Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0016199 (flank pain)
 2,189 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Peptic ulcers complicated by penetration into the surrounding tissue and presenting as an intra-abdominal mass simulating a malignancy are uncommon. We report on a case of a 56-yr-old physician with a 40-yr history of peptic disease. Due to recent and transitory right flank pain, an ultrasound then a computed tomography scan demonstrated a 4-cm retropancreatic mass. A fine-needle aspiration biopsy (FNAB) of the mass showed an acute and chronic inflammatory exudate. After a course of medical treatment for peptic ulcer disease and 5 mo after the biopsy, the mass remarkably decreased in size. In view of the clinical and FNAB findings, the lesion likely developed as a result of penetration of the duodenal ulcer into the retropancreatic space. Awareness of this uncommon complication of peptic gastroduodenal ulcer disease is helpful in the diagnosis of this benign lesion. A failure in making a firm diagnosis by considering the aspirate material as nonrepresentative may lead to an unnecessary repeat biopsy or an invasive procedure.
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PMID:Fine-needle aspiration biopsy of an intra-abdominal inflammatory mass secondary to a penetrating duodenal ulcer mimicking neoplasm. 1174 19

A 39-year-old Samoan man presented to the emergency department with fever, progressive weakness, and left flank pain of 1-month duration. For several months, he had also experienced progressive weight loss. There was no history of recent trauma, and he was not taking any medication. His medical history was notable for a large left groin abscess and left lower lobe pneumonia of unknown cause 1 year prior to the current admission. Furthermore, he had undergone exploratory laparotomy and gastric surgery for peptic ulcer disease approximately 10 years ago. Physical examination findings were positive for a tender firm mass in the left flank with no associated skin changes. Laboratory findings revealed an elevated white blood cell count of 18 x 10(9)/L. The urine cultures were negative. A computed tomographic (CT) image obtained 1 year prior to the current admission was unremarkable. CT of the abdomen and pelvis (section thickness, 5 mm) was performed after ingestion of 900 mL of 2% diatrizoate meglumine and diatrizoate sodium (Gastrografin; Bracco Diagnostics, Princeton, NJ). A 150-mL dose of iohexol (300 mg of iodine per milliliter) (Omnipaque; Nycomed, New York, NY) was administered intravenously at a rate of 4 mL/sec with a 70-second scan delay. Unenhanced CT images (not shown) did not reveal any areas of high attenuation.
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PMID:Case 117: actinomycosis of left kidney with sinus tracts. 1758 11

Milk-alkali syndrome is a rare cause of hypercalcemia characterized by the triad of hypercalcemia, renal insufficiency, and metabolic alkalosis that results from the overconsumption of calcium containing products. In the setting of pregnancy where there is a physiologic increase in calcium absorption, milk-alkali syndrome can be potentially life threatening. We report a case of a 26-year-old woman in her second trimester of pregnancy who presented with 2 weeks of flank pain, nausea, vomiting, anorexia, headache, and lightheadedness. The history revealed consumption of a large quantity of milk, calcium carbonate antacid, and calcium-containing prenatal vitamins. Her symptoms and hypercalcemia resolved with intravenous fluids and a loop diuretic. With the increased use of calcium carbonate for peptic ulcer disease, gastroesophageal reflux disease, and osteoporosis, milk-alkali syndrome has experienced a resurgence and must be considered in the differential diagnosis of hypercalcemia. In this clinical vignette we review the literature on milk-alkali syndrome in pregnancy and discuss important diagnostic and therapeutic considerations when managing the pregnant patient with hypercalcemia.
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PMID:Hypercalcemia in pregnancy: a case of milk-alkali syndrome. 2134 76