histologic changes in the spleen, caution is urged in electing the conservative approach to this clinical situation.
 ...
PMID:Splenic rupture and infectious mononucleosis. 269 60

Three patients with infectious mononucleosis and splenic injury were managed nonoperatively. Mechanisms of injury included significant left upper quadrant trauma during a football game in a 17-year-old boy, a minor fall in a 16-year-old girl, and no apparent trauma in the remaining patient, a 28-year-old man. All had significant abdominal pain and two were hypotensive upon admission. All had computerized tomographic scan documentation of splenic enlargement, significant injury, and free peritoneal blood. Paracentesis was not performed. Only the first patient received transfused blood. The hospitalization period ranged from nine to 14 days. Gradual and finally complete healing (return to normal size) was documented in all three patients. Follow-up is 66, 14, and 10 months. Although clearly controversial and not free from danger, successful nonoperative management of the injured enlarged spleen in select patients with mononucleosis is possible in an appropriate setting.
 ...
PMID:Splenic injury: nonoperative management in three patients with infectious mononucleosis. 272 83

Of 501 patients with chronic myeloproliferative diseases (c-MPD) 18 developed thrombosis of major abdominal vessels including 6 with hepatic vein thrombosis (Budd-Chiari syndrome). The complication was seen in 14 of 140 (10%) patients with polycythemia vera (PV), 3 of 23 (13%) patients with essential thrombocythemia (ET), 1 of 106 (1%) patients with idiopathic myelofibrosis (IMF), and none of 232 patients with chronic myelogenous leukemia (CML). Leading symptoms and signs were abdominal pain, progressive splenomegaly, widening abdominal girth, ascites, venous collaterals, and nausea and vomiting. The diagnostic modalities with highest specificity were angiography and explorative laparotomy. A causal relationship between the thrombotic event and hematocrit, thrombocyte count, or hemostatic abnormalities at the time of diagnosis could not be established. Detailed laboratory tests of platelet function and coagulation and fibrinolytic parameters of 5 surviving patients did not show any specific defect. Despite medical and surgical intervention, 39% of the patients died within 2 months after diagnosis of the thrombosis. The majority of the survivors developed further complications like liver cirrhosis with portal hypertension and esophageal varices or the short bowel syndrome after extensive bowel resection for mesenterial infarction.
 ...
PMID:Budd-Chiari syndrome and thrombosis of other abdominal vessels in the chronic myeloproliferative diseases. 279 52

We examined 56 French Canadians, aged 1 week to 54 years, from eastern Quebec who were referred to the Laval University Lipid Research Centre and in whom coincidental finding (in 46% of the cases), abdominal pain (in 32%) or family screening (in 22%) led to the diagnosis of primary lipoprotein-lipase-activity deficiency (familial hyperchylomicronemia). Half of the patients had one or more of the following signs: lipemia retinalis, eruptive xanthomas, splenomegaly and hepatomegaly; the plasma triglyceride concentrations were significantly higher (greater than 40 mmol/L) among these patients than among those without clinical signs (mean 21.7 [standard deviation 13.5] mmol/L). The prevalence rate of this disorder was 30 times higher than the previously published rate and was highest in the counties of Charlevoix and Saguenay-Lac-St-Jean (200 and 100 cases per million respectively) because of the distinct demographic history of these areas. Because of a founder effect an autosomal recessive gene involved in lipoprotein-lipase expression or activation has probably been disseminated among this isolated French Canadian population.
 ...
PMID:Primary lipoprotein-lipase-activity deficiency: clinical investigation of a French Canadian population. 291 62

The histological changes in cytomegalovirus (CMV) infection were first described by RIBBERT in 1881, and for years the virus was dreaded as the agent of infection in newborns. An infectious mononucleosis-like disease with negative heterophil antibodies in otherwise healthy adults was described in 1965. We present six previously healthy adults with CMV mononucleosis observed in 1984. The diagnosis was established by CMV-IgM-ELISA. All patients were febrile for an average of 20 days. The general state of health was reduced in three patients; one patient suffered from headache and another from abdominal pain. Physical examination showed splenomegaly and mild tonsillitis in one patient each, but in no case lymphadenopathy. All patients had lymhocytosis with reactive forms (virocytes). Elevation of transaminases was seen in four cases. Compared to Epstein-Barr virus mononucleosis, fever in CMV mononucleosis lasts significantly longer and lymphadenopathy is evidently rarer. The combination of fever of unknown origin, a negative heterophil antibody titer and the presence of virocytes prompts suspicion of CMV mononucleosis.
 ...
PMID:[Clinical aspects of cytomegalovirus infection in nonimmunosuppressed adults]. 301 71


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>