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

Obstructive choledocholithiasis in a 12-year-old mare was corrected surgically by choledocholithotripsy. The mare had a history of chronic weight loss, intermittent fever, partial anorexia, jaundice, recurrent abdominal pain, and an abdominal mass palpable per rectum. Values for alkaline phosphatase, bilirubin, gamma-glutamyl transferase, sorbitol dehydrogenase, and bromsulpthalein half-life were increased and bilirubinuria was evident before surgery. Two liver biopsies revealed periportal and portal fibrosis, bile duct proliferation, cholestasis, and variable amounts of hepatocellular necrosis, with infiltration by polymorphonuclear cells. Immediate clinical improvement was seen after surgery, and results of selected liver function tests gradually returned to normal. Since surgery, the mare has returned to her normal weight, has remained clinically normal for liver disease for 28 months, and has been useful as a broodmare.
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PMID:Choledocholithotripsy in a mare. 401 95

The presenting features of seven elderly patients with pyogenic liver abscess were reviewed retrospectively. Symptoms of malaise, anorexia and abdominal pain referrable to intra-abdominal pathology were present in only 43% cases and physical examination was frequently unhelpful. Leucocytosis, hyperbilirubinaemia and raised alkaline phosphatase were of diagnostic value in the majority of patients. Chest and urinary tract infections were frequent predisposing conditions. Antibiotic therapy for four weeks is adequate in elderly patients if combined with drainage procedures.
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PMID:Clinical presentation of pyogenic liver abscess in the elderly. 407 22

Twenty-six adult patients with histologically confirmed celiac disease on gluten-free diet after apparent disease remission were reexamined at 4-6 months intervals for a mean period of 55.4 months (range 13-137). Eight patients remained clinically well with normal blood tests. Eighteen patients had clinical or biological abnormalities. Eleven patients reported repeated episodes of meteorism and abdominal pain and/or diarrhea which disappeared in 2 after lactose withdrawal. Iron deficiency and macrocytic anemia were sometimes observed in 5 and 4 patients respectively. Altered plasma calcium, phosphorus and alkaline phosphatase and/or bone densitometry findings were detected in 7 patients. Seventeen patients (12 presenting some of the above findings) agreed to a repeat biopsy: 13 of these showed grade II and 4 grade III abnormalities. Although adult celiac patients may show marked improvement during gluten-free diet, minor clinical disturbances and biochemical abnormalities may still be present.
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PMID:Clinical, biochemical and histological abnormalities in adult celiac patients on gluten-free diet. 408 41

Analysis of 56 patients with obstructive jaundice due to carcinoma of the pancreas or extrahepatic biliary tree showed that unexpected features were present in 25%. Presentation with painless jaundice was uncommon, and the symptoms were more often non-specific, with malaise, anorexia, and vomiting. Abdominal pain was frequent, and the condition was found in young patients. One-fifth presented with serum alkaline phosphatase levels of less than 30 K.A. units. Some had high serum aspartate aminotransferase levels, more characteristic of hepatocellular jaundice. A mathematical model may be helpful in correctly weighting these various criteria.
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PMID:Pitfalls in the diagnosis of jaundice due to carcinoma of the pancreas or biliary tree. 451 75

In a model developed to study acute pancreatitis in the dog, the disease process was comparable with the spontaneously occurring disease. Infusion of oleic acid into the accessory pancreatic duct induced, grossly and microscopically, acute hemorrhagic pancreatitis with pancreatic atrophy, fibrosis, fat necrosis, and edema. Clinical changes included persistent fever and tachycardia in all dogs and abdominal pain, vomiting, and diarrhea in most. Serum amylase and lipase activities increased markedly as did activities of alkaline phosphatase, aspartate aminotransferase, and alanine aminotransferase. Hematologic alterations included hemoconcentration (despite intensive fluid therapy) and leukocytosis due primarily to neutrophilia and monocytosis. Neither corticosteroid nor anticholinergic therapy begun 24 to 32 hours after oleic acid infusion altered the course of the disease. Dogs survived 8 days and appeared clinically normal when the study was terminated.
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PMID:Effects of an anticholinergic and a corticosteroid on acute pancreatitis in experimental dogs. 617 2

Four hundred and fifty-four consecutive patients who had had their gallbladder removed were interviewed to determine the presence of upper abdominal pain, increased serum alkaline phosphatase and/or serum amylase activity. Patients with unexplained upper abdominal pain and/or enzyme abnormalities were offered endoscopic retrograde cholangiopancreatography (ERCP) and manometric evaluations. Dysfunction of the sphincter of Oddi diagnosed by ERCP manometry may account for the abdominal pain seen in 14% of the patients with postcholecystectomy syndrome. It may rarely be the cause of an elevated serum alkaline phosphatase and/or amylase when abdominal pain is not present. Papillary dysfunction is seen in less than 1% of the patients who have had their gallbladders removed. ERCP manometry is recommended in cholecystectomized patients with unexplained abdominal pain suggesting pancreaticobiliary origin.
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PMID:Frequency of papillary dysfunction among cholecystectomized patients. 620 Apr 20

A case of hepatic leiomyosarcoma is reported and the literature on smooth muscle tumors of the liver is reviewed. All 15 patients with hepatic leiomyosarcoma presented initially with hepatic or abdominal mass. About half of these patients also had abdominal pain or weight loss or both. Elevated levels of serum alkaline phosphatase, SGOT, and lactic dehydrogenase were frequent but inconsistent findings. The prognoses appeared grave, but potentially curable. All but four patients died in less than 3 years. One patient was not followed. The three patients who were alive in follow-ups survived 8 months, 1 year, and 6.5 years, respectively, with no evidence of disease. All three surviving patients had resectable tumor and were surgically treated.
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PMID:Hepatic leiomyosarcoma. 636 91

Early recognition of pyogenic liver abscess requires a high index of suspicion. The abrupt onset of hectic fevers and jaundice is rarely seen today; instead, an insidious progression of malaise, abdominal pain, and night sweats is more common. Biliary tract disease is the most frequent underlying disorder. An elevated alkaline phosphatase is a useful clue to the condition, but diagnosis depends on imaging of an abscess cavity followed by aspiration. Treatment involves antibiotics together with drainage, which can often be performed successfully by a nonsurgical percutaneous approach. However, prognosis continues to be poor unless the diagnosis is made promptly.
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PMID:Pyogenic liver abscess: new concepts of an old disease. 636 2

A 3-year-old child presented with vague abdominal pain, fever, leucocytosis and elevation of alkaline phosphatase. Ultrasonography revealed a space occupying process within the extrahepatic bile ducts surrounded by fluid. Various densities (between 15-25 Hounsfield units) were measured in this intrabiliary tumor by computed tomography.
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PMID:Sonographic and computed tomographic features of embryonal rhabdomyosarcoma of the biliary tract. 639 Mar 23

Distal common bile duct stenosis was observed in 16 (9%) of 170 alcoholic patients admitted to a Veterans Administration Medical Center in the last five years. The following clinical and biochemical features were significantly more common (P less than 0.05) among the 16 patients with common bile duct stenosis than in 154 without: jaundice, cholangitis, hyperbilirubinemia, alkaline phosphatasemia, pancreatic calcification, and malabsorption. Surgical decompression of biliary tree was necessitated in 13 of 16 cases due to obstructive jaundice in seven, cholangitis in four, portal fibrosis in one, and persistent abdominal pain in one. The mean (+/- SE) time interval between initial serum alkaline phosphatase elevation and surgical intervention was 308 +/- 108 days. Liver histology in eight cases was remarkable for portal fibrosis in seven and biliary cirrhosis in one. These data suggest that distal common bile duct stenosis is a progressive lesion which is quite prevalent in patients with advanced pancreatic disease of alcoholic etiology.
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PMID:Prevalence and natural history of distal common bile duct stenosis in alcoholic pancreatitis. 647 79


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