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 54-year-old man, who had the history of a blood transfusion 29 years ago, was admitted to our hospital because of dyspnea and abdominal fullness. Physical examination revealed jaundice and massive ascites and laboratory data suggested liver cirrhosis. The high level of AFP and a CT scan indicated the association of hepatocellular carcinoma and its metastasis to the right adrenal gland. On the 21st hospital day, he suddenly complained of severe pain in the right upper quadrant and the right flank, and fell into hemorrhagic shock. Blood transfusion was given, but he died on the 24th hospital day. Autopsy revealed liver cirrhosis, accompanied by hepatocellular carcinoma with the metastasis to the right adrenal gland and multiple pulmonary tumor thrombi. Massive hemorrhaging due to rupture of the right adrenal metastasis was seen in the retroperitoneal space.
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PMID:[A case of hepatocellular carcinoma associated with multiple pulmonary tumor thrombi and rupture of its right adrenal metastasis]. 303 33

A case of leiomyoblastoma of the greater omentum, occurring in a 36-year-old man was described. Leiomyoblastoma of the omentum is extremely rare and only 6 cases have been reported in the Japanese and English literature up to date. According to the review of these cases, including the present case, 1) females were affected more frequently than males, and the age ranged from 36 to 76 years; 2) leiomyoblastoma was usually a large tumor which caused abdominal fullness and pain, and occasionally complicated with anemia and bloody ascites; 3) mitosis was rare, and there was no sign of metastasis and recurrence. Finally the morphological criteria and clinical parameters of malignancy in leiomyoblastoma were discussed.
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PMID:Leiomyoblastoma of the greater omentum. A case report and review of literature. 332 43

The medical records of 51 patients with primary small bowel cancer were reviewed. Twenty patients had carcinoid tumors, 17 had adenocarcinomas, 8 had leiomyosarcomas, and 6 had lymphomas. Presenting complaints were protean in nature and only 33 percent of patients had a correct diagnosis at the time of operation. Curative resection was attempted in 55 percent, but most patients presented late in their illness and only 27 percent had localized tumors. Survival has been poor: at most recent follow-up, 59 percent were dead, 14 percent were alive with disease, and 27 percent were alive and well. Earlier diagnosis may improve survival. Patients at risk for these tumors are usually more than 50 years of age with vague complaints such as weight loss, pain, abdominal fullness, and fatigue. They should undergo complete evaluation centered around exhaustive radiographic studies and liberal use of endoscopy.
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PMID:Primary malignant tumors of the small bowel. The Hartford Hospital experience, 1969-1983. 356 78

One complication of choledochal cyst in adulthood is the development of secondary carcinoma, usually well-differentiated adenocarcinoma. We report a case of extrahepatic bile duct carcinoma associated with choledochal cyst and presenting predominantly sarcomatous features. The patient was a 52-year-old female who presented with abdominal fullness and pain. Ultrasound (US), computed tomography (CT), and cholangiography revealed a choledochal cyst with a tumor. The resected choledochal cyst was 10 x 7.5 cm and contained a protruding, ulcerated tumor, measuring about 4.0 x 2.5 cm. Histologically, the tumor was composed of spindle-shaped or fusiform cells with occasional pleomorphic or bizarre giant cells and abundant fibrous stroma, similar to malignant mesenchymal tumors. However, further histologic and immunohistochemical examination revealed that the tumor was adenocarcinoma with prominent sarcomatous features. To our knowledge, sarcomatous change in extrahepatic bile duct carcinoma associated with choledochal cyst has not been previously described.
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PMID:A case of choledochal cyst associated with adenocarcinoma exhibiting sarcomatous features. 800 May 20

A 24-year-old man presented with vague abdominal fullness and a mild epigastric dull pain for about 3 months was found to have a pancreatic head tumor at a medical center 2 months ago. He came to our hospital for further treatment. Ultrasonography, endoscopic retrograde cholangiopancreatography (ERCP) and abdominal computed tomography (CT) all revealede a pancreatic head tumor. Laparotomy was performed because pancreatic head carcinoma was highly suspected. Indurated mass in the pancreatic head, enlarged lymph nodes and white tubercles on the intestine proved to be tuberculosis on histological examination of a frozen section. Acid fast bacilli were also found. The patient was given antituberculous therapy and is now doing well. To avoid unnecessary laparotomy, CT, echo-guided percutaneous aspiration cytology or biopsy and culture of the tissue for mycobacteria should be done in a patient with pancreatic mass, especially in a region where pulmonary and abdominal tuberculosis are common.
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PMID:Pancreatic tuberculosis mimicking pancreatic head carcinoma: a case report and review of the literature. 800 90

Five cases of primary cystic tumors of the intrahepatic bile duct are documented over a 5-yr period. Clinically, two cases had recurrent episodes and one had a first attack of jaundice, fever, and pain in the upper abdomen; one complained of abdominal fullness and one was asymptomatic. The appearance of the tumors were single, large, multilocular, and cystic. Important radiological findings included irregular thickness of the cystic wall, internal septation, and papillary projection. Marked biliary dilation was demonstrated in four of the patients. On the cholangiogram, amorphous filling defects were seen in the dilated extrahepatic bile ducts, and mucinous material could be removed from the ducts as well. Obstruction of the bile ducts by this mucinous bile was assumed to be the cause of cholangitis in three patients. Histological examination revealed three cases of cystadenoma and two cases of cystadenocarcinoma.
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PMID:Primary biliary cystic tumors of the liver. 847 Jun 46

Inflammatory fibroid polyp of jejunum is a very rare nonneoplastic lesion of gastrointestinal tract. We reported a 66-year-old male who presented with abdominal fullness, colicky pain, and vomiting for 4 days. Plain abdomen showed intestinal obstruction with dilated small bowel loops. The exploratory laparotomy was performed under the clinical impression of intussusception caused by small bowel tumor. The diagnosis of an inflammatory fibroid polyp causing jejunojejunal intussusception was confirmed after surgery.
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PMID:Inflammatory fibroid polyp of the jejunum causing intussusception. 899 61

Hirschsprung's disease rarely occurs in adult. If it occurs, the symptoms and signs are usually milder than those in children and manifest in form of chronic or intermittent constipation. Definite surgical intervention could be performed with good results. We reported a 36-year-old male adult with Hirschsprung's disease who manifested as obstructive colitis. The clinical course presented as abdominal fullness and pain, and colonoscopy revealed ulcerations and pseudopolyps formation in the sigmoid colon and rectum. Ganglion was absent in transanal rectal biopsy. Soave's procedure with protective ileostomy was done. Patient's bowel movements turned normal after closure of ileostomy three months later. The literature was also reviewed.
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PMID:Hirschsprung's disease manifested with obstructive colitis in adult: a case report. 906 13

While widely used in research, the 1991 Rome criteria for the gastroduodenal disorders, especially symptom subgroups in dyspepsia, remain contentious. After a comprehensive literature search, a consensus-based approach was applied, supplemented by input from international experts who reviewed the report. Three functional gastroduodenal disorders are defined. Functional dyspepsia is persistent or recurrent pain or discomfort centered in the upper abdomen; evidence of organic disease likely to explain the symptoms is absent, including at upper endoscopy. Discomfort refers to a subjective, negative feeling that may be characterized by or associated with a number of non-painful symptoms including upper abdominal fullness, early satiety, bloating, or nausea. A dyspepsia subgroup classification is proposed for research purposes, based on the predominant (most bothersome) symptom: (a) ulcer-like dyspepsia when pain (from mild to severe) is the predominant symptom, and (b) dysmotility-like dyspepsia when discomfort (not pain) is the predominant symptom. This classification is supported by recent evidence suggesting that predominant symptoms, but not symptom clusters, identify subgroups with distinct underlying pathophysiological disturbances and responses to treatment. Aerophagia is an unusual complaint characterized by air swallowing that is objectively observed and troublesome repetitive belching. Functional vomiting refers to frequent episodes of recurrent vomiting that is not self-induced nor medication induced, and occurs in the absence of eating disorders, major psychiatric diseases, abnormalities in the gut or central nervous system, or metabolic diseases that can explain the symptom. The current classification requires careful validation but the criteria should be of value in future research.
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PMID:Functional gastroduodenal disorders. 1045 43

Hemangiomas represent the most common primary tumor of the liver. Clinically the significance of these lesions is highly variable. The management of hemangiomas is controversial and is intimately related to the size, symptoms, and associated comorbidities of the patients who harbor these benign tumors. Series suggest that the vast majority of hemangiomas are less than 4 cm, asymptomatic, and clinically incidental findings. Symptomatic hemangiomas are large and associated with a constellation of vague upper abdominal complaints including pain, mass, distention, early satiety, and weight loss. A number of small series of surgically treated symptomatic hemangiomas have demonstrated enucleation as a safe and effective intervention. We report a collection of case reports using embolization as a primary treatment of symptomatic hemangiomas. The first patient is a 73-year-old black man previously treated for prostate cancer by radical prostatectomy and radiation. He developed weight loss, abdominal fullness, and early satiety. His symptoms were attributed to a large left lateral segmental liver mass that was biopsy proven to be a hemangioma. The second patient is a 49-year-old black women who complained of weakness, fatigue, night sweats, and anemia. The only abnormality discovered was a large right posterior hemangioma. The third patient is a 49-year-old black women with unexplained right upper quadrant pain and anemia who was found to have a 19 x 11 x 7.5-cm left hepatic hemangioma by CT. All three patients underwent elective treatment of their hemangiomas with highly selective hepatic embolization. There were no significant complications related to the procedures. Symptoms resolved for all patients acutely after treatment. The use of embolization for hepatic hemangiomas provides safe and effective treatment of the patient's symptoms while avoiding operative intervention, extended hospitalization, or postoperative recuperation. This treatment modality should be considered for the symptomatic hemangioma under elective conditions.
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PMID:Embolization for management of hepatic hemangiomas. 1124 41


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