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

A 61-year-old man consulted his local physician because of abdominal pain and was referred to our hospital after bilateral renal tumors were suspected on CT. CT and MRI showed a tumor, approximately 3 cm in diameter in the right renal pelvis and a cyst in the left kidney. There were no malignant cells detected on cytological studies of two urine specimens that were voided commonly and obtained from the right renal pelvis, respectively. Under a diagnosis of right renal pelvic tumor, the patient underwent laparoscopic right nephroureterectomy. Pathological examination demonstrated two inflammatory myofibroblastic tumors; one was located in the upper portion of the right kidney and the other was in the fatty tissue of the right renal hilus. There has not been any evidence of recurrence detected on follow-up for three months postoperatively.
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PMID:[A case of inflammatory myofibroblastic tumor recognized in the retroperitoneum and the kidney]. 1826 Mar 52

Acute intermittent prophyria (AIP) is an autosomal dominant disease that results from a defect in the enzyme porphobilinogen deaminase. Acute intermittent porphyria is the most common of hepatic porphyrias and can tax the therapeutic capabilities of the physician to the limit. Motor weakness is a major feature of an acute attack, and flaccid paralysis of all extremities can occur rapidly, within a matter of days. The acute attacks may be life threatening. Hematin (Heme Arginate) should be given early during an acute attack to prevent neurologic sequel. Hemodialysis and hemoperfusion have been tried in the treatment of acute attacks of AIP with success. As hematin is not available in India, a severe acute attack of AIP in a patient was managed with hemodialysis successfully. Later, hematin was imported and provided to the patient. An 18-year-old girl was admitted to our hospital with recurrent abdominal pain and 2 episodes of convulsions. She had undergone an appendectomy earlier at another hospital for abdominal pain. On evaluation, she had hyponatremia, episodic abnormal behavior, generalized muscle pain, hypertension, and sinus tachycardia. In view of the above clinical picture, a clinical diagnosis of acute intermittent porphyria was made. Her 24-hr urinary porphobilinogen was 90.8 mg/day (<2 mg-normal) and alpha amino levalunic acid was 108.8 mg/day (1-7 mg-normal), consistent with the diagnosis. Her hyponatremia was corrected. Arrangements were made to import hematin and she was managed with dextrose infusion. Meanwhile, she developed flaccid quardriparesis with urinary incontinence and bulbar palsy. Her brain MRI was normal. Her nerve conduction study was suggestive of motor radiculoneuropathy. Specific treatment for severe porphyric crisis was planned. She failed to improve with dextrose infusion alone. As hematin was not readily available in the country, other therapeutic options were considered. As few case reports of AIP being successfully treated with hemodialysis were available, the option of dialytic support was explained to the family. After procuring informed consent, she was subjected to hemodialysis for 4 hr in the first day, increasing to 6 hr a day for the next 6 days. Her abdominal pain and myalgia subsided on the third day of dialysis. Her lower limb muscle power improved and she became ambulant by the fourth day. Urinary retention improved within 4 days. Hematin was imported by then from the United States. Later, 2 doses of hematin (4 mg/kg-160 mg in 20% albumin) were given via a central vein. She was maintained on physiotherapy. Repeat nerve conduction study revealed recovery. She has been provided with a list of drugs that have to be avoided. Currently, she is on outpatient follow-up with occasional abdominal pain, which subsides with intravenous dextrose therapy.
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PMID:Hemodialysis: a therapeutic option for severe attacks of acute intermittent porphyria in developing countries. 1827 38

A 31-year-old woman presented to King Abdulaziz University Hospital complaining of an abdominal pain and a rapid increase in abdominal girth. An ultrasound and MRI, revealed a huge cystic ovarian mass without ascites. Ovarian tumor markers were all within normal range. Exploratory laparotomy showed huge right ovarian mass with omental mass. Frozen section from the omentum showed metastatic malignant neoplasm. Total abdominal hysterectomy was carried out with bilateral salpingooophorectomy and omentectomy with residual tumor of less then one centimeter. Final pathology assessment showed primitive neuroectodermal tumor arising from the right ovary. She received post- operative chemotherapy. Four months later she had recurrence and was given second line chemotherapy, but she did not respond and died 15 months after the diagnosis due to obstructive uropathy.
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PMID:Primitive neuroectodermal tumor of the ovary. 1832 77

We report a case of sclerosing liver haemangioma with pericapillary smooth muscle proliferation in a 63-year-old man who presented with abdominal pain. Because the tumour showed atypical features on CT and MRI, a correct diagnosis could not be made until surgery. In this report, the atypical radiological findings are illustrated and correlated with pathological findings.
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PMID:Case report. Sclerosing liver haemangioma with pericapillary smooth muscle proliferation: atypical CT and MR findings with pathological correlation. 1848 82

Autoimmune pancreatitis is characterized by a lympho-plasmacytic infiltrate centred around the pancreatic ducts along with venulitis; it can produce a mass-like fibroinflammatory lesion and often simulates pancreatic malignancy or chronic pancreatitis of other types. This may lead to unnecessary surgical interventions. Patients, who are usually over 40 years of age, show 1) mild unspecific abdominal pain, 2) increased serum immunoglobulins (specifically IgG4) and autoantibodies, and 3) diffuse or focal enlargement of the pancreas with pancreatic strictures and sometimes jaundice due to biliary obstruction (detectable by US, CT, MRI, ERCP and/or endoscopic ultrasound (EUS)). The diagnosis can be strongly supported by EUS- or US-guided biopsies showing typical histological changes and specific indirect immunohistochemistry with the patient's serum or a steroid trial showing often a dramatic decrease of pathological findings within weeks.
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PMID:[Autoimmune pancreatitis: new concepts of an often overlooked disease]. 1854 13

We report two cases of hepatobiliary cystadenoma. Case 1. A 58-year-old male presented with dull abdominal pain and recurrent jaundice. Abdominal echo revealed biliary tracts dilatation; ERCP revealed amorphous filling defect inside the dilated CBD, a cystic tumor in the left lobe communicated with bile duct was disclosed by MRI/MRCP. He received left lobectomy and microscopic findings proved hepatobiliary cystadenoma. Case 2. Abdominal ultrasound detected a huge cystic tumor over the left hepatic lobe in a 69-year-old male. Abdominal CT revealed a large cystic mass lesion over the left hepatic lobe with septations and multiple papillary projections. A liver biopsy was performed and microscopic findings proved biliary cystadenoma. An abdominal ultrasound 6 months later revealed intrahepatic spread of cystadenocarcinoma over both lobes. Hepatobiliary cystadenoma is a rare benign cystic tumor of the liver. It usually occurs in middle-aged women and can undergo malignant change and become lethal. It is frequently misdiagnosed and should be suspected when a uni- or multilocular cystic lesion with papillary infoldings is detected in the liver by CT or ultrasound. ERCP/MRCP have a role in pre-operative evaluation. Elevated serum and cystic fluid tumor markers CA19-9 are only seen in some patients; cystic fluid cytology does not provide adequate diagnostic aid. Its morphologic features maybe confused with biliary papillomatosis or IPMN of bile duct. Its prognosis is excellent after complete resection.
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PMID:Hepatobiliary cystadenoma: a report of two cases. 1856 43

Spontaneous intrahepatic bleeding is a rare condition. In the absence of trauma, intrahepatic hematoma may be due to underlying liver disease. We report a case of hepatocellular carcinoma in the patient who had huge intrahepatic hematoma without definite intrahepatic tumor at the time of initial presentation. A 54-year-old man was admitted to our hospital with a sudden onset of upper abdominal pain. Initial abdominal CT scan showed huge hematoma measuring more than 13 cm in diameter in the right lobe of the liver. However, there was no enhancing lesion in the liver. Laboratory data showed high alanine aminotransferase, alpha-fetoprotein and positive HBsAg. The MRI and angiography could not also depict any mass in the liver. The patient was treated with percutaneous drainage on the intrahepatic hematoma. The cytology from drainaged blood revealed no malignant cell. After hematoma decreased, follow-up CT scan depicted an enhancing tumor in the liver. He underwent right hepatic lobectomy and histopathological examination showed hepatocellular carcinoma.
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PMID:[A case of hepatocellular carcinoma presented as a huge intrahepatic hematoma]. 1860 42

Abdominal pain is a major reason patients seek medical attention yet relatively little is known about neuronal pathways relaying visceral pain. We have previously characterized pathways transmitting information to the brain about visceral pain. Visceral pain arises from second order neurons in lamina X surrounding the spinal cord central canal. Some of the brain regions of interest receiving axonal terminations directly from lamina X were examined in the present study using enhanced functional magnetic resonance imaging (fMRI) before and one week after induction of a rat pancreatitis model with persistent inflammation and behavioral signs of increased nociception. Analysis of imaging data demonstrates an increase in MRI signal for all the regions of interest selected including the rostral ventromedial medulla, dorsal raphe, periaqueductal grey, medial thalamus, and central amygdala as predicted by the anatomical data, as well as increases in the lateral thalamus, cingulate/retrosplenial and parietal cortex. Occipital cortex was not activated above threshold in any condition and served as a negative control. Morphine attenuated the MRI signal, and the morphine effect was antagonized by naloxone in lower brainstem sites. These data confirm activation of these specific regions of interest known as integration sites for nociceptive information important in behavioral, affective, emotional and autonomic responses to ongoing noxious visceral activation.
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PMID:fMRI of supraspinal areas after morphine and one week pancreatic inflammation in rats. 1872 38

Uterine carcinosarcoma is a highly aggressive neoplasm with tendency to early recurrence and/or metastasis. The neoplasia has both epithelial and stromal malignant components. Clinically, it is characterized by a postmenopausal metrorrhagia, associated sometimes with abdominal pain. The Authors describe a case of carcinosarcoma in a 82-year old woman with a vaginal bleeding since 10 months and an ingravescent hypochromic anemia. The RMN of the abdomen and pelvis showed a mass occupying the whole uterine lumen, without signs of pelvic diffusion. A bilateral hystero-oophorectomy was performed; the patient's critical conditions and a high anaesthesiological risk advised us not to perform a bilateral pelvic lymphadenectomy with aortic sampling. Six months after operation, a clinical follow-up with a total-body CT didn't show any sign of local recurrence and/or distant metastasis. From the analysis of this case report and from the data of the literature some important considerations can be done: a) gynecologic check up in post-menopausal women with associated risk factors (obesity and hypertension) can allow an early diagnosis also in asymptomatic patients; b) sovrapubic and transvaginal US, abdomino-pelvic CT and MRI are essential for a correct clinical staging; c) surgical excision followed by the histological examination of the specimen is mandatory to establish a correct diagnosis.
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PMID:[A case of uterine carcinosarcoma]. 1883 71

Symptoms and findings during physical examination of patients with a femoral hernia are notoriously aspecific. Signs in the inguinal region tend to be overlooked, particularly in obese patients. Three women aged 72, 83 and 68, presented with abdominal pain and ileus due to incarcerated femoral hernias. A correct diagnosis was not considered prior to emergency laparotomy. One progressively septic patient with disseminated breast cancer refused reintervention after successful correction of the femoral hernia, and succumbed. The other two recovered uneventfully. Any older female patient with recurrent abdominal complaints may harbour a femoral hernia. The inguinal region should be examined, if possible in the upright position. Ultrasound, CT or MRI scans should establish the diagnosis. Open or laparoscopic intervention is required in patients fit for surgery since incarceration of a femoral hernia is associated with considerable morbidity and even mortality.
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PMID:[Elderly women with abdominal pain due to an incarcerated 'femoral hernia']. 1899 63


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