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Query: UMLS:C0000737 (
abdominal pain
)
31,184
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Diagnostic and therapeutic ERCPs are complicated by pancreatitis in 1% to 10% of patients, and evidence suggests that the contrast agent used for ERCP may be important in the pathogenesis of such pancreatitis. This prospective, double-blind study was undertaken to determine whether the use of a low-osmolality, nonionic contrast agent (Omnipaque 300; iohexol, 672 mOsm/kg H2O) would reduce the frequency and severity of postprocedure pancreatitis as compared to a high-osmolality, ionic contrast agent (
Hypaque
50%; diatrizoate sodium, 1515 mOsm/kg H20). Six hundred ninety patients undergoing diagnostic ERCP (pancreatogram, cholangiogram, or both) either with or without sphincter of Oddi manometry and therapy were randomized to iohexol or diatrizoate sodium. Postprocedure pancreatitis was diagnosed when the serum amylase or lipase level was elevated to at least four times the upper limits of normal at 18 hours and was associated with increased
abdominal pain
persisting for at least 24 hours after the procedure that required administration of narcotic analgesics. The pancreatitis was graded as mild, moderate, or severe depending on the length of hospital stay and the need for intervention. The overall frequency (7.2% versus 7.5%) and severity (4.3% mild, 2% moderate, 0.9% severe for the diatrizoate sodium group versus 4.3% mild, 2.6% moderate, and 0.6% severe for the iohexol group) of postprocedure pancreatitis and the frequency and severity within each procedure category were similar for the two contrast agent groups (p > .05).(ABSTRACT TRUNCATED AT 250 WORDS)
...
PMID:Post-ERCP pancreatitis: randomized, prospective study comparing a low- and high-osmolality contrast agent. 792 31
A 49-year-old premenopausal woman presented with acute onset of lower
abdominal pain
. Physical examination revealed her abdomen was distended and nontender. Her white blood cell count and serum markers for ovarian cancer were normal (alpha-fetoprotein level, 1.6 microg/L; Ca-125 level, 15 U/mL; beta-human chorionic gonadotrophin level < 2 IU/mL). She had no important medical history; in particular, she had no history of malignancy. She denied having any chest symptoms; in particular, she denied experiencing chest pain, cough, or dyspnea. She had stopped smoking at the age of 40 years after having smoked for a total of 20 pack-years. A computed tomographic (CT) examination of the abdomen and pelvis was performed. Helical CT was performed with 150 mL of intravenous contrast material (iohexol, Omnipaque; Amersham Healthcare, Cork, Ireland) and 750 mL of oral contrast material (diatrizoate sodium,
Hypaque
; Amersham Health, Princeton, NJ). CT sections were 5 mm thick and were acquired from the top of the diaphragm through the ischial tuberosities with a rotation time of 13.5 seconds per rotation and use of a LightSpeed 16 CT scanner (GE Medical Systems, Milwaukee, Wis).
...
PMID:Case 116: lymphangioleiomyomatosis. 1758 10