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)

Acute pancreatitis with severe belt-like upper abdominal pain developed within 1-4 weeks of starting medication in three patients (29-year-old man with ulcerative colitis; 43-year-old woman and 22-year-old woman with Crohn's disease) treated, for the first time, with 5-aminosalicylic acid (mesalazine), 500 mg three times daily. Concentrations of lipase initially were 545, 1182 and 3000 U/l, and of amylase 243, 449 and 129 U/l, respectively. Symptoms receded within a few hours after the drug had been discontinued, enzyme levels returning to normal in the course of the next 2-3 weeks. On repeating the drug in two of the patients, in lower dosage, the pancreatitis recurred within a few days. These observations support the view that 5-aminosalicylic acid can cause acute pancreatitis, perhaps as an allergic reaction.
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PMID:[Pancreatitis associated with 5-aminosalicylic acid]. 170 59

Forty-four patients undergoing single-stage surgery for scoliosis were monitored for biochemical and clinical evidence of pancreatitis. Six patients (14%) developed elevation of both serum amylase and lipase levels. Four of these had symptoms or signs suggestive of pancreatitis. Mean intraoperative blood loss was significantly higher in the group with pancreatitis. No significant differences were noted with regard to age, surgical technique, degree of initial or residual deformity, or length of surgery. The patients with pancreatitis required a longer average period of fasting time. Patients with prolonged ileus or abdominal pain after scoliosis surgery should be investigated for possible pancreatitis.
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PMID:Pancreatitis following scoliosis surgery in children and young adults. 171 7

Using an elevated serum amylase level to diagnose acute pancreatitis in an alcoholic patient with abdominal pain may not be appropriate, because hyperamylesemia is common in asymptomatic alcoholics without acute pancreatitis. To determine whether serum lipase also suffers from the same drawback, we undertook a prospective study involving 202 asymptomatic alcoholics admitted to the detoxification unit of our hospital. Sixty-six of the 202 patients had serum lipase levels above the normal range (0-213 U/L). Of these 66, 55 (83%) had levels that were one to two times normal, while 11 patients had levels ranging between two and three times normal. No patient exceeded three times the normal level. This background information is important in the interpretation of serum lipase levels in alcoholic patients with abdominal pain.
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PMID:Serum lipase levels in chronic alcoholics. 171 40

A healthy 3-year-old black girl had acute onset of abdominal pain, vomiting, and elevated aminotransferase, amylase, and lipase levels. Sonographic evaluation suggested a choledochal cyst, but hepatobiliary scintigraphy clearly showed an extrahepatic biliary leak. Exploratory laparotomy confirmed bile peritonitis and a ruptured choledochal cyst. Other cases with this unusual presentation is reviewed in the literature. An anomalous insertion of the pancreatic duct into the common duct appears to facilitate reflux of pancreatic secretions into the biliary tree and may contribute to formation and even perforation of a choledochal cyst.
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PMID:Spontaneous rupture of a choledochal cyst: clues to diagnosis and etiology. 179 9

Acute pancreatitis is characterized by clinical, morphological, and functional aspects. Severe abdominal pain with progression during the first hours after onset is the leading symptom. In the majority of patients acute pancreatitis had a "mild" clinical course, but 10 to 20% will develop severe local and systemic complications. Symptoms at the onset of disease are not specific and need consideration of several other diagnoses. Elevation of pancreatic serum enzymes is the main parameter in the diagnosis of acute pancreatitis. Besides the traditional parameter of total amylase, several specific pancreatic enzymes (e.g. pancreatic amylase, lipase, immunoreactive trypsin or elastase) are now widely used in clinical routine and guarantee a higher diagnostic specificity. The imaging procedures ultrasonography and computed tomography aid in identifying etiological factors in grading the severity of the disease and deciding therapeutic strategies. Endoscopic retrograde chol- angiopancreatography is most sensitive in detecting biliary lithiasis and can be successfully complemented by sphincterotomy if needed. Besides complex clinical and laboratory criteria, several biochemical markers (e.g. C-reactive protein, PMN-elastase, trypsinogen activation peptides) have been found to be valid for the detection of pancreatic necrosis and are of definite prognostic value. On the basis of such detailed information, the therapeutic strategy can be planned in a straight-forward manner.
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PMID:Clinical picture and diagnosis of acute pancreatitis. 185 80

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

We compared the diagnostic sensitivities of serum amylase, lipase (assayed enzymatically and immunologically), trypsinogen and elastase-1, the 2-h-timed urine amylase excretion and the ratio of amylase and creatinine clearances in the recognition of acute pancreatitis. Serial serum and urine findings from 39 patients with acute pancreatitis, and from 42 patients with non-pancreatic causes of abdominal pain (controls), as well as findings from 24 healthy subjects (normals) were studied. Decision thresholds were established for each parameter using either the control or the normal population, and the resulting diagnostic sensitivities determined. On hospital admission, all serum assays were equally sensitive, but on subsequent days lipase, trypsinogen and elastase-1 assays all significantly surpassed the sensitivity of the serum amylase assay. On the second and subsequent hospitalization days, determination of timed urine amylase excretion offered no advantage over the serum amylase, and the ratio of amylase and creatinine clearances lacked discrimination altogether.
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PMID:Comparative evaluation of the diagnosis of acute pancreatitis based on serum and urine enzyme assays. 232 64

A 48-year-old patient presented with a 24 hour history of diffuse abdominal pain and diarrhea. Based on elevated serum amylase and lipase levels, a CT-scan, and a history of chronic alcohol intake, acute alcoholic pancreatitis was diagnosed. The patient clinically improved under conservative therapy, but after restarting enteral nutrition on the fourth day, he developed full blown mechanical ileus. Intraoperatively, an adhesive band and acute edematous pancreatitis and fat necrosis was found. Retrospectively, the initial clinical symptoms and plain abdominal x-ray findings suggest coincidence of obstructive ileus and acute pancreatitis. We hypothesize that obstructive ileus had triggered pancreatitis.
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PMID:Obstructive ileus and acute pancreatitis. 239 51

Amylase activity in blood and urine, lipase activity in blood, and amylase/creatinine clearance ratio have been prospectively compared in order to test these parameters against estimation of pancreatic isoamylase. Pancreatic isoamylase had been evaluated by inhibition methodology and not by electrophoresis. One hundred patients admitted for strictly sus-umbilical abdominal pain in emergency unit have been studied. Results show that we do not have in blood specific biochemical marker for acute pancreatitis. Lipase and P isoamylase activity evaluation have about the same specificity. In emergency situation the choice of routine investigation will be rather based on methodological simplicity and lower cost.
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PMID:[Acute pancreatitis and biochemical markers. Isoamylase]. 240 10

Thirty patients with leukemia and lymphoma have been treated at our institution with high doses of cytosine arabinoside (Ara-C). Gastrointestinal symptoms were frequent after therapy, and 6 of the 30 patients had severe abdominal pain. Of the six, two had pancreatitis; two had normal amylase and lipase determinations; and in two, neither amylase nor lipase levels were determined. The two patients with pancreatitis are presented because this complication of high-dose Ara-C therapy has not been described. The authors conclude that pancreatitis can follow high-dose Ara-C chemotherapy and that patients with abdominal pain following this treatment be evaluated for pancreatitis.
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PMID:High-dose cytosine arabinoside-associated pancreatitis. 241 82


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