Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 55-year-old female patient was admitted for flushing and abdominal pain in the right upper quadrant. Her past medical history revealed high blood pressure and a recent echocardiography showed thickened appearance of tricuspid valve with coaptation defect and grade II tricuspid regurgitation. Contrast enhanced abdominal CT scan and MRI were subsequently performed and revealed a large macronodular liver mass, as well as other micronodular lesions disseminated in the liver parenchyma. CT guided biopsy from the main liver mass revealed neuroendocrine tumor of unknown origin (probably GI) with Ki-67 of 8%. Surgical exploration was decided. During laparotomy, the primary tumor was found in the proximal ileum and the patient underwent segmental enterectomy. Non-anatomical hepatectomy was also performed to remove the bulk of the tumor burden (more than 90%). Postoperative course was uneventful and the carcinoid syndrome relieved. At present, 15 months postoperatively, the patient is under treatment with somatostatin analogue for its antiproliferative effect, with good clinical, biochemical and tumoral control and stable heart disease. In patients with neuroendocrine liver metastases from unknown primary, surgical exploration could allow detection (and resection) of the primary tumor and surgical debulking of liver metastases to control carcinoid syndrome and carcinoid heart disease.
 ...
PMID:THE ROLE OF SURGERY IN A PATIENT WITH CARCINOID SYNDROME, COMPLICATED BY CARCINOID HEART DISEASE. 3114 45

Somatostatinoma is a rare neuroendocrine tumor with an incidence rate of 1 in 40 million people. It presents mostly as asymptomatic tumor diagnosed incidentally on imaging or surgery when evaluating or treating possible causes of abdominal pain. It also can present with vague symptoms, or as a clinical triad of glucose intolerance, steatorrhea, and achlorhydria. The majority of somatostatinomas are present in the pancreatic head, followed by the duodenum, the pancreatic tail, and rarely the ampulla of Vater. The prognosis is poor as more than 77% of cases present as advanced disease with local invasion or distant metastasis. Surgical resection is the main treatment for early stage disease. Other treatment options include somatostatin analogue, molecular targeted therapy, and cytotoxic chemotherapy. The scarcity of somatostatinoma cases led to the lack of fully formulated treatment options. Herein, we present a 43-year old male patient who was referred by his primary care physician to our gastroenterology clinic due to elevated liver function test and double-duct sign on CT scan. We performed an ERCP, which revealed 2 cm ampullary lesion with upstream obstruction. Biopsies were taken and histopathology was unrevealing. He underwent a laparoscopic pancreaticoduodenectomy with histopathology revealed stage IIb somatostatinoma. Treating physicians should hold a high index of suspicion and maintain a broad differential diagnosis of elevated liver enzymes.
 ...
PMID:Somatostatinoma Presented as Double-Duct Sign. 3121 Sep 94

The objective of this study was to investigate effects of somatostatin combined with pantoprazole on serum C-reactive protein (CRP) and intercellular adhesion molecule-1 (ICAM-1) in severe acute pancreatitis (SAP) patients. It was an experimental study carried out from February 2016 to April 2018. Eighty-two patients were randomly divided into group A and group B with 41 in each group. Pantoprazole was used in group A and somatostatin combined with pantoprazole was used in group B. Results showed that time of abdominal pain relief, intestinal function recovery and ventilator weaning in group B were shorter than those in group A (all p<0.001). After treatment, levels of CRP and ICAM-1 in group B were lower than those in group A (both p<0.001). Compared with pantoprazole alone, somatostatin combined with pantoprazole has a better therapeutic effect on SAP, and its mechanism may be related to reduction of serum CRP and ICAM-1.
 ...
PMID:Effects of Somatostatin Combined with Pantoprazole on Serum C-Reactive Protein and Intercellular Adhesion Molecule-1 in Severe Acute Pancreatitis. 3125 26

Carcinoid syndrome causes substantial morbidity and reduces quality of life and survival. In a recent clinical trial, 97% of patients reported bowel movement-related issues, abdominal pain, flushing, and low energy. Combining somatostatin analogs with elotristat ethyl provides a new option for managing refractory CS symptoms. Health care providers should consider strategies that take advantage of approved dosing for patients with CS-related diarrhea.
 ...
PMID:Evidence-Based Policy in Practice: Management of Carcinoid Syndrome Diarrhea. 3125 14

A 45-year-old woman visited a local clinic with left-flank abdominal pain. Abdominal computed tomography (CT) revealed a tumor 20 cm in diameter in the left adrenal gland. She was referred to our hospital for further treatment. No endocrinological abnormality was detected on either serum or urine examination. CT and haematology findings led to a preoperative diagnosis of primary adrenal carcinoma, and we performed a left adrenalectomy. Histopathological examination revealed a paraganglioma with intact adrenal gland. Therefore we diagnosed this case as primary retroperitoneal paraganglioma. Six months after the surgery, she developed peritoneal dissemination including bilateral ovarian metastases. After cytoreductive metastasectomy, she received 131I-meta-iodobenzylguanidine (MIBG) radiotherapy. During the following five-year follow-up, MIBG radiotherapy in conjunction with cytoreductive metastasectomy (3 surgeries and 6 sessions of 131I-MIBG radiotherapy) was performed, aiming at disease control. Five years after the initial surgery, liver, lung, and intra-peritoneal dissemination progressed. Thereafter, she developed severe diarrhea, hypokalemia, and metabolic acidosis with an elevated level of vasoactive intestional peptide, which was consistent with water diarrhea, hypokalemia, achlorhydria (WDHA) syndrome. Despite intensive treatments such as with a somatostatin analogue, she died two months after the onset of this syndrome.
 ...
PMID:[A Case of WDHA Water Diarrhea Hypokalemia Achlorhydria Syndrome that Developed after Multimodal Therapy for Retroperitoneal Paraganglioma]. 3150 91

Although metastasis of carcinoid tumours of the intestine is rare, it has been reported in several organs, mainly in the lungs, the liver and less commonly in the orbits. We report a 50-year-old male patient who presented at Hamad General Hospital, Doha, Qatar, in 2016 with central abdominal pain, distention, nausea and vomiting for the previous four days. The patient had unilateral right-sided exophthalmos for two years prior to presentation. Following an abdominal computed tomography (CT) scan and an ultrasound guided biopsy, the patient was diagnosed with extensive multi-focal metastatic carcinoid tumour of the small bowel and mesentery; histopathology confirmed the diagnosis. Subsequently, the patient underwent a laparotomy and small bowel resection and was administered somatostatin therapy. One week postoperatively, the patient developed an acute increase in his right eye exophthalmos. CT, magnetic resonance imaging and scintigraphy scans revealed an orbital metastatic lesion, which probably originated from the previously diagnosed carcinoid tumour. The orbital metastasis was treated with somatostatin therapy and the patient was lost to follow-up when he left the country.
 ...
PMID:Mid-Gut Carcinoid Tumour Presenting as Suspected Orbital Metastasis. 3172 25

A 68-year-old woman with an 11-day history of sudden abdominal pain and severe watery diarrhea was transferred to our hospital due to an exacerbation of renal function despite hydration. After treatment for dehydration and acidemia was provided in our intensive care unit, patient's renal function improved. Contrast-enhanced abdominal computed tomography was finally performed, revealing a hypervascular pancreatic mass with multiple hepatic masses. This imaging finding along with her clinical symptoms indicated watery diarrhea hypokalemia achlorhydria (WDHA) syndrome caused by a pancreatic VIPoma. Somatostatin analog was administered immediately leading to the improvement of her diarrhea and her general condition. As a result, endoscopic ultrasonography-guided fine-needle aspiration could be performed. Consequently, she was diagnosed with a pancreatic neuroendocrine tumor. She then underwent surgical resection of the pancreatic tumor and liver metastasis. As revealed in the immunohistochemical analysis of the excised tumor tissue, VIP was highly expressed, resulting in the final diagnosis of pancreatic VIPoma. Therefore, the immediate use of a somatostatin analog is crucial for improving the patient's general condition and achieving a definitive diagnosis pathologically when a patient is suspected of having a pancreatic VIPoma.
 ...
PMID:[Use of a somatostatin analog to improve a patient's condition and the subsequent diagnosis of pancreatic VIPoma:a case report]. 3194 61

Small bowel neuroendocrine tumors (SBNETS) are slow-growing neoplasms with a noted propensity toward metastasis and comparatively favorable prognosis. The presentation of SBNETs is varied, although abdominal pain and obstructive symptoms are the most common presenting symptoms. In patients with metastases, hypersecretion of serotonin and other bioactive amines results in diarrhea, flushing, valvular heart disease, and bronchospasm, termed carcinoid syndrome. The treatment of SBNETs is multimodal and includes surgery, liver-directed therapy, somatostatin analogues, targeted therapy, and peptide receptor radionuclide therapy.
 ...
PMID:Management of Small Bowel Neuroendocrine Tumors. 3215 57

Small bowel neuroendocrine tumours (NET) are relatively rare malignancies. Due to the lack of specificity, the symptoms are usually initially attributed to irritable bowel syndrome. Frequently there is a delay of years after the onset of symptoms, before the diagnosis is made. We describe two patient cases with a small bowel NET that illustrate the typical course of the symptoms, as well as the complications of carcinoid syndrome, carcinoid heart disease, mesenteric venous congestion and arterial ischemia. On coloscopy the primary tumour can often not be reached. CT scan is the best diagnostic modality and should be considered in a patient with abdominal pain, diarrhoea, weight loss and a negative coloscopy, especially in the presence of flushing. In a non-curative situation, first-line treatment consists of a somatostatin analogue, in order to prolong progression-free survival and reduce hormonal hypersecretion. Palliative surgery can also play an important role in the management of small bowel NET.
 ...
PMID:[Small bowel neuroendocrine tumours: to be considered in the differential diagnosis of unexplained abdominal pain and diarrhoea]. 3218 28

Carcinoid syndrome (CS) is a paraneoplastic syndrome caused by the release of serotonin and other substances from well-differentiated neuroendocrine tumors (NETs). The hallmark symptoms of carcinoid syndrome are flushing and diarrhea; atypical signs and symptoms can include wheezing, abdominal pain, valvular heart disease, telangiectasias, pellagra, and the complications of mesenteric fibrosis, including ureteral obstruction, bowel obstruction, and bowel ischemia. These symptoms are mediated by the release of serotonin (5-HT), histamine, kallikrein, prostaglandins, and tachykinins. The diagnosis of CS requires these symptoms and corresponding elevations in lab tests. Treatment options include surgery and medical management with somatostatin analogs.
 ...
PMID:Carcinoid Syndrome: A Review. 3225 25


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>