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Query: UMLS:C0033774 (pruritus)
 14,546 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A technique of percutaneous transhepatic drainage under local anaesthesia is described for the relief of intractable pruritus in patients with obstructive jaundice due to inoperable carcinoma. After standard percutaneous transhepatic cholangiography a polyethylene catheter is introduced into one of the large dilated bile ducts and left in situ, thereby establishing external retrograde biliary drainage. The technique has been used successfully in 6 cases with reduction in serum bilirubin levels and relief of pruritus.
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PMID:Palliative percutaneous transhepatic drainage for inoperable obstructive jaundice. 618 32

Viral hepatitis characterized by prolonged cholestasis has not been associated with a specific serologic marker. We report the cases of six patients presenting with a clinical syndrome typical of cholestatic hepatitis who were subsequently found to have acute hepatitis A. Usual features include pruritus, fever, diarrhea, and weight loss with serum bilirubin levels greater than 10 mg/dL, and a clinical course lasting at least 12 weeks. All patients recovered completely without sequelae. Knowledge of this unusual manifestation of hepatitis A may help avoid potentially invasive procedures involved in the evaluation of suspected obstructive jaundice and facilitate appropriate immunoprophylactic measures.
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PMID:Prolonged intrahepatic cholestasis secondary to acute hepatitis A. 648 95

Two siblings with progressive intrahepatic cholestasis were reported. The brother died at 4 years of age because of hepatic failure followed by persistent obstructive jaundice starting at 4 months of age. The sister had unique clinical features, including recurrent obstructive jaundice since early infancy, radiopaque gallstone and neurological abnormalities which were cerebellar ataxia, bilateral ptosis, hyporeflexia and visual disturbance involving retinal degeneration and optic atrophy. She had a coarse facial appearance, camptodactyly and sclerotic skin with many scratch marks. Persistent high levels of serum bile acids were found while the patient was icteric and even anicteric, though serum cholesterol levels were approximately within normal limits. The serum lipoprotein-X was negative whenever examined. Cholestyramine treatment gave incomplete relief from pruritus but resulted in no improvement in her clinical course.
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PMID:Familial cholestasis with gallstone, ataxia and visual disturbance. 711 42

Cholestatic jaundice associated with chills, pruritus and blood eosinophilia developed in a patient who received prajmalium bitartrate therapy for ventricular arrhythmia following acute myocardial infarction. Discontinuation of the drug resulted in a spontaneous improvement in the clinical and biochemical findings. Challenge by prajmalium bitartrate caused rapid reappearance of the clinical and biochemical features. In immunological studies, deposits of IgG and IgA were detected at the bile canaliculi by fluorescent staining, and the patient's lymphocytes produced macrophage migration inhibition after in vitro incubation with prajmalium bitartrate. Thus, laboratory results support the assumption of an allergic mechanism.
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PMID:Cholestatic jaundice: an immune response to prajmalium bitartrate. 722 Apr 13

Twenty-seven patients underwent percutaneous antegrade biliary drainage for obstructive jaundice. The serum bilirubin levels was elevated in all patients. Generalized pruritus was a major complaint. Twenty of the patients had had a laparotomy for malignant disease. Of the 24 patients in whom this method of drainage was successful, the obstructing lesion was found at the porta hepatis in 12 and in the extrahepatic bile ducts in 12. Metastatic disease was the commonest cause of obstruction. Following drainage the serum bilirubin level fell from a mean of 21.4 mg/dl (366 mumol/l) to a mean of 4.1 mg/dl (70.1 mumol/l) within a week. Pruritus was relieved. The major complications were transient cholangitis in five patients and inadvertent dislodgement of the catheter in four. In three of these patients another catheter was reinserted with ease. There was no peritonitis or uncontrolled bleeding. Twenty-one patients were able to leave hospital. Their mean survival time was 7.3 months. A multiperforated catheter manipulated through the obstruction has the advantage of permitting bile flow into the duodenum (antegrade) in contrast to external drainage (retrograde) by T- or U-tubes. Although the mean survival time with this method is similar to that with insertion of drainage tubes at the time of laparotomy, morbidity and mortality are reduced; this is important in view of the poor prognosis of bile duct obstruction due to malignant disease.
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PMID:Percutaneous antegrade biliary drainage: a nonoperative approach to biliary obstruction. 732 20

PTC was performed in 86 patients with obstructive jaundice, between February/80--March/81 diagnosing 20 cases of the hepatic hilium carcinoma, 14 of pancreatic carcinoma, and 2 multiplex abscess of the liver. PTC-D was successfully attempted on 16 patients, catheterizing the intrahepatic biliary tree in 15 and maintaining a good biliary flow in 10 of them. The catheter was on the correct position into the biliary tree in 6 patients, and the drainage continued for 7-20 days. General improvement was obtained in 83.33%, itching decreased in 40% and disappeared in 60%, cholestasis was reduced in 100% and sepsis in 75%. Complications of the technique were: pain during the introduction of the guide wire (18.75%) and transitory hemobilia (31.21%). PTC-D seems to be a procedure with a precisely indication in every transitory obstructive jaundice, in order to put the patient in better conditions to a definitive therapy: 1) Surgery 2) Prosthesis 3) External-internal biliary drainage.
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PMID:[Percutaneous transhepatic biliary drainage in obstructive jaundice]. 733 50

This paper reports 19 cases of malignant obstructive jaundice treated by endoscopic retrograde biliary drainage (ERBD). Since 1989, ERBD is a palliative treatment of inserted into the obstructed bile duct by endoscopy. This method can efficiently relieve biliary obstruction. Elimination jaundice reduces some discomforts such as irritating pruritus. It also increases the appetite and improve patient's general physical condition. Temporary preoperative decompression of the bile ducts in seriously jaundiced patients should result in a significant reduction postoperative morbidity and mortality. There were 9 patients of this group who underwent operation after a short period of drainage, These patients weren't found any postoperative complication. ERBD also be used for palliative decompression of the bile duct in cases of inoperable cancer. The method was carried out in 7 inoperable patients of this group. Results were satisfactory.
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PMID:[Endoscopic retrograde biliary drainage for malignant obstructive jaundice]. 751 76

One-hundred-and-forty-five cases of malignant obstructive jaundice were seen from January 1989-December 1992. Carcinoma gallbladder (74/145) and carcinoma pancreas (67/145) were the two common causes. Fifty patients underwent a palliative surgical biliary bypass procedure. Jaundice was present in all the patients. Pruritus (40/50), cholangitis (17/50) and gastric outlet obstruction (11/50) were the other predominant symptoms which required palliation. Surgical palliation was achieved with a morbidity and mortality of 38% and 8%, respectively. Jaundice, pruritus and cholangitis were relieved in 92%, 88% and 88%, respectively. All patients with gastric outlet obstruction had complete relief. The mean hospital stay was 18.5 days. The mean survival was 6.5 months and 8.6 months for carcinoma gallbladder and carcinoma pancreas, respectively.
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PMID:Palliative surgical treatment of malignant obstructive jaundice. 752 98

Jaundiced patients experience intense pruritus, the pathophysiology of which is unclear. In this study, blood histamine concentrations, skin mast cell counts and intracellular histamine concentrations in peritoneal mast cells were examined in an experimental model of biliary obstruction. Three weeks after bile duct ligation (BDL), total blood histamine concentrations were significantly elevated compared with those from control animals (p < 0.0001). Skin mast cell counts were increased (p < 0.05) and peritoneal mast cell histamine content decreased (p < 0.05) in jaundiced animals. These results demonstrate that mast cells degranulate in biliary obstruction with consequent release of histamine into the systemic circulation. This may contribute to cholestatic pruritus. These data may have significant pharmacological implications in patients with obstructive jaundice.
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PMID:The role of mast cell activation in cholestatic pruritus. 752 50

We report a case of von-Recklinghausen's disease presenting with obstructive jaundice and found to have a somatostatin-containing carcinoid tumor in the papilla of Vater and a small neurofibroma in the duodenum. A 42-year-old woman with von-Recklinghausen's disease presented with intermittent jaundice, pruritus, and mild steatorrhea of a two-year duration. Abdominal ultrasonography and computed tomography showed dilated intrahepatic ducts, common bile duct and pancreatic ducts. Duodenoscopy showed a tumor at the papilla of Vater, but a preoperative biopsy failed to provide a definite diagnosis. Laparotomy revealed a yellowish tumor at the papilla of Vater and another nodule on the mesenteric side of the second section of the duodenum. Microscopically, the tumor at the papilla of Vater was found to be a somatostatin-containing carcinoid tumor. The small nodule on the mesenteric side was a neurofibroma. The jaundice, pruritus and steatorrhea disappeared after surgery.
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PMID:Somatostatin-containing carcinoid tumor of the duodenum in neurofibromatosis: report of a case. 790 72


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