Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The aim of this study was to evaluate the endoscopic retrograde pancreatographic (ERP) findings in respect of alcohol intake. Two hundred eleven patients consecutively submitted to ERP for upper abdominal symptomatology, with suspected pancreatic disease (SPD; 79 patients) or without (NSPD; 132 subjects), were classified in 3 groups of different ethanol intake: 1 (0-40 g/day), 2 (41-80 g/day), 3 (more than 80 g/day). The following conclusions could be drawn: (1) the frequency of ERP changes increases with the increase of alcohol intake both in SPD (34.6-63.8%) and NSPD (8.2-29.8%); (2) the frequency of pancreatic cancer was not related to alcohol intake, but in NSPD it was about 2-fold that in SPD: 12/132 (9.1%) vs 4/79 (5.06%); (3) a pancreatic morphological assessment, by means of ERP or other imaging techniques, should be performed in every subject with upper abdominal pain of unknown origin both in alcoholics (for the high incidence of chronic pancreatitis) and in non-alcoholics (for the risk of pancreatic cancer, which approximates 10%).
 ...
PMID:Frequency of pancreatographic changes in subjects with upper abdominal symptoms and its relationship with alcohol intake. 369 81

Pancreaticopleural fistula is an uncommon complication of chronic pancreatitis or pancreatic trauma. Clinical features include pleural effusion and resulting pulmonary symptoms. Abdominal pain and other clinical manifestations of pancreatitis may be minimal or absent. As in this case, computed tomography and endoscopic retrograde cholangiopancreatography may provide complementary diagnostic information in the evaluation of this condition. A discussion of the pathophysiology, diagnosis, and management of pancreaticopleural fistula is presented.
 ...
PMID:Pancreaticopleural fistula: demonstration by computed tomography and endoscopic retrograde cholangiopancreatography. 369 35

Complete duplication of the ventral pancreatic ductal system in 2 patients is reported. Both patients, during evaluation for recurrent abdominal pain, underwent endoscopic retrograde cholangiopancreatography that revealed typical changes of chronic pancreatitis and pseudocysts confined to 1 ductal system with the other ductal system completely normal. Both ductal systems filled with contrast medium via a common opening at the major papilla. A rudimentary minor papilla was present, but cannulations were unsuccessful. This unusual anomaly of the ventral pancreas with its embryologic basis, diagnosis, and clinical implications is discussed.
 ...
PMID:Duplex ventral pancreas. 379 52

We operated on 102 patients (89 men and 13 women) who had chronic pancreatitis. The mean age at the time of surgery was 45 1/2 years. Of these patients, 77 had resections (57 distal pancreatectomies, 17 duodenopancreatectomies, an three total pancreatectomies) and 25 had diversion procedures (15 Puestow operations and 10 internal drainage of cysts). The indication for surgery was abdominal pain in 88% and the presence of jaundice in 21%. Our patients had severe pancreatic disease: 64% had pseudocysts, 41% had calcifications, and 26% had calculi in the duct of Wirsung. The postoperative mortality rate was low (3%), but morbidity occurred in 18% (mostly after resection procedures). The incidence of diabetes after surgery was high after resection (57%) but it also occurred after diversion procedures (10%). The quality and length of survival was similar after resections and after diversions, although patients with alcoholic pancreatitis had the worst long-term prognosis. Reoperations were performed in 16% of all patients; the incidence was lower after duodenopancreatectomy.
 ...
PMID:Surgery for chronic pancreatitis. 381 Apr 83

Acute recurrent pancreatitis in the absence of alcoholism and gallstones is a frustrating illness for both the patient and the physician. Over a 10 year period, 33 patients were operated on and found to have a duct of Wirsung entering the duodenum through the fibers of the sphincter of Oddi. Recurrent pancreatitis of sufficient intensity to require hospitalization had occurred an average of 4.2 times per patient, and each had experienced numerous episodes of abdominal pain of lesser severity. At least two attacks of pancreatitis that required hospitalization had occurred in all patients. All known causes of pancreatitis, including alcoholism, gallstones, hypercalcemia, hyperlipidemia, drug reactions, and pancreas divisum were excluded. Endoscopic retrograde cholangiopancreatography showed no ductal abnormalities. Twenty-eight of the patients had previously undergone cholecystectomy 8 months to 20 years before operation. A sphinteroplasty of the common bile duct and duct of Wirsung resulted in elimination of attacks of pancreatitis in all except two patients. Follow-up has been more than 5 years in 16 patients, more than 4 years in 10 patients, and more than 1 year in 5 patients. There have been no deaths. It appears that the entrance of the duct of Wirsung into the duodenum through a separate orifice through the fibers of the sphincter of Oddi causes recurrent acute pancreatitis. It seems likely that the problem is one of intermittent pancreatic duct obstruction. Normal pancreatic duct caliber is attributed to the intermittent nature of the obstruction. Enlargement of the orifice of the duct of Wirsung and division of the sphincter of Oddi relieved attacks of recurrent pancreatitis.
 ...
PMID:Misplaced pancreatic duct orifice as a cause of recurrent acute pancreatitis. 381 90

This case concerns a 20-year-old male patient with an approximate 10-year history of recurrent and severe abdominal pain radiating to the back. Endoscopic retrograde cholangiopancreatography revealed a short obstructing stenosis of the main pancreatic duct in the head of the pancreas, marked and tortuous dilatation of the prestenotic portion of the main pancreatic duct and its side branches, and a filling defect in the side branch in the body of the gland. Pancreaticojejunostomy was performed to induce decompression of the pancreatic duct. Histology of the pancreas showed advanced chronic pancreatitis. Three nonopaque concretions were obtained at operation. The largest one, which was milky white in appearance and elastic and soft in consistency, proved to be made up of protein. The concretion was rich in acidic amino acids, but poor in basic or aromatic residues. The molar composition of amino acids in the concretion was, in decreasing order, aspartic acid, serine, valine, glycine, and glutamic acid. Powder x-ray diffractometry revealed no crystalline structures.
 ...
PMID:Chronic pancreatitis at early age of onset presenting interesting findings through endoscopic retrograde pancreatography and chemical analysis of nonopaque pancreatic concretion. 382 83

A case is presented of a 67-year-old man with chronic abdominal pain thought to be due to peptic ulcer disease. He developed nodules of panniculitis (nodular fat necrosis), resulting in extensive investigations for pancreatic disease. He was ultimately found to have low-grade pancreatitis associated with a pancreas divisum. Surgical treatment of this congenital anomaly resulted in complete resolution of the panniculitis and abdominal pain. Panniculitis as a manifestation of pancreatitis is well documented. However, panniculitis leading to the discovery of chronic pancreatitis with a surgically treatable ductal abnormality has not been previously reported. In cases of unexplained nodular fat necrosis, an aggressive search for a pathologic condition of the pancreas is indicated.
 ...
PMID:Panniculitis associated with a pancreas divisum. 395 Jan 33

In 55 patients undergoing pancreaticojejunostomy for intractable abdominal pain, common bile duct obstruction occurred in 29% (16/55) and duodenal obstruction occurred in 15% (8/55). Serum alkaline phosphatase and total and direct serum bilirubin levels were significantly higher in patients with intrapancreatic common bile duct stenosis. Transient upper gastrointestinal (UGI) tract obstruction was common with chronic pancreatitis; however, if symptoms persisted beyond 2 weeks, fixed duodenal obstruction was likely. Endoscopic retrograde cholangiopancreatography and UGI roentgenograms and endoscopy were useful in confirming mechanical obstruction to the biliary and UGI tracts, respectively. There was no difference in operative mortality and morbidity from combined drainage procedures compared with pancreaticojejunostomy alone. The biliary and UGI tracts should be investigated in symptomatic patients both before and after pancreaticojejunostomy. Combined drainage of the pancreatic duct and UGI and biliary tract is safe and effective treatment for obstructing complications of chronic pancreatitis.
 ...
PMID:Combined pancreatic duct and upper gastrointestinal and biliary tract drainage in chronic pancreatitis. 397 Jun 72

Previous studies have suggested that intraduodenal protease suppression of pancreatic exocrine secretion may be mediated through cholecystokinin (CCK) release. Our study compares basal plasma immunoreactive CCK concentrations in normal human subjects with those obtained in patients with chronic pancreatitis. Fasting plasma samples were collected from 18 normal subjects and from 18 patients with chronic pancreatitis. Eight patients had mild to moderate pancreatic exocrine impairment, and 10 had severe exocrine insufficiency. Venous plasma immunoreactive CCK concentrations were measured with two distinct peptide region-specific antibodies. Basal plasma CCK concentration in controls was 14.3 +/- 1.3 fmol/ml (mean +/- SEM), a value significantly less than that obtained in all patients with chronic pancreatitis, 30.1 +/- 4.0 fmol/ml (p less than 0.001). Patients with mild to moderate impairment had a fasting plasma CCK concentration of 32.8 +/- 7.9 fmol/ml (vs. control p less than 0.01), and those with severe disease 27.9 +/- 3.6 fmol/ml (vs. control p less than 0.001). In five patients with mild to moderate impairment of exocrine function and pancreatic extract-responsive abdominal pain, there was a 39 +/- 11% decrease in basal CCK levels during extract therapy (p less than 0.05). Results of this study indicate that pancreatic exocrine impairment is associated with elevated basal CCK levels, which may reflect a failure to provide feedback downmodulation of CCK release.
 ...
PMID:Elevated fasting cholecystokinin levels in pancreatic exocrine impairment: evidence to support feedback regulation. 397 64

A 36-year-old man, followed for 14 years with recurrent abdominal pain, developed chronic calcific pancreatitis and was found to have pancreas divisum on endoscopic retrograde pancreatography. An intraoperative biopsy showed normal acinar tissue in the head of the pancreas, while the body and tail were replaced by fibrous tissue. His pain resolved following surgical drainage of the dorsal pancreatic duct. Evaluation of the clinical course of this patient and critical review of other such cases in the literature support the role of compromised ductal drainage of the dorsal pancreas in the pathogenesis of chronic pancreatitis in pancreas divisum.
 ...
PMID:Pancreas divisum. A cause of chronic relapsing pancreatitis. 399 62


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>