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

Acute pancreatic injury has been attributed to occupational exposure to chemical agents in workers, but there have been no previous reports of occupationally induced chronic pancreatitis. Severe chronic exocrine pancreatic insufficiency was found in a 29-year-old house painter, where other known causes of chronic pancreatitis could be ruled out. The patient had previously experienced abdominal pain and diarrhoea associated with exposure to spray paints followed by remission of the symptoms during vacations. Although the association between exposure and pancreatic insufficiency may be a random one, a possible causal relation should be further evaluated.
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PMID:Chronic pancreatitis possibly caused by occupational exposure to organic solvents. 400 86

By convention, resection of the proximal pancreas includes the distal stomach (and duodenum) and resection of the distal pancreas includes the spleen. In 28 patients the stomach and spleen were preserved to minimize functional disability. In 13 patients with proximal pancreatectomy (7 men, median age 39 years) the pylorus and first 3 cm of duodenum were preserved. Indications were chronic pancreatitis (n = 9) and localized neoplasia (ampulla 2, duodenum 1, insulinoma 1). One patient died (aged 81 years), and 2 required re-operation for a pancreatic abscess or stenosed choledochojejunostomy. The 12 survivors are well at a median of 1.25 years (range 0.25-3.25 years). In 15 patients with distal pancreatectomy (6 men, median age 44 years) the spleen was preserved. Indications were islet cell tumour in 2 and chronic abdominal pain in 13,9 of whom had an isolated dorsal pancreas and 6 of whom had histological evidence of chronic pancreatitis. Recovery was uneventful apart from 2 patients with a fluid collection in the lesser sac, 1 needing percutaneous aspiration. In the absence of gross inflammatory adherence, partial pancreatectomy need not entail removal of the adjacent stomach or spleen.
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PMID:Conservative pancreatectomy. 404 11

We report the history and endoscopic treatment of a 63 year old female patient with chronic pancreatitis and stenosis of the pancreatic duct. Several operations of the biliary system had been performed in this patient previously (cholecystectomy 1964, choledochoduodenostomy 1972, revision of the choledochoduodenostomy 1974). In 1976 a chronic pancreatitis and a prepapillary stenosis of the Ductus wirsungianus has been diagnosed by clinical and endoscopic radiological findings. In order to relief pain we performed endoscopic sphincterotomies of the pancreatic duct orifice in 1976, 1977 and 1979. Because of relapsing abdominal pain and worsening of the pancreatic duct stenosis we performed two endoscopic balloon dilations of the proximal pancreatic duct at 20 months intervals. These lowered the pancreatoduodenal pressure difference from 40 mm Hg to normal values (below 13 mm Hg) over more than 12 months. Until today only few--less than ten--endoscopic dilations of the pancreatic duct orifice have been reported. A final estimation of this procedure is premature. However our case should stimulate other groups to consider this new form of therapy in selected patients with chronic pancreatitis and marked stenosis of the pancreatic duct.
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PMID:[Endoscopic balloon dilatation in stenosis of the pancreatic duct orifice (case report)]. 406 Aug 4

A 12-year-old boy presented with recurrent abdominal pain and failure to thrive and was shown to have chronic calcific pancreatitis. Investigations failed to show any of the demonstrable causes of pancreatitis, but on family study four close paternal relatives were found to have had chronic pancreatitis, three with radiological calcification. No definable cause for pancreatitis had been determined in any of these relatives.
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PMID:Hereditary pancreatitis presenting in childhood: case report with family studies. 406 23

The name juvenile tropical pancreatitis syndrome (JTPS) is proposed for a disease which affects young people of both sexes in certain parts of the tropics and which is characterised by abdominal pain, diabetes, steatorrhoea, and pancreatic calcification. The condition seems to start with blockage of the pancreatic ducts by laminated secretions or inspissated mucus plugs which later calcify. Chronic pancreatitis follows. The hypothesis is that plugs are the result of pancreatic stasis due to prolonged lack of food in the stomach and/or gastroenteritis and dehydration. Most plugs are probably dislodged during convalescence when protein-containing foods are eaten and stimulate vigorous flow of pancreatic juice. The sluggish pancreatic flow produced by very-low-protein diets may not dislodge plugs. Repeated infection and anorexia can enlarge the plugs which ultimately calcify. JTPS therefore occurs in Third-World areas with a high rate of childhood infections, and where low-protein staples are taken. Cereal staples seem to reduce the incidence of JTPS in endemic areas because of their protein content.
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PMID:Pathogenesis of juvenile tropical pancreatitis syndrome. 610 87

A 29-year-old woman admitted for alcohol detoxification five years after a 90% distal pancreatectomy for chronic pancreatitis had abdominal pain similar to that associated with preoperative pancreatitis. Although her clinical course was consistent with recurrent pancreatitis, the serum amylase level remained normal, but the amylase creatinine clearance ratio became elevated and then returned to normal, paralleling her clinical course. The ACCR may be a useful laboratory method in diagnosing chronic recurrent pancreatitis in patients with decreased functional pancreatic tissue.
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PMID:Elevated amylase creatinine clearance ratio and normal serum amylase levels in chronic relapsing pancreatitis after partial pancreatectomy. 616 Jun 21

The purposes of this study were to (a) evaluate the effect of pancreatic extract administered to patients with chronic pancreatitis and recurrent abdominal pain in a placebo-controlled, double-blind crossover study, (b) investigate the effects of acute intraduodenal pancreatic enzyme perfusion on pancreatic secretion, and (c) assess the effect of chronic, noninterrupted pancreatic extract administration on basal and stimulated pancreatic secretion. These studies demonstrated that pancreatic extract decreases abdominal pain and that intraduodenal perfusion with proteases but not with amylase or lipase suppresses pancreatic exocrine secretion in patients with chronic pancreatitis. Chronic administration of pancreatic extract to patients with chronic pancreatitis decreased both basal and stimulated pancreatic exocrine secretion.
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PMID:Protease-specific suppression of pancreatic exocrine secretion. 620 86

The purpose of this report is to evaluate the role of endoscopic elimination of protein plugs in the treatment of chronic pancreatitis (CP) and suspected CP. Endoscopic aspiration of pure pancreatic juice (PPJ) was performed on 69 patients with CP or suspected CP. PPJ was collected from within the main pancreatic duct by endoscopic retrograde catheterization of the papilla after a rapid intravenous injection of secretin and CCK-PZ. Following results were obtained. (1) Various numbers of protein plugs were obtained along with PPJ in 26 of the 69 patients. (2) Endoscopic elimination of protein plugs provided 17 of the 26 patients with dramatic relief from abdominal pain and back pain, indicting that the procedure was often useful, at least, for relieving pain in patients with protein plugs in the pancreatic duct system. (3) Follow-up studies suggested that the procedure could be an effective therapeutic tool in selected cases of CP or suspected CP in which no prominent stenotic lesions were noted in the major pancreatic duct system and abstinence from alcohol beverage was strictly observed. (4) In 43 patients with no protein plugs in the pancreatic juice, in contrast, transient or partial relief from abdominal pain was provided in only one patient, respectively.
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PMID:Role of endoscopic elimination of protein plugs in the treatment of chronic pancreatitis. 621 3

Chronic pancreatitis is a serious disease with high morbidity and high mortality. It mostly affects young adults and specifically people with long-term alcohol intake. The diagnosis must be suspected in patients with abdominal pain of unknown origin and in patients with diarrhoea and/or weight loss, particularly if they regularly use alcohol or present with a mild diabetes developed after the age of 30 years. Fundamental problems, such as the aetio-pathogenesis and the mechanism for the abdominal pain, are still unanswered. Contradictory observations concerning the natural history have been reported and further studies are needed to characterize the long-term course of symptoms and complications. The long-term management of patients requires careful attention to medical abuse and to complications (pseudocysts, duodenal ulcer, overt diabetes, and exocrine insufficiency). The high risk for malignant diseases also has to be taken into consideration.
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PMID:Chronic pancreatitis: pathogenesis, natural history and conservative treatment. 638 43

Forty five cases of chronic pancreatitis have been diagnosed between January 1966 to July 1983 in the Hospital A. Posadas. The diagnosis was confirmed by the presence of one or more of the following data: pancreatic calcifications positive in 35, abnormal secretin test 37, ultrasonography and computed tomography pathological findings 10. Surgical operations were carried out in 25 patients and biopsy taken in 5. Thirty nine (86.6%) were males, 6 (13.3%) females, the mean age in each group was 47.4 and 39.8 years. Chronic alcoholism was certain in 41 (91.9) patients, in the remainder 4 no other etiologic factors were found. The main clinical data were: Weight loss 38 (84.4%) diabetes 34 (75.5%) pain 33 (73.3% in 7 as acute pancreatitis) Steatorrhea 23 (51.1%) jaundice 16 (35.5%- 11 by extrahepatic biliary tree obstruction, 5 by hepatic cirrhosis) pseudocysts 12 (26.6%). The more common associated diseases were: hepatic cirrhosis 6, fatty liver 2 (17.7%) gastroduodenal ulcer 6 (13.3%) cancer 4 (8.8%--gastric 1, pancreatic 3). In order to study the frequency of the clinical data the patients were grouped according to the presence or absence of calcifications and the etiologic factor Symptoms and signs were matched and statistic analysis (coefficient association phi) was made. Only a moderate association between acute pancreatitis in no calcified group and diabetes in calcified group were found. The chronologic study of certains clinical data shows that acute pancreatitis, jaundice, pseudo-cyst and surgical operations were significative more frequent in the first five years while diabetes has little more frequency in the second five year period. Twenty six surgical operations were carried out in 25 patients; 20 (76.9%) due to complications, 6 (23.1%) secondary to pain (pancreatic resection 3, pancreatoyeyunostomy 2, exploration 1). Twenty three patients were lost to follow-up, 12 died and 10 are still alive. This last group was followed at regular period, 8 remained asymptomatic and 2 have intermittent abdominal pain related to alcoholic ingestion.
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PMID:[Chronic calcified pancreatitis. Our experience]. 639 6


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