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Query: UMLS:C0000737 (abdominal pain)
31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The aim of our study was to assess the diagnostic accuracy yielded by endoscopic retrograde cholangio-pancreatography (ERCP) in a group of 41 patients presenting with persistent or recurrent abdominal pain and/or cholestasis following cholecystectomy. Each patient had previously undergone, without success, a different combination of non-invasive tests. Cannulation with adequate opacification of at least one duct was achieved in all patients. Aetiologically diagnostic findings obtained with ERCP were as follows: normal 36.8%, choledocholithiasis 34%, benign biliary stenosis 9.8%, chronic pancreatitis 4.9%, pancreatic carcinoma 2.4%, ampullary carcinoma 2.4%, cholangiocarcinoma 2.4%, miscellaneous 7.3%. ERCP gave a final diagnosis in 26 patients (63%) and in all the cases presenting with cholestasis. ERCP plays a first-line role in the diagnostic assessment of patients with the post-cholecystectomy syndrome. However, there is still a considerable part of this population in whom ERCP does not contribute to a diagnosis.
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PMID:ERCP in the assessment of patients with post-cholecystectomy syndrome: benefits and limitations. 263 83

In a prospective study the pancreatic duct diameter was measured sonographically before and after secretin stimulation in 20 healthy controls and 59 patients with upper abdominal pain, weight loss, and/or diarrhea. Whereas healthy controls and patients without pancreatic disease after secretin stimulation showed a distinct pancreatic duct dilatation of more than 90% of basal duct diameter, no distinct secretin-induced duct enlargement was observed in most patients with chronic pancreatitis. Patients with circumscript pancreatic duct stenosis even had a marked and longer-lasting duct dilatation after stimulation. In patients with anomalies of the pancreatic duct system, no uniform response was found after secretin injection. In this study the sonographic secretin test showed a sensitivity of 92% and a specificity of 95% for diagnosis of chronic pancreatitis. The results confirm that this diagnostic method can be recommended as a reliable screening test for pancreatic disease.
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PMID:Significance of a sonographic secretin test in the diagnosis of pancreatic disease. Results of a prospective study. 264 57

Two cases of haemorrhage from rupture of a splenic artery aneurysm into the pancreatic duct are reported. Both patients suffered from chronic pancreatitis; when haemorrhage appeared both patients experienced abdominal pain. In one patient the melaena was repetitive, in the other one--with a single episode of melaena - the endoscopy showed fresh blood near the papilla. In both patients ultrasonography and computerized tomography (CT) revealed a cystic mass in the pancreatic tail; CT scan also showed a clear contrast enhancement of these lesions after iodinated medium intravenous bolus. Coeliac arteriography confirmed the presence of two large saccular aneurysmal dilatation of the splenic artery. Both patients underwent a laparotomy: distal pancreatectomy with aneurysm resection and splenectomy were successfully performed.
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PMID:[Hemorrhage in the Wirsung's duct caused by aneurysm of the splenic artery in chronic pancreatitis]. 265 96

The clinical aspects, complications and association with other diseases were investigated in 407 patients with chronic pancreatitis. The most frequent symptoms were abdominal pain (93.6%), weight loss (91.6%), diabetes (37.8%) and malabsorption (31.7%). Pancreatic cysts (32.6%), ascites and/or pleural effusion (12.5%), pancreatic necrosis (11.2%), gastrointestinal bleeding (12.8%) and pancreatic abscess (7.3%) were the most frequent complications. The symptoms and complications observed are discussed and their incidences compared to those reported from other countries.
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PMID:[Chronic pancreatitis: clinical characteristics, complications and association with other diseases]. 270 Jan 4

In 122 patients with severe chronic pancreatitis and inflammatory enlargement of the head of the pancreas a duodenum-preserving resection of the pancreatic head was performed. Postoperative hospitalization was 16 days in median, the frequency of re-operation was 4.9%. In the early postoperative phase one patient died and hospital mortality amounted to 0.8%. Following a medium follow-up period of 4.2 years (min. 6 months, max. 15 years) 7 patients died (late mortality 4.9%). 77% of the patients were completely free of abdominal pain, 84% went back to their previous occupation. During the follow-up period in 81% of the patients the glucose metabolism was unchanged, in 13% it deteriorated, and in 5% it improved permanently; 80% of the patients had a marked increase in weight averaging 8.7 kg. Compared to the Whipple procedure the duodenum-preserving resection of the head of the pancreas spares the patient with chronic pancreatitis a gastric resection, the duodenectomy, and the resection of the extrahepatic bile ducts. The limited operative intervention at the head of the pancreas in terms of a subtotal resection and the preservation of the duodenum explains the low early and late postoperative morbidity and mortality.
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PMID:[Cephalic pancreatectomy with conservation of the duodenum in chronic pancreatitis with inflammatory lesions of the head of pancreas. Results of 15 years' experience]. 280 28

We report a case of subacute pancreatitis in a 26-year-old woman, who underwent partial pancreatectomy after a two-week history of abdominal pain. The patient had a long history of allergy. She did not show any well recognized cause of acute or chronic pancreatitis. This patient was thought to have eosinophilic pancreatitis because of the presence of a prominent eosinophilic infiltrate in the resected pancreas. Eosinophilic infiltration of the pancreas has been reported very rarely in the literature, and is usually associated with more generalized disease. In our case there was no extrapancreatic involvement, as shown by repeatedly normal blood eosinophil counts, and by histologically normal spleen, celiac lymph nodes, and gastroduodenal biopsies. We suggest that an allergic mechanism might be responsible for this patient's disease, based on past history of allergic manifestations and the important increase in her serum IgE.
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PMID:[Eosinophilic pancreatitis: a rare manifestation of digestive allergy?]. 280 7

In this study both pancreatic and bile duct sphincter pressures were measured on the same occasion by means of endoscopic manometry in 42 patients with long-standing upper abdominal pain. Nine (53%) of the 17 patients with abnormal sphincter function had a marked difference between the pancreatic duct sphincter pressure (PSOP) and the bile duct sphincter pressure (BSOP): 6 patients with a clinical diagnosis of biliary dyskinesia showed elevated BSOPs, whereas the PSOPs were normal. The reverse, an abnormal PSOP but normal or only a slightly elevated BSOP, was registered in the three patients with chronic pancreatitis. These findings indicate that a motor abnormality may be restricted to only one of the sphincters. Thus, when the sphincter of Oddi is investigated only from the pancreatic duct, manometry may either fail to show an abnormal BSOP in some patients with biliary dyskinesia, or it may falsely suggest this diagnosis in patients with unrecognized pancreatitis.
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PMID:Clinical significance of manometric assessment of both pancreatic duct and bile duct sphincter in the same patient. 281 40

A patient with intractable abdominal pain due to chronic pancreatitis was successfully treated by direct electrical stimulation of the celiac plexus. The details of the procedure are presented. This simple innocuous technique could be of value in treating patients with pain due to chronic pancreatitis who would otherwise have a near normal life expectancy. Also, it can be used in patients suffering from cancer of the pancreas and upper abdominal viscera.
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PMID:Electrical stimulation of the celiac plexus for pain relief in chronic pancreatitis. A clinical note. 287 14

A patient with annular pancreas presenting with severe upper abdominal pain is discussed. Endoscopic retrograde cholangiopancreatography (ERCP) was diagnostic, with successful injection of major and minor papillae showing pancreas divisum, an annular duct emptying at the major papilla and changes of severe chronic pancreatitis in all duct systems. Pylorus preserving pancreatoduodenectomy gave complete pain relief. The annulus was shown immunohistochemically to be entirely of ventral gland origin. Chronic pancreatitis was histologically less severe in the dorsal gland. Antegrade dye injection with x-ray showed dorsal to ventral connection in the resected specimen.
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PMID:Annular pancreas: a clinical, endoscopic, and immunohistochemical study. 292 Sep 17

In 128 patients with severe chronic pancreatitis and inflammatory enlargement of the head of the pancreas, a duodenum-preserving resection of the pancreatic head was performed. Median post-operative hospitalization was 15.5 days, and the frequency of reoperation was 5.5%. One patient died during the early post-operative phase, and hospital mortality amounted to 0.8%. After a median follow-up period of 3.6 years (range of 7 months to 16 years), six of 127 patients died (late mortality of 4.7%). Seventy-seven per cent of the patients were completely free of abdominal pain, 67% returned to their former occupations. During the late follow-up period, the glucose metabolism was unchanged in 80.7% of the patients, in 13.7% it deteriorated, and in 5.5% it improved permanently; 80% of the patients experienced a marked increase in weight averaging 8.7 kg. Compared with the Whipple procedure, the duodenum-preserving resection of the head of the pancreas spares the patient with chronic pancreatitis a gastrectomy, duodenectomy, and resection of the extrahepatic biliary ducts. In terms of a subtotal resection, the limited operative intervention at the head of the pancreas and the preservation of the duodenum explain the low early and late postoperative morbidity and mortality.
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PMID:Duodenum-preserving resection of the head of the pancreas in severe chronic pancreatitis. Early and late results. 292 14


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