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Query: UMLS:C0031154 (peritonitis)
 15,372 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

One hundred patients suffering from acute pancreatitis and studied in two large teaching hospitals in Brisbane between 1959 and 1973 were reviewed. Gallstones were present in 43 patients (of whom 31 were female), and a history of alcoholic excess were elicited in 23. Sixty-three patients were aged over 50 years. Characteristic clinical features included spreading epigastric pain with radiation to either of the upper quadrants of the abdomen. Left-sided upper abdominal peritonitis associated with severe repetitive vomiting was suggestive of the diagnosis. The serum level in most cases fell below the arbitrary diagnostic level of 500 Somogyi units/100 ml within 72 hours of the onset of the pain. Acute haemorrhagic necrosis of the pancreas was positively diagnosed in 15 patients, six of whom died. The overall mortality rate in the series was 9%.
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PMID:Acute pancreatitis: the Queensland scene. 26 65

Seven primary carcinomas of the duodenum were observed from 1973 to 1976 at the University Hospital Hamburg; four in females and three in males with an age between 32 and 69 years of age. The interval between the first symptoms (epigastric pain, jaundice, pruritus, diarrhea, and loss of weight) and surgical therapy (duodeno-pancreatectomy) averaged four months. All carcinomas were resected radically from the macroscopic (intraoperative) aspect as well as from the histological findings. Local tumour recurrences which proved fatal occurred in five patients within nine to twenty-one months. One patient died of peritonitis and another of pancreatitis. The diagnostic mode has been changed since the introduction of endoscopy and retrograde cholangio-pancreaticography (ERCP). The consistent inclusion of the duodenum in routine gastroscopy leads to the hope that more carcinomas of the duodenum can be detected early.
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PMID:[Duodenal cancer. A clinical-pathological study]. 65 97

An alcoholic man with known reflux esophagitis and Barrett's esophagus developed fever, epigastric pain, subcutaneous crepitus, and leukocytosis from an esophageal perforation at a Barrett's ulcer. Possible risk factors for perforation in this patient included alcoholism, severe gastroesophageal reflux, corticosteroid therapy, noncompliance with antacid and H2 blocker therapy, and the presence of acid-secreting parietal cells in the Barrett's epithelium. Five cases of this complication have previously been reported in a review of the literature, which included 536 cases of Barrett's esophagus or esophageal perforation. This entity may present with a clinical triad of a patient (a) in acute distress with fever and epigastric or noncardiac chest pain and without signs of peritonitis, (b) with symptoms of or known gastroesophageal reflux, and (c) with chest examination revealing subcutaneous crepitus, or chest roentgenogram revealing subcutaneous emphysema, pneumomediastinum, or hydropneumothorax.
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PMID:Esophageal perforation at a Barrett's ulcer. 258 67

Two years and 10 months after gastrectomy, a 38-year-old man was diagnosed as having carcinomatous peritonitis due to gastric cancer. He was treated by intra-abdominal administration of 100 mg CDDP three times in addition to UFT. After each administration of CDDP, the amount of ascites and the serum value of CEA were decreased. Subjective symptoms, such as epigastric pain or sensation of fullness, were also improved. Although one year and 8 months has passed since the first administration of CDDP, the performance status of the patient remains 0. Nausea or vomiting was noted within 2 days after each administration. However, severe complications, like renal failure or intra-abdominal hemorrhage, were not observed. These findings suggest that repeated intra-abdominal administration of CDDP may be a useful therapy for carcinomatous peritonitis due to gastric cancer.
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PMID:[Repeated intra-abdominal administration of CDDP in carcinomatous peritonitis due to gastric cancer--a case report]. 336 74

Reports of the presence of two histologically different neoplasms in one organ are still unusual. We experienced a rare case of coexisting primary malignant lymphoma and adenocarcinoma of the stomach. A 66-year-old woman was admitted in April 1983 because of weight loss and epigastralgia. Several examinations including gallium scan, upper GI endoscopy, biopsy and touch cytology of the stomach, were performed, and she was diagnosed as having primary malignant lymphoma (noncleaved, large cell type) of the stomach. After the administration of 20 mg of vincristine, 6,000 mg of cyclophosphamide, 1,000 mg of prednisolone and 150 mg of Adriamycin, she improved to complete remission in August 1983. In February 1984, she received gastrectomy because of stenosis of the esophagogastric junction. Microscopic examination of the ulcerated lesion at esophagogastric junction revealed moderately differentiated tubular adenocarcinoma infiltrating to the subserosa. Despite chemotherapy, peritonitis carcinomatosa developed, and the patient died of cachexia in July 1984.
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PMID:[A case of coexisting primary malignant lymphoma and adenocarcinoma of the stomach]. 375 8

We report 5 cases of human anisakiasis revealed respectively by an acute intestinal obstruction due to multiple small bowel stenosis, an acute inflammatory ileitis simulating appendicitis, ulcer type epigastralgia, purulent peritonitis and a latent small bowel tumor. Diagnosis was established in 4 cases on microscopic analysis of bowel specimens (eosinophilic granulomas and/or parasitic fragments) and in 1 case at gastroscopy. Serodiagnosis was positive in 2 of 4 cases and the consumption undercooked fishes was found in 4. In small samples we estimated the infestation (1 to 50 parasites) by anisakis larvae of 3 fish species: 80 p. 100 for herrings, 63 p. 100 for mackerels and 100 p. 100 for whitings. This work emphasizes the role of anisakiasis as a source of digestive symptoms and intestinal eosinophilic granuloma.
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PMID:[Human anisakiasis: 5 cases in northern France]. 395 15

Three percent to 30% of the episodes of peritonitis occurring in patients undergoing chronic peritoneal dialysis are culture-negative or aseptic. The etiology of these episodes remains poorly defined, though endotoxin-contaminated dialysates and fastidious anaerobic organisms occasionally have been implicated. We treated a patient who had fever, epigastric pain, and peritoneal fluid neutrophilic leukocytosis while undergoing chronic peritoneal dialysis. Despite multiple negative pretherapy aerobic, anaerobic, fungal, and mycobacterial cultures, bacterial peritonitis was the presumptive diagnosis. At postmortem examination, there were no findings to suggest infectious peritonitis; however, myocardial infarction with pericarditis was noted. We conclude that myocardial infarction should be included in the differential diagnosis of aseptic peritonitis in the patient undergoing peritoneal dialysis.
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PMID:Aseptic peritonitis secondary to myocardial infarction. 669 56

Pneumoperitoneum is most commonly caused by the perforation of a hollow viscus, in which case an emergency laparotomy is indicated. We report herein the case of a patient who presented with the signs and symptoms of peritonitis, but who was found to have idiopathic pneumoperitoneum which was successfully managed by conservative treatment. A 70-year-old man presented with epigastric pain, nausea, and a severely distended and tympanitic abdomen. Abdominal examination revealed diffuse tenderness with guarding, but no rebound tenderness. He was febrile with leukocytosis and high C-reactive protein. Chest X-ray and abdominal computed tomography demonstrated a massive pneumoperitoneum without pneumothorax, pneumomediastinum, pneumoretroperitoneum, or subcutaneous emphysema, and subsequent examinations failed to demonstrate perforation of a hollow viscus. Thus, a diagnosis of idiopathic pneumoperitoneum was made, and the patient was managed conservatively, which resulted in a successful outcome. This experience and a review of the literature suggest that idiopathic pneumoperitoneum is amenable to conservative management, even when the signs and symptoms of peritonitis are present.
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PMID:Conservative management of idiopathic pneumoperitoneum masquerading as peritonitis: report of a case. 764 Apr 58

Percutaneous gastrostomy is reported to be an effective alternative to total parenteral feeding or long-term nasogastric tube in the treatment of mechanical or functional dysphagia. The authors report their personal experience with 137 percutaneous gastrostomies performed on 98 men and 39 women from January 1986 through December 1993. All the maneuvers were performed under fluoroscopic guidance in the patients with head or neck cancer, neoplastic, vascular or post-traumatic neuropathy and upper GI tract cancer. To avoid left hepatic lobe trauma, percutaneous gastrostomy needs to be performed under US guidance. A 7F nasogastric tube is used to fill the stomach with air. After distending the gastric cavity, with the Seldinger technique under local anesthesia, fascial dilators of progressively increasing caliber are introduced into the gastric cavity and the final 12F gastrostomy catheter is positioned under fluoroscopic guidance. No major complications, such as hemorrhage or peritonitis, occurred. In one case, during the maneuver, the patient complained of severe epigastric pain which regressed with no further problems two hours later. In three cases the gastrostomy catheter fell out of place and was replaced by running the fistolous tract with a venous cannula and then a guidewire for gastrostomy repositioning. With this type of treatment, the patient can be given enteral feeding the following day. The maneuver requires approximately 10 minutes to perform and is well tolerated by the patient as it requires no general anesthesia. Percutaneous gastrostomy is more cost-effective than surgery or endoscopy and hospitalization is shorter. The only contraindications to this maneuver are hepatomegaly (because of the risk of liver trauma during percutaneous maneuvers), ascites (because of the risk of infection) and finally the complications resulting from gastric resection.
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PMID:[Percutaneous gastrostomy. Personal experience in 137 cases]. 787 38

Intraperitoneal administration of cisplatin (CDDP) etoposide (VP-16) and EAP therapy (combination chemotherapy with CDDP, adriamycin (ADM) and etoposide provided the curative resection for advanced gastric cancer with peritonitis carcinomatosa in a 48-year-old woman. She suffered from epigastralgia. CT shows the ascites, and ultrasonography shows Schnitzler metastasis. First, CDDP 100 mg and etoposide 200 mg were given intraperitoneally. Then, the ascites completely disappeared. Next, the patient underwent EAP therapy, after which Schnitzler metastasis disappeared, and total gastrectomy was performed. Macroscopically, it was of H0P0N0S2. Histopathologically, it was poorly differentiated adenocarcinoma and n0s2. She has been doing well with no evidence of recurrence for 18 months after operation.
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PMID:[A case of curatively operated gastric cancer with peritonitis carcinomatosa treated by intraperitoneal administration of CDDP.Etoposide and EAP therapy]. 799 23


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