Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 65 year old woman with gall stones presented with crushing chest pain after an attack of biliary colic. The electrocardiogram showed ST segment elevation in leads I, aVL, and V1-V3 while leads II, III, and aVF showed ST segment depression. Cardiac enzyme activity remained within the normal range. During the next three weeks attacks of epigastric and right hypochondrial pain preceded by crushing chest pain with identical electrocardiogram changes occurred with decreasing frequency. Coronary arteriography showed 60% obstruction of the left anterior descending coronary artery and good left ventricular function. During the next three years the patient complained both of mild abdominal pain, probably biliary colic, and mild effort related angina pectoris without a relation between the two symptoms. It is suggested that the attack of variant angina was triggered by biliary colic through sympathoadrenal discharge causing vasospasm.
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PMID:Variant angina induced by biliary colic. 367 31

A randomized placebo-controlled double-blind trial was carried out in 24 patients with biliary colic pain in order to evaluate the analgesic effect of caerulein (CRL). Caerulein (1 ng/kg . min infused intravenously over 15 min) showed an analgesic effect that was significantly higher than placebo (p less than 0.001). The analgesic action of CRL was not inhibited by naloxone (0.4 mg intravenously, administered two times). Further, the effect of i.v. CRL or saline on artificially induced biliary tree hypertension was studied in 7 patients with a T-tube common bile duct drainage. During saline intravenous administration, increasing biliary tree pressure resulted in pain in 5 patients, with the threshold for pain being 40 cmH2O. During CRL intravenous infusion, significantly higher perfusion pressures were required to achieve a given common bile duct pressure and the pressure threshold for pain was not reached. Consequently, pain was prevented in all patients. These data suggest that CRL relieves biliary colic pain by reducing biliary tract pressure.
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PMID:Effect of caerulein in patients with biliary colic pain. 389 43

Biliary colic from spasm of the sphincter of Oddi has been a difficult diagnosis to prove. We describe a patient in whom the diagnosis was arrived at using a pharmacological provocative test employing codeine to reproduce pain and a change in liver and pancreatic serum enzymes, and ultrasound to demonstrate a transient increase in common bile duct diameter. Testing carried out before surgical sphincteroplasty reproduced symptoms, and brought about marked pancreatic and liver enzyme elevation and an increase in common bile duct diameter measured by ultrasound (0.4 to 1.0 cm). Such events did not occur after sphincteroplasty. This case study suggests that codeine may be a useful provocative agent and that ultrasound measurements of changes in common bile duct diameter may provide a useful method in the diagnostic approach to Sphincter of Oddi Spasm.
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PMID:Ultrasound in the diagnosis of sphincter of Oddi spasm. 391 Jul 12

In a double-blind trial, 60 patients with biliary colic were allocated at random to receive 200 mg ketoprofen, 1.8 g lysine acetylsalicylate or placebo by intravenous bolus. The patients were asked to rate their pain at intervals within 3 hours of injection and to indicate their overall pain experience on a visual analogue scale. Both ketoprofen and lysine acetylsalicylate proved significantly more effective than placebo in relieving pain, with no significant difference between them. A good analgesic response, reflected by complete or almost complete relief of pain within 30 minutes of injection, was recorded in 4, 17, and 16 patients, respectively, in the placebo, ketoprofen, and lysine acetylsalicylate treatment groups. All drugs were well tolerated. It is concluded that the results provide further evidence for a useful therapeutic role of prostaglandin inhibitors in the treatment of biliary colic.
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PMID:Successful treatment of biliary colic with intravenous ketoprofen or lysine acetylsalicylate. 392 64

Thirty-six patients with biliary colic and normal oral cholecystograms, upper gastrointestinal tract roentgenograms, and results of gallbladder ultrasonography underwent sincalide-stimulated biliary excretion scanning. Nineteen of these patients subsequently underwent cholecystectomies. Gallbladder ejection fractions (EFs) ranged from 0% to 88% (mean, 38%) and nine of 19 patients had exact pain reproduction with sincalide. All patients except one (EF, 35%) were cured of their symptoms. However, five patients were also cured who had a normal EF (greater than 50%). Histologically, 11 gallbladders showed chronic cholecystitis and eight were normal. We conclude that the sincalide biliary excretion scan is a useful test to study this group of patients. In patients with a decreased EF, cholecystectomy can be recommended with a high probability of symptom relief. In patients with normal EFs, clinical judgment is required, as some of these patients (five of five in this series) may still benefit from operation.
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PMID:The role of sincalide cholescintigraphy in the evaluation of patients with acalculus gallbladder disease. 400 56

Ceruletide is a decapeptide isolated from the skin of an Australian frog. Its chemical and biologic relationship to cholecystokinin and its potent relaxant effect on the sphincter of Oddi makes it useful in biliary colic. In this double-blind placebo-controlled experiment, 60 subjects with moderate to severe pain caused by biliary colic were injected with ceruletide, 1 ng/kg iv or with an equal volume of saline solution. Pain in the right hypochondrium, referred pain, and Murphy's sign were scored before and after treatment. Data indicate that ceruletide is effective in biliary colic.
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PMID:Ceruletide analgesia in biliary colic. 647 36

Monooctanoin, a cholesterol solvent, was infused into the biliary system of 11 patients. Twenty-eight (74%) of 38 total stones responded to monooctanoin: 16 (42%) decreased in size, and 12 (32%) dissolved completely. Ten stones (26%) did not change in size. We attribute this to inadequate drug-stone contact, which was corrected by placement of the infusion catheter contiguous to the stone(s). The use of a second catheter for biliary drainage avoided the side effect of biliary colic and increased patient compliance. An infusion rate greater than 5 ml per hour invariably produced pain and diarrhea. There were no significant side effects from monooctanoin in any of our patients when a two catheter system and an infusion rate of 5 ml per hour or less were used. A major drawback to use of this still experimental agent is the prolonged hospital stay. This may be ameliorated when at home use of monooctanoin is approved.
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PMID:Monooctanoin perfusion for in vivo dissolution of biliary stones. A series of 11 patients. 648 70

Endoscopic papillotomy was attempted in 60 high risk patients (mean age 76 years) with complications of common bile duct stones and preserved gallbladder. Successful papillotomy and bile duct clearance was achieved in 56 patients (93%). One patient died of bleeding shortly after papillotomy. In 5 patients without signs of complication, cholecystectomy was performed prophylactically. Three patients were lost to follow-up. No cholecystectomy was performed in 47 patients (mean follow-up 24 months). 35 (74%) of these cases were free of biliary symptoms; 5 (11%) complained of nonspecific dyspeptic pain and only 2 (4%) had biliary colic. Complications due to the preserved gallbladder occurred in 5 of 47 patients (11%). Two patients had a short transient bout of jaundice and cholangitis respectively. Three patients developed acute cholecystitis with subsequent empyema. Four out of five complications occurred within one month and in three of them the cystic duct was occluded at papillotomy. In summary, treatment of common bile duct stones by endoscopic papillotomy appears to be justified in high risk patients with preserved gallbladder. Gallbladder related complications are mainly to be expected early in the follow-up or in cases with cystic duct occlusion at papillotomy. Because of the risk of empyema, early cholecystectomy is indicated in cases of acute cholecystitis.
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PMID:[Endoscopic papillotomy in preserved gallbladder]. 662 47

The case is described of a 32-year old woman with an 8 year history of oral contraceptive (OC) use who developed vascular complications. Significant findings in the patient's history included an appendectomy and repeated biliary colic dating back 7 years. The patient sought help for an attack of hepatic colic with vomiting, chills, and fever, dyspepsia, and intolerance of fats. Pain was noted on palpation and the clinical and sonographic findings indicated hepatomegaly. Based on the other clinical and laboratory findings, a preliminary diagnosis of infected hepatic hydatidic cyst was made and the intrahepatic hematoma was drained. The postoperative diagnosis was a large hematoma occupying the greater part of the right hepatic lobe. A pleural hemorrhage occurred during postoperative hospitalization and was treated medically, but 4 days after discharge from the hospital the patient returned with a pleural hemorrhage that required drainage. Hydatidosis is endemic in the region of Spain where the case occurred, and the grounds for differential diagnosis are specified. Several illustrations including sonograms, X-rays, and results of computerized axial tomography are included and explained. With the increasing use of OCs in Spain, it is likely that more such cases will be seen.
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PMID:[Hepatic hematoma and pleural hemorrhages caused by prolonged ingestion of oral contraceptives]. 687 43

Though lymphocytic lymphoma often presents as a disseminated disease, involvement of the gallbladder or biliary tree in the absence of jaundice is very uncommon [1]. A patient with poorly differentiated lymphoma in complete clinical remission after combination chematherapy experienced repeated episodes of biliary colic; at laparotomy her right-upper-quadrant pain was found to be due to lymphomatous involvement at the common bile duct. Recurrence in nodes surrounding the biliary tree heralded by several months the onset of a systemic relapse which did not respond to further cytotoxic therapy.
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PMID:Biliary colic heralding systemic relapse in non-Hodgkin lymphoma. 689 67


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