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Query: UMLS:C0023890 (cirrhosis)
 42,195 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Nine major hepatic resections for hepatocellular carcinoma were performed during a period of 2 years and 4 months. HBsAg was positive in six patients, preoperative serum alpha-fetoprotein was more than 20 ng/ml in 5 patients, and liver cirrhosis was present in four patients. Two patients presented with spontaneous rupture of hepatocellular carcinoma. The great value of ultrasonography is stressed as an emergency diagnostic tool in any patient with an acute abdomen without obvious cause. There was no operative mortality or morbidity among this series of patients. All but one patient with a ruptured hepatoma are alive without evidence of disease 3-31 months after liver resection. These encouraging operative results made the authors willing to adopt an aggressive policy toward the surgical treatment of hepatocellular carcinoma.
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PMID:Experience with major hepatic resections for hepatocellular carcinoma. 253 54

Primary peritonitis, or spontaneous bacterial peritonitis, is a highly morbid and often fatal complication of cirrhosis and other conditions associated with ascites. Prompt antibiotic therapy may be lifesaving, as may early surgical intervention in patients who have signs and symptoms of an acute abdomen. During a 5-year period, 12 patients had 14 episodes of primary peritonitis diagnosed in our hospital. Three patients had exploratory laparotomy, and gram-positive organisms were obtained from peritoneal fluid in two patients. The clinical features, patho-physiology, and natural courses of these patients are presented and the current literature reviewed.
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PMID:Primary peritonitis. An unusual operative diagnosis. 268

The clinical features of 81 cases of abdominal tuberculosis (TB) are presented. The peritoneum was involved in 41 patients, the ileocecal area in 17, the anorectal area in 16, and mesenteric glands in 8. There was one case each involving the liver and sigmoid colon. Most patients were young women. The tuberculin reaction was significant in 83% of patients tested, and 54% had evidence of TB elsewhere. Tuberculous peritonitis was more common in native North American Indians and presented as an acute abdomen, abdominal tumor, or cirrhosis. Asians developed the majority of ileocecal and mesenteric lymph node disease and were frequently diagnosed as having Crohn's disease, appendicitis, or cancer. Anorectal cases presented with fistulae or abscesses and usually had concomitant pulmonary TB. The disease was fatal in five patients (6%), four of whom were diagnosed only after death. One noncompliant patient had a relapse. All other patients were cured after receiving treatment.
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PMID:Clinical features of abdominal tuberculosis. 276 Apr 89

During 1970-1976, 459 cases of primary carcinoma of the liver were admitted to the Department of Medicine, Siriraj Hospital, Thailand. Three hundred and two cases (66%) had associated cirrhosis. Fifty-five cases or 12 per cent presented with hemoperitoneum from ruptured carcinomatous nodules. In most of these, the presenting symptom were not dramatic and might be indistinguishable from other uncomplicated carcinoma of the liver. Only 2 cases presented as acute abdomen and 5 cases had severe abdominal pain for short duration prior to admission. Peritonoscopy were performed routinely in all cases with hemoperitoneum except the two cases which presented as acute abdomen. Fifty cases or 91 per cent had associated cirrhosis and the site of the rupture were visualized in 6 cases or 11.32 per cent. Fourteen patients were treated conservatively with the mortality rate of 100 per cent. Eight patients who presumably bled from coagulation defect were also treated conservatively with only 50 per cent mortality. Hepatic artery ligation was employed in 23 cases with 52 per cent mortality and bleeding stopped in 95 per cent, as compare with other conventional surgical measure such as packing, suture and cauterization to control the hemorrhage with 90 per cent mortality. Judging from our experience, hepatic artery ligation is of definite value for palliative treatment particularly in patient with hemoperitoneum from ruptured carcinoma of the liver.
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PMID:Intraperitoneal hemorrhage due to spontaneous rupture of primary liver cancer with particular reference to hepatic artery ligation. 742 31

Spontaneous bacterial peritonitis (SBP) is defined as infection of preexisting ascites without evidence for any intraabdominal source for secondary infection. SBP is now recognized with rising frequency and has mainly been reported in patients with alcohol-induced cirrhosis of the liver. We report SBP in a female dialysis patient whose ascites was not due to liver disease, but was possibly due to lupus erythematosus or represented 'nephrogenic ascites'. The patient had severe abdominal pain and a positive rebound phenomenon, fever and an elevated peripheral white cell count of 21,000 cells/microliters. Ascitic fluid analysis revealed an exudate with a protein concentration of 5.2 g/dl, 13,000 white cells/microliters with 94% neutrophils and positive cultures for Streptococcus morbillorum. Because of the dramatic clinical features the patient underwent laparotomy which did not reveal a source for secondary infection and in retrospect was unnecessary. The patient responded well to antibiotic therapy. This case report draws attention to SBP as a cause of acute abdomen in patients on chronic hemodialysis.
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PMID:Spontaneous bacterial peritonitis in a hemodialysis patient with systemic lupus erythematosus. 779 66

A case of hepatobiliary dysfunction as the initial manifestation of disseminated cryptococcosis is described. The patient was admitted with symptoms of hepatitis with cholestatic jaundice. Antibody tests for hepatitis B and C and human immunodeficiency virus were negative. The patient continued to deteriorate clinically. Eventually, the patient succumbed to hepatic failure. Autopsy disclosed systemic cryptococcosis that caused extensive necrosis of the liver. In review of the literature, only nine cases of cryptococcal infection presenting as hepatitis, cholangitis, and cholecystitis as initial manifestation were reported. Four of these patients had been subjected to exploratory laparotomy for clinical suspicion of acute abdomen. One patient developed cirrhosis as a result of cryptococcal hepatitis. Two patients succumbed to hepatic failure. Cryptococcosis is known to occur commonly in immunocompromised patients, yet only two reported cases presenting as hepatitis were associated with immunocompromised status.
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PMID:Hepatobiliary dysfunction as the initial manifestation of disseminated cryptococcosis. 1019 23

The entity of delayed splenic rupture represents an initially missed injury, a delayed presentation of the latter, or an actually delayed development of an initially latent, minor, splenic injury. Having encountered a number of patients presenting with splenic rupture days after what was considered a minor abdominal trauma we review our experience with this entity. This is a retrospective study. During the past 6 years 26 patients were treated at our level II trauma center for blunt splenic injuries. The 8 patients who presented 48 h or more after injury are the focus of this communication. All patients had an underlying medical condition: five were drug addicts (one was HIV positive) and the other three were affected by cirrhosis, sickle cell disease, and HIV. The mechanisms of injury were as follows: blunt assault in 5 patients, a fall in 2 patients, and unknown in 1 patient. The patients presented to our hospital after a mean lag time of 5 days after injury (range, 2-10 days). One patient presented in shock and underwent laparotomy after a positive diagnostic peritoneal lavage. Four presented with a clinical acute abdomen, and three presented with abdominal pain and anemia. Abdominal computed tomography (CT) was performed in the seven hemodynamically stable patients demonstrating hemoperitoneum in all: five had a grade III injury and two had a grade II injury. All patients survived after an emergency splenectomy. Delayed presentation of splenic injury after minor abdominal trauma is not uncommon in our indigenous population. It may be associated with drug abuse and HIV.
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PMID:Delayed presentation of splenic injury: still a common syndrome. 1222 14

The authors present case of patient with biliary stent dislocation after chest injury and fracture of VIII. rib. Polymorbid patient with cirrhosis, chronic pancreatitis, portal hypertension (Child Plugh B) and biliary stent insertion came with acute abdominal pain and inflammatory signs. Progressive signs of acute abdomen have led to laparotomy. Perforation of duodeno-jejunal-loop due to dislocated biliary stent, small loop adhesions and thickened intestine wall were found. Postsurgical period was complicated with obstructive ileus, cholecystitis and cholangiolitis and the second biliary stent was inserted. Present-day status of the patient is satisfactory.
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PMID:[Jejunal perforation by a plastic biliary stent after injury]. 1508 18

Eosinophilic colitis is an uncommon condition and rarely presents as acute abdomen. We report a 65-year-old man who presented with acute abdomen-- severe pain in upper abdomen, with pyrexia, tachycardia, guarding and right-sided intercostal tenderness--secondary to eosinophilic colitis and was successfully managed. He had additional problems in form of cirrhosis, chronic hepatitis, cholangitis, pyogenic liver abscesses and gout.
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PMID:Acute abdomen due to eosinophilic colitis with liver abscess. 1697 40

Three patients with hepatic cirrhosis and ascites, a 65-year-old man, a 17-year-old woman and a 49-year-old man, were admitted to hospital for progressive drowsiness, increased ascites, and melaena, respectively. An elevated number of polymorphonuclear leukocytes was found in the ascites. The three patients became more and more seriously ill. On the basis of the laboratory findings, a diagnosis of 'spontaneous bacterial peritonitis' was made. The patients recovered after administration of antibiotics. The signs and symptoms of spontaneous bacterial peritonitis can range from subtle, renal dysfunction or an altered mental state to the signs ofan acute abdomen. The common signs of infection such as fever and an elevated leukocyte count are present in only 50% of the patients. Gram-negative bacteria are most frequently isolated from cultures of the ascites fluid. The 1-year mortality is still 50-70% and is partly a result of the underlying liver disease. Prophylactic oral administration of a quinolone decreases the risk of spontaneous bacterial peritonitis in patients with gastrointestinal haemorrhage and in patients with a prior episode of spontaneous bacterial peritonitis. Long-term prophylaxis has been associated with the development of infections with quinolone-resistant microorganisms.
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PMID:[Spontaneous bacterial peritonitis, a severe complication in patients with liver cirrhosis]. 1758 97


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