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

Herein we report the case of an ampullary tumor in a 53-yr-old Japanese woman who presented in March 1988 with abdominal pain, weight loss, and jaundice. A pancreatoduodenectomy was carried out, and 3 months later, she presented with a Virchow's node. She was initially treated with cytokines plus 5-fluorouracil derivative, resulting in a complete remission lasting over a year. However, in July 1990, the Virchow's node reappeared and was surgically excised. Histology revealed a small-cell neuroendocrine carcinoma (SCNC) similar to the prior ampullary tumor, which was confirmed by immunohistochemical studies and electron microscopic examination. The patient was discharged within 1 month, remaining disease-free over a 18-month period following excision. We suggest that the use of cytokines can be effective, and can increase survival in gastrointestinal neuroendocrine tumors.
Am J Gastroenterol 1992 Dec
PMID:Can cytokines prolong survival in ampullary neuroendocrine carcinomas? 144 47

We report the first known case of syphilitic gastritis in an HIV-infected person. The presentation of nonspecific abdominal pain and weight loss in a 48-yr-old former intravenous drug user previously treated for asymptomatic syphilis led to a barium swallow which demonstrated linitis plastica. Upper endoscopy reinforced a suspicion of carcinoma, but biopsy made the diagnosis of syphilis by silver staining. Further testing revealed a positive serology for syphilis as well as HIV infection with a depressed CD-4 lymphocyte count. Treatment with parenteral penicillin led to a rapid resolution of symptoms. This case represents a rare complication of late syphilis, and is another example of the unusual manifestations of syphilis seen in the HIV-infected population.
Am J Gastroenterol 1992 Dec
PMID:Syphilitic gastritis in an HIV-infected individual. 144 50

A patient developed delayed life-threatening hemobilia after apparently uncomplicated percutaneous needle liver biopsy. An arteriobiliary fistula demonstrated by arteriography was successfully treated by selective transcatheter arterial embolization, with Gelfoam and a Gianturco coil. The diagnosis of liver biopsy-induced hemobilia should be suspected when a postprocedure fall in hematocrit is associated with abdominal pain, hyperbilirubinemia, or unexplained gastrointestinal bleeding. A review of the diagnosis and management of liver biopsy-related hemobilia is presented.
Am J Gastroenterol 1992 Dec
PMID:Delayed massive hemobilia following percutaneous liver biopsy: treatment by embolotherapy. 144 53

Listeria monocytogenes is a Gram-positive bacillus that is pathogenic in both the normal and compromised host. We describe Listeria peritonitis and cerebritis in a patient with cirrhosis due to non-A, non-B hepatitis, and review the 11 other cases of Listeria peritonitis reported in the English-language literature. Listeria is a rare cause of peritonitis in debilitated, older patients, with two-thirds of the cases occurring in patients with chronic liver disease. Listeria peritonitis may also occur in patients undergoing peritoneal dialysis, or in those with malignancy. Peritonitis due to Listeria is clinically similar to spontaneous bacterial peritonitis, and is associated with fever, variable abdominal pain, and neutrocytic ascites; bacteremia commonly accompanies Listeria peritonitis. This syndrome can be successfully treated with antimicrobial drugs, although the third-generation cephalosporins commonly used in the therapy of spontaneous bacterial peritonitis are not recommended. Ampicillin may be the drug of choice, with combination therapy with an aminoglycoside reserved for cases that do not respond to ampicillin alone.
Am J Gastroenterol 1992 Dec
PMID:Listeria monocytogenes peritonitis: case report and literature review. 144 54

Isotretinoin, a retinoid derivative, is in wide use as a treatment for severe acne and other dermatologic conditions. Its effects on serum lipids, most notably the induction of hypertriglyceridemia, have been well documented. We present a case of a young woman with a previous history of gestational hyperlipidemia who developed hypertriglyceridemia and pancreatitis after initiation of isotretinoin therapy. A history of gestational hyperlipidemia may serve as a marker to help identify patients who are at increased risk for developing severe hypertriglyceridemia while receiving isotretinoin. Her case emphasizes the need to consider the possibility of pancreatitis in patients who develop abdominal pain while receiving this drug.
Am J Gastroenterol 1992 Dec
PMID:Marked hyperlipidemia and pancreatitis associated with isotretinoin therapy. 144 57

The diagnosis of acute appendicitis can be difficult. Barium enemas, computed tomography (CT) scans, ultrasound examinations and Indium scans are used to aid in making the diagnosis with varying degrees of success. This blinded, prospective study reports the use of a Technetium 99-m Hexamethylpropyleneamineoxide (HMPAO) labelled white blood cell scan in 30 patients with suspected appendicitis. Autologous white blood counts from 25 cc of whole blood labelled with Tc-99 HMPAO were reinjected into patients. Abdominal imaging was performed at a half hour postinjection and repeated at 2 to 4 hours postinjection. A positive study showed an increased isotope uptake in the right lower quadrant. Nineteen patients had histologically proven appendicitis. Three of these patients were excluded because they were operated on before scan completion. Thirteen of the remaining 16 patients with appendicitis had positive studies (false negative rate = 19%). All patients without appendicitis had either negative scans or scans that detected other intra-abdominal diseases, such as diverticulitis, tubo-ovarian abscess, or small bowel infarction (false positive rate = 0%). Overall, this Tc-99 HMPAO study had a sensitivity of 81 per cent, a specificity of 100 per cent and an overall accuracy of 89 per cent. The 4-hour Tc-99 HMPAO WBC scan is a useful, noninvasive test for confirming the clinical diagnosis of acute appendicitis, but it may prove more valuable as a diagnostic study to rule out appendicitis in patients that have abdominal pain of unclear etiology.
Am Surg 1992 Dec
PMID:Detection of acute appendicitis by technetium 99 HMPAO scanning. 145 3

Cysts of the falciform ligament are rare. Only a dozen cases have been reported in the English literature, with the first reported case in 1909. The etiology of these cysts is diverse but can be classified into primary and secondary causes. No specific complex exists and their presentations vary among persons. Physical examination may demonstrate a mass in the right upper abdomen. Although rare, they should be considered in the differential diagnosis of right upper quadrant abdominal pain. They are treated through excision.
Am Surg 1992 Dec
PMID:Cyst of the falciform ligament of the liver: a rare cause of right upper quadrant pain. 145 7

In order to assess the prevalence and importance of abdominal pain in the elderly, an epidemiological study of a 70-year-old Danish population was carried out. Seventy two percent of 1119 randomly selected persons answered a questionnaire concerning abdominal pain. One year prevalence of abdominal pain was 28% among women and 17% among men (p < 0.01). Among those with abdominal pain no significant sex difference was found as regards location, severity, frequency, or medicine consumption. Eleven percent of the men and 19% of the women had abdominal pain which they considered to be of importance to their well-being in terms of frequency, severity, or need of medicine (sex difference: chi 2 = 10.18, df = 2, p < 0.01). Participants who had no abdominal pain judged their general health to be better than those who had experienced abdominal pain (p < 0.01). It is concluded that abdominal pain is frequent in a 70 year old population and influences the well-being of the subjects. Further studies are needed to evaluate whether subjects with abdominal pain have a poorer prognosis than subjects without.
J Clin Epidemiol 1992 Dec
PMID:Abdominal pain in a 70-year-old Danish population. An epidemiological study of the prevalence and importance of abdominal pain. 146 Apr 75

We report the case of a patient on dialysis for 13 years, including continuous ambulatory peritoneal dialysis (CAPD) for 11 years, who developed sclerosing peritonitis with gross peritoneal calcification. The patient first presented with abdominal pain in January 1990, when peritoneal calcification was detected for the first time. Her symptoms settled spontaneously and 1 year later she presented with acute peritonitis and adynamic ileus. The peritonitis settled with antibiotics and Tenchkoff catheter removal, but the ileus persisted. She was commenced on long-term parenteral nutrition, but never recovered useful bowel function. After 8 weeks of hemodialysis and total parenteral nutrition, a further laparotomy for an acute abdomen showed what appeared to be extensive bowel infarction and peritoneal calcification. She died several days later. Of significance, peritoneal calcification was first noted on x-ray and computed tomography (CT) scan while the patient was still largely asymptomatic and before peritoneal ultrafiltration capacity was significantly impaired. Unlike other reported cases of calcifying peritonitis, sclerosing peritonitis was present and calcification was far more extensive. It was not associated with factors such as frequent infective peritonitis or acetate dialysate. Calciphylaxis was not present nor was there any abnormality of calcium-phosphate metabolism. The outcome of this case suggests that patients with recurrent or persistent bowel symptoms on long-term CAPD should have early abdominal x-ray or CT scanning to exclude sclerosing peritonitis or bowel calcification. If present, consideration should be given to transferring the patient to another therapeutic dialysis modality if possible.
Am J Kidney Dis 1992 Dec
PMID:Sclerosing peritonitis with gross peritoneal calcification: a case report. 146 95

The prognosis for ductal cancer of the pancreas is extremely poor. Diagnosis of pancreatic cancer in the earlier stages has become possible by taking note of early symptoms, mild abdominal pain, back pain, anorexia, diabetes and obstructive jaundice. Presently, measurements of amylase in serum and urine, serum elastase-1, serum CA 19-9 and US are usually used for screening patients with the symptoms. Furthermore, for correct diagnosis, intensive study by US, dynamic CT, ERCP, MRI, cytological examination and CEA of pancreatic juice, endoscopic pancreatoscopy and endoscopic ultrasonography are used. The results of surgical treatment for resectable pancreatic cancer are not generally favorable. Extended pancreatic resection (pancreatoduodenectomy, total pancreatectomy or distal pancreatectomy) with en bloc dissection of the lymph nodes has been performed for patients with invasive cancer. However, local recurrence and distant metastasis usually occurred after surgery. It seems difficult to cure pancreatic cancer by surgery alone. To improve the prognosis of resectable pancreatic cancer, multimodality treatment with intraoperative radiation therapy and chemotherapy is performed and a better outcome is achieved.
Gan To Kagaku Ryoho 1992 Dec
PMID:[Selection of methods for diagnosis and treatment of pancreatic cancer]. 146 36


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