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

The clinical course of 40 patients with histologically proven hepatocellular carcinoma was reviewed. The majority had symptoms and signs suggesting abdominal malignancy; these included abdominal pain, weight loss, tenderness in the right upper quadrant, hepatomegaly, and fever. The most useful diagnostic tests were determination of serum alkaline phosphatase level, sodium sulfobromophthalein (Bromsulphalein) excretion, and liver scan. Prothrombin time and bilirubin levels were normal or only slightly elevated. Celiac angiography was helpful in determining the extent of the disease. Surgical exploration was done in 25% of the cases, but in only 5% was resection attempted. The grim prognosis is indicated by the fact that only 10% of patients were alive six months after admission to the hospital.
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PMID:Hepatocellular carcinoma: a clinical study. 17 24

Twenty-six cases of miliary tuberculosis were studied in retrospect. The mean age of the patients was 62 years. Eighteen patients suffered from another underlying chronic disease. Nine had been treated with corticosteroids or cytotoxic agents. A limited manifestation of tuberculosis had been previously verified or suspected in ten cases. Fever was present in 85% of the patients, frequently combined with fatigue or abdominal pain. Serum alkaline phosphatase was elevated in 81% of the cases. Minor haematological abnormalities (anaemia, etc.) were found in 16 cases and pancytopenia, stimulated lymphocytes or chronic myeloid leucaemia in six. Miliary mottling was found in the chest radiographs of 13 patients. Other findings were pleural effusion, mediastinal node enlargement, opacities suggesting pneumonia or old, possibly tuberculous lesions. Antituberculosis therapy was initiated in 12 patients, two of whom died within a few days. There was a high frequency of liver or system involvements. It is concluded that laparoscopy or liver needle biopsy are valuable diagnostic procedures in patients with fever and elevated alkaline phosphatases of unknown aetiology. A therapeutic test with antituberculous drugs should be undertaken in suspected cases.
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PMID:Miliary tuberculosis. 39 82

Ten episodes of massive transaminase increase with hepatic necrosis were observed in 7 patients after infusion of megluminioglycamide (Biligram). The patients were 3 men and 4 women aged 49 to 65 years with biliary tract disease (n = 1), recurrent pancreatitis (n = 1), hyperlipidaemia and minimal toxic liver damage (n = 1), pyelonephritis (n = 1), , arteriitis (n = 1), and pseudo-LE (n = 1). In 6 patients there was an increase of the alkaline phosphatase without icterus before the investigation and a slight increase of transaminases in 3 patients. After infusion of 100 ml of Biligram in 5 patients and of 200 ml in 2 patients there was an abrupt increase of GPT (98-2202 U/l) with a lesser increase of GOT. The alkaline phosphatase activity remained unchanged. Three patients showed symptoms such as upper abdominal pain, fever erythema, or conjunctivitis. Histologically all patients showed centrolobular necroses. Transaminases should be checked 2 days after intravenous cholangiograms. In patients with a definite increase reexposure should be avoided.
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PMID:[Hepatic necroses after infusion cholangiography (author's transl)]. 63 57

Clinical features and validity of a duodenofiberscopic examination for the diagnosis of carcinoma of the papilla of Vater were evaluated on 13 cases preoperatively diagnosed endoscopically. Followings are the conclusions derived. 1) Average age was 59.8 years. Incidence was equal among men and women. 2) As initial symptoms, general fatigue and easy fatigability or symptoms of cholangitis should be emphasized. 3) Other important symptoms include jaundice, fever with chills and weight loss. Abdominal pain, when present, was noted as one of symptoms of cholangitis in most cases. 4) Important laboratory findings include elevated serum bilirubin and alkaline phosphatase, elevated erythrocyte sedimentation rate, positive occult blood in stool. 5) Carcinomas of the papilla of Vater were divided into 3 types (type I, II and III) according to endoscopical and pathological findings. Clinical features and laboratory findings were discussed in relation to the type of lesions. Characteristic endoscopic findings of each type of the lesions were described. Validity of aspiration cytology, pancreatocholangiography and biopsy under duodeno-fiberscopic observation was also discussed. As a result, duodenofiberscopy was considered to be the most useful method for the diagnosis of carcinoma of the papilla of Vater because it provides us with an opportunity to perform simultaneously an endoscopic observation, aspiration cytology, pancreatocholangiography and biopsy.
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PMID:Diagnosis of carcinoma of the papilla of Vater by duodenofiberscopy: simultaneous attempt on endoscopic observation, aspiration cytology, retrograde pancreatocholangiography and biopsy. 78 67

A man, aged 42 years, presented as an emergency with a history of stabbing upper abdominal pain, nausea and diarrhoea of two weeks' duration. Apart from abnormal transaminase and alkaline phosphatase values, the routine clinical and laboratory examinations did not reveal any abnormality. As the abdominal pain increased in severity, particularly in association with eating, and projectile vomiting supervened, aortography was carried out and showed severe stenosis of the coeliac axis, involving about 1 cm of the artery. At operation a thick fibrous band, which originated from the median arcuate diaphragm, was seen to constrict the point of origin of the artery and to compress the vessel against the aorta. The band was divided, whereupon the coeliac artery immediately showed strong pulsations and adequate filling. Microscopic examination of the fibrous band revealed, among other structures, those characteristic of a ganglion. The symptoms disappeared after operation.
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PMID:A case of severe compression of the coeliac artery. 87 19

Ten cases of pancreatitis with elevated serum alkaline phosphatase (SAP) levels are reported. Patients with chronic or relapsing pancreatitis may at times develop increased SAP levels, either with or without definitive biochemical evidence of pancreatic disease. SAP estimation may assist in establishing a clinical diagnosis in cases of abdominal pain in which pancreatitis is suspected.
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PMID:Elevated serum alkaline phosphatase level may aid in the diagnosis of pancreatitis. 90 83

Eighty-eight African patients with amoebic liver abscess are described. The diagnosis was readily made in pyrexial patients who had right-sided upper abdominal pain, an enlarged, very tender liver and signs at the right base. However, in apyrexial subjects (10%) and where abdominal pain was absent (7%), the diagnosis was considerably delayed. Five children (7%) were seen under the age of five, four of whom died because the diagnosis was not suspected. It is particularly emphasized that there should be a greater awareness of this condition in this age group. Amoebae were found in only a small percentage of stool (14%) and pus specimens (11%), while biopsy of the abscess edge yielded 40%. The relative values of a positive amoebic latex test (82%) and an elevated alkaline phosphatase (71%) are noted. In only half the aspirations was the classical anchovy sauce appearance seen. Metronidazole is the drug of choice with repeated aspirations for large abscesses. Mortality was 13-5%, occurring mainly in the extremes of life.
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PMID:Amoebic liver abscess in Rhodesian Africans. 100 58

Oxymetholone, a steroid which inhibits progesterone synthesis, was given to 6 women in early pregnancy to produce abortions. Patients were less than 7 weeks pregnant; duration since last menstrual period was less than 46 days when therapy started. Dosage varied from 50 mg daily for 7 days to 100 mg 3 times a day for 10 days. Serum HCG, progesterone, and estradiol levels were measured before, during, and after therapy. Also total serum proteins, albumin, globulin, total bilirubin, direct bilirubin, alkaline phosphatase, SGOT, SGPT, and complete blood counts were obtained before and immediately after treatment. All determinations were normal, including the hormones. No abortions resulted from the therapy although some vaginal bleeding was noted by 3 patients. Nausea, vomiting, or abdominal pain were side effects in 4. Results indicate that oxymetholone is an ineffective agent for termination of early pregnancy.
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PMID:A study of the abortifacient effect of oxymetholone in early gestation. 113 38

A 15-year old Black teenager came to a clinic at the University of Alabama's School of Medicine in Tuscaloosa requesting oral contraceptives (OCs). The physical examination indicated that she was in good health and the physician prescribed an OC (1 mg norethindrone and .035 mg ethinyl estradiol). 21 months later she returned complaining of yellow eyes for 3 weeks. The oral mucosa was also jaundiced. She had considerably high levels of bilirubin and alkaline phosphatase. She had no hepatitis virus antibodies. 5 months later she returned for the physical examination required to renew the OC prescription. She did not have jaundice at this time. 10 months later she complained of malaise and muscular pain. Her alkaline phosphatase level was high, but her bilirubin level was normal. She had mild hepatosplenomegaly without focal defects. After reviewing her medical records, the physician diagnosed intrahepatic cholestasis and discontinued her OC prescription. Liver function tests were normal within 3 months. 14 months later, she returned complaining of malaise and reported taking OCs obtained at another clinic 3 months earlier. The physician advised her about the complications of OCs and about other contraceptive methods. The same physician also examined a 32-year-old Black woman who had intermittent epigastric and right-upper quadrant abdominal pain for 2 weeks. Eating worsened the pain, which lasted for up to 15 minutes. She had used an OC for 12 years. Ultrasound revealed a 4.2 cm hypoechoic mass in the left upper lobe of the liver. The physician discontinued the OCs. The tumor regressed over 12 months. Active liver disease is a contraindication to OC use. Women who had cholestatic jaundice while pregnant or have first degree relatives with cholestatic jaundice of pregnancy should not use OCs. Physicians may introduce OCs to closely monitored women with a history of liver disease whose liver function tests are normal. Women with a family history of biliary excretion defects should not use OCs.
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PMID:Hepatobiliary complications of oral contraceptives. 133 97

A 59-year-old woman who had undergone a Whipple's operation for carcinoma of the head of the pancreas, developed septic fever of up to 40 degrees C on the fourth postoperative day, accompanied by severe upper abdominal pain and local guarding on palpation over the liver. Her general condition markedly and quickly deteriorated. Liver abscess was suspected. Computed tomography demonstrated a hypodense, wedge-shaped lesion in the right lobe of the liver without any abscess capsule. Liver infarction was diagnosed when injection of contrast medium failed to show any increase in density. Magnetic resonance imaging confirmed the wedge-shaped signal-rich lesion. Laboratory tests revealed a leucocytosis of 30,000/microliters, a postoperative rise in serum alkaline phosphatase activity (up to 800 U/l), gamma-glutamyl transaminase (up to 190 U/l) and lactate dehydrogenase (up to 320 U/l), while GOT and GPT activities remained within normal limits throughout. Fever subsided within 3 weeks. --It is stressed that, if a patient's condition worsens after a major abdominal operation, liver infarction should be considered in the differential diagnosis. Modern imaging methods have increased the frequency of this diagnosis. They, together with the clinical picture and the pattern of biochemical tests, make it possible to distinguish reliably infarction from liver abscess.
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PMID:[Liver infarction after Whipple's surgery. Diagnosis based on clinical course and imaging procedures]. 134 77


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