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)

Seventeen patients with chronic hyperamylasemia were studied using standard clinical and laboratory parameters, amylase/creatinine clearance ratios, and polyacrylamide gel electrophoresis of serum amylases. These patients, none of whom had evidence of pancreatic disease or other specific source for the elevated serum amylase, fell into three groups: (1) Normal serum isoamylase profile and normal amylase clearance (6 patients). We postulate that the generalized hyperamylasemia may be due to reduced extrarenal catabolism of amylase, a previously undescribed phenomenon. (2) Macroamylasemia and very low amylase clearance (9 patients). Seven of the nine patients had recurrent epigastric pain. Evidence for an autoimmune basis is discussed. (3) Salivary-type hyperamylasemia and low amylase clearance (2 patients). This entity may really be macroamylasemia in which the macroamylase complex dissociated during analysis. Chronic hyperamylasemia is often not of pancreatic origin. The assumption that the pancreas is at fault, especially if there is abdominal pain, may cause morbidity due to gross overtreatment.
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PMID:Macroamylasemia and other chronic nonspecific hyperamylasemias: chemical oddities or clinical entities? 63 93

A report from a medium-sized community hospital of 4 additional cases of hepatocellular adenoma is presented. Of these, 3 were pedunculated tumors. A 29-year-old woman, gravida 7, had been taking Enovid-E for 8 years. After 3 attacks of epigastric pain a mass was detected in her right upper abdomen. Surgical exploration revealed the mass pedunculated from the right hepatic lobe. The mass was excised. 3 years later a liver scan was normal. The histological appearance of the tissue resembled mature hepatic architecture without protal areas or bile ducts. A 34-year-old woman, gravida 4, para 2, had been taking Enovid-E for 6 years. She previously had had a partial thyroidectomy for carcinoma of the thyroid and later radical neck dissection for metastatic thyroid carcinoma. A mass was detected in the right abdomen. At operation, a pedunculated mass was found attached to the right hepatic lobe with 2 smaller nodules. All lesions were excised. The microscopic picture was similar to that of the other patient. A 24-year-old woman, gravida 4, para 3, had been taking Oracon for 1 year. Upper abdominal pain, vomiting, and diarrhea were complained of. An upper abdominal mass was present. At operation, a 9 cm mass was excised. The histology was the same as in the previous cases. A 28-year-old woman, gravida 2, para 1, had been taking Ovulen for 5 years. An abdominal mass was present. Surgical exploration revealed a nodular mass pedunculated from the left lobe of the liver. The mass was excised. Histological appearance was similar to the other 3 tumors. Of 42 other reported cases of similar tumors, the mean age was 27.3 years. About 40% had been admitted as emergency cases with hemoperitoneum. Almost 20% had complained of upper abdominal pain. A palpable mass was usually present. Multiple nodules were found in 13% of cases. For nonemergency cases, selective hepatic angiography has been a reliable method of diagnosis. The treatment has been resection of the tumor when feasible. However, regression of tumors has occurred when exogenous hormone influence ceased. The outcome has been fatal in 8 cases. The low incidence of this tumor is not considered sufficient cause to justify discontinuing use of oral contraceptives.
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PMID:Hepatocellular adenoma and oral contraceptives. 127 46

We report a patient with classical features of amiodarone hepatotoxicity who died of progressive liver failure. Throughout the course of his illness, he had epigastric pain, nausea, vomiting, and persistent mild to moderate elevation of amylase and lipase in his serum and peritoneal fluid. Pancreatitis due to amiodarone has not been reported. We raise the question of whether or not the pancreas is yet another organ subject to amiodarone toxicity and speculate as to possible pathogenesis. We suggest that patients on amiodarone who develop abnormal liver enzymes, nausea, vomiting, or abdominal pain be evaluated not only for hepatotoxicity, but for pancreatitis as well.
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PMID:Can pancreatitis be associated with amiodarone hepatotoxicity? 168 30

We hypothesized that selective ordering of serum amylase in the emergency department (ED) is justified because (a) most patients with elevated amylase can be prospectively identified by characteristic clinical findings, and (b) the diagnosis of pancreatitis is usually predominantly based on clinical findings, since amylase is known to be neither sensitive nor specific for pancreatitis. The study population included 133 consecutive patients with a chief complaint of abdominal pain who had amylase drawn over a 2-week period at a university hospital ED. Patients with known major trauma were excluded. Emergency department and hospital charts were reviewed for selected clinical variables. The first part of our hypothesis was evaluated by comparing clinical characteristics of cases (elevated amylase) and controls; the second part was tested by comparing clinical findings and amylase in cases (patients diagnosed as having pancreatitis) and controls. We found that 17 patients with and 116 without elevated amylase were similar with regard to all clinical variables, and that no combination of findings could be used to predict elevated amylase. Amylase level was not predictive of an ultimate diagnosis of pancreatitis, which was, however, strongly related to classical clinical findings. Pancreatitis risk factors, epigastric pain and tenderness, radiation of pain to the back, and nausea and vomiting were each statistically more common in patients diagnosed as having pancreatitis (regardless of amylase) than in patients in whom pancreatitis was excluded despite elevated amylase; all patients diagnosed with pancreatitis had at least two of these. Thus, selective ordering of amylase on the basis of clinical characteristics fails to identify a large proportion of patients with elevated amylase.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Serum amylase determination in the emergency department evaluation of abdominal pain. 171 39

A 12-year-old boy presented with a 7-year history of intermittent colicky epigastric pain. Serial abdominal ultrasound studies showed a contracted gallbladder, and single and double dose oral cholecystograms demonstrated nonfunction. All other investigation results were normal. At cholecystectomy, there was a fibrotic stricture at the junction of the gallbladder neck and cystic duct. The small, thin-walled gallbladder contained white bile. Histologically, the gallbladder was lined with normal mucous secreting columnar epithelium. The area of stricture showed diffuse fibrosis with islands of heterotopic gastric mucosa containing all gastric mucosal cell types. One year postoperatively, there have been no further episodes of abdominal pain. This is the seventh reported case of heterotopic gastric mucosa in the gallbladder of a child causing symptoms necessitating cholecystectomy. We recommend that a child with abdominal pain and a nonfunctioning gallbladder be considered for cholecystectomy even in the absence of cholelithiasis.
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PMID:Heterotopic gastric mucosa in the gallbladder: a cause of chronic abdominal pain in a child. 181 60

The Chinese traditional drug "Hua Jiao" specified in the Chinese Pharmacopoeia 1990 edition is the dried pericarp of ripe fruit of Zanthoxylum schinifolium Sieb. et Zucc. or Z. bungeanum Maxim., family Rutaceae. It has been used for epigastric pain accompanied by cold sensation, vomiting, diarrhea and abdominal pain due to intestinal parasitosis, ascariasis and used externally for eczema. By the investigation of the drug resources in the main producing areas and distributing regions (Sichuan, Guangxi, Henan, Liaoning, Zhejiang, Anhui, Jiangsu and Shandong Provinces or Autonomous Regions), we found that there are pericarps derived from more than 18 spp. of Zanthoxylum used as drugs in China. In this paper, the morphological and histological characters of crude drugs derived from the following 8 species, viz. Zanthoxylum bungeanum Maxim., Z. schinifolium Sieb. et Zucc., Z. armatum DC., Z. simulans Hance, Z. avicennae (Lam.) DC., Z. ailanthoides Sieb. et Zucc., Z. molle Rehd. and Z. nitidum (Roxb.). DC. were described with illustrations. It was discovered that such features as the external characters of pericarp, the occurrence of hairs on fruit stalk, the presence and location of pigment and crystals of hesperidin, the thickness of the cell walls of endocarp and the presence and shape of nonglandular hairs on fruit stalk were important for the identification of these drugs.
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PMID:[Morphological and histological studies of Chinese traditional drug "hua jiao" (pericarpium zanthoxyli) and its allied drugs]. 182 95

In a retrospective study performed on 125 patients with histologically diagnosed giardiasis, it is shown that this disease can lead to a variegated picture involving numerous gastroenterological symptoms. The main symptoms noted were epigastralgia (41%), diarrhoea (32%), nausea and vomiting (23%), and loss of weight (20%). The material for histological diagnosis was obtained in hospitals in 49% of the cases, in the doctor's office in 32%, and in two gastroenterological rehabilitation centres in 19%. The average duration of symptoms before establishment of the diagnosis was 2.01 years (range: 1 week to 30 years). In only 8% of the cases was the disease preceded by a visit to an endemic area. Treatment with nitroamidazole preparations completely relieved symptoms in 78% of the patients and remained unsuccessful in 4%; for the remaining 18% of the patients, no follow-up data were available. On the basis of these results, it is recommended that in patients with upper abdominal pain, diarrhoea, loss of weight, meteorism, flatulence, nausea and vomiting, the possibility of giardiasis should be considered, and that during endoscopy, two or three forceps biopsies should be obtained from macroscopically normally-appearing mucosa of the descending part of the duodenum to enable a histological search for Giardia lamblia.
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PMID:Giardiasis--a simple diagnosis that is often delayed. 195 49

A 50-year-old woman complained of upper abdominal pain for several weeks, getting worse and radiating towards the left shoulder in the 24 hours preceding her hospital admission. Plain X-ray film of the abdomen revealed plaque-like calcifications projecting onto the tail of the pancreas. Ultrasound imaging demonstrated splenic rupture with free intra-abdominal fluid. During an emergency laparotomy the spleen was removed. At first the postoperative course was uneventful. But epigastric pain recurred a few days after discharge. Serum amylase and lipase concentrations were elevated (280 U/l and 553 U/l, respectively). Endoscopic retrograde cholangiopancreatography revealed chronic pancreatitis with a 3 cm pseudocyst in the tail of the pancreas. A papillotomy was performed, after which the symptoms rapidly regressed and the pancreatic enzyme concentrations fell. This was thus a case of spontaneous splenic rupture associated with previously undiagnosed chronic pancreatitis with inflammatory papillary stenosis and pseudocyst in the pancreatic tail.
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PMID:[Spontaneous splenic rupture in chronic pancreatitis]. 200 88

The syndrome of haemolysis, elevated liver enzymes and low platelets (HELLP Syndrome) is a consequence of severe preeclampsia/eclampsia. The clinical course is characterized by an unusual presentation with abdominal pain, and manifestations of inadequate haemostasis and excessive bleeding are common. Maternal and perinatal morbidity and mortality are high. We report our experience with 33 patients over a five-year period. The mean gestational age (GA) of the pregnancies was 34 +/- 2.8 wk including 11 patients who delivered 12 neonates of less than 34 wk GA. The most common presenting complaints were right upper quadrant or epigastric pain in 25 patients (76%) and nausea or vomiting in 14 patients (42%). Diagnosis was missed or delayed in 12 patients (36%). Thirty-one patients (94%) were delivered by Caesarean section and a deteriorating maternal condition was the most common indication for operative delivery. Twenty-three patients received general anaesthesia, eight received epidural anaesthesia and there were no complications related to the anaesthetic. There was clinical evidence of abnormal haemostasis: seven patients had excessive blood loss at Caesarean section, two had postpartum haemorrhage, three developed DIC and four developed wound haematoma. The average decrease in haemoglobin concentration was 32 g.L-1 and twelve patients (36%) received blood transfusions. There was one stillbirth. There were no neonatal deaths but morbidity was prominent and related primarily to prematurity. Delayed or missed diagnosis is common in HELLP syndrome and a premature delivery by Caesarean section is usual.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Obstetrical anaesthesia for patients with the syndrome of haemolysis, elevated liver enzymes and low platelets. 173 44

One hundred and thirty-seven consecutive outpatients with non-ulcer dyspepsia (NUD) and erosive prepyloric changes (EPC) were randomly allocated to double-blind treatment with 400-micrograms misoprostol tablets twice daily or placebo for 4 weeks. Misoprostol had a significant worsening effect on epigastric pain, nausea, meteorism, lower abdominal pain, and diarrhoea, as compared with placebo. The fact that symptoms in patients with NUD and EPC were exacerbated by an antisecretory dose of misoprostol indicates that the symptoms are largely unrelated to gastric acid.
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PMID:Misoprostol treatment exacerbates abdominal discomfort in patients with non-ulcer dyspepsia and erosive prepyloric changes. A double-blind, placebo-controlled, multicentre study. 212 24


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