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Query: UMLS:C0001339 (acute pancreatitis)
 10,593 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report here an extremely rare case of breast signet-ring cell carcinoma (SRCC) initially manifesting as duodenal metastasis and acute pancreatitis. A 62-year-old female presented with duodenal obstruction and swollen head of the pancreas, and the diagnosis of acute pancreatitis was initially made. Upper gastrointestinal endoscopy revealed duodenal stenosis with erosive mucosa, with signet-ring cells infiltrating the submucosal layer, suggesting duodenal metastasis of SRCC. Despite absence of a palpable mass in both breasts, computed tomography revealed diffuse enhancement of the left breast in addition to left axillary lymphadenopathy. Histological examination of mammary needle biopsy samples revealed SRCC with a non-invasive lobular carcinoma component. Primary breast SRCC with duodenal metastasis was therefore diagnosed. The patient underwent palliative surgery twice for intestinal obstruction due to peritoneal dissemination. She has remained alive without bowel obstruction for 18 months while being treated with cytotoxic chemotherapies.
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PMID:Breast signet-ring cell lobular carcinoma presenting with duodenal obstruction and acute pancreatitis. 1763 43

The use of videolaparoscopic methods for the treatment of penetrating stomach and duodenal ulcers, acute cholecystitis, acute pancreatitis, acute appendicitis, intestinal obstruction, acute gynecological diseases and abdominal trauma is analyzed. Laparoscopic methods at urgent abdominal surgery improves the quality of diagnosis and treatment, decrease the rate of postoperative complications and lethality, reduce the hospital stay.
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PMID:[Laparoscopy in urgent abdominal surgery]. 1782 42

Most laparoscopic procedures are performed on an elective basis. However, as general surgeons have gained more experience with laparoscopy, they are employing this procedure also for the evaluation and treatment of acute abdominal conditions such acute appendicitis, acute cholecystitis, perforated gastroduodenal ulcer and abdominal trauma, acute pancreatitis and intestinal obstruction. Although its advantages are still under debate, the laparoscopic approach has already been adopted by many centers in the emergency setting.
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PMID:[Laparoscopic appendectomy]. 1809 58

The laparoscopic approach has represented a major step forward in general and emergency surgery. Its application in the emergency setting still raises a number of concerns that limit its more widespread use. To assess the true scope of laparoscopic surgery in the acute abdominal setting, we retrospectively evaluated our experience. From February 2003 to June 2007, 314 patients underwent an emergency laparoscopic operation, for low abdominal pain (193 patients), acute cholecystitis (78 patients), bowel obstruction (18 patients), diffuse peritonitis (16 patients), blunt abdominal trauma (6 patients), and acute pancreatitis (3 patients). Laparoscopy yielded a good diagnostic definition in all cases. The conversion rate was 16.6% (52 patients). Mean operative time was 63 +/- 29 minutes. The general major morbidity rate was 1.5% (4 patients) and the mortality rate was 0.4% (1 pt.). The laparoscopic approach in patients with abdominal emergencies is a useful tool that yields a reliable diagnostic definition in uncertain cases and allows minimal access treatment of the causative disease in the majority of cases.
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PMID:[Emergency laparoscopic surgery]. 1868 67

Eosinophilic gastroenteritis (EG) is an uncommon disease characterized by focal or diffuse eosinophilic infiltration of the gastrointestinal tract, and is usually associated with dyspepsia, diarrhea and peripheral eosinophilia. Diffuse gastrointestinal tract and colonic involvement are uncommon. The endoscopic appearance may vary from normal to mucosal nodularity and ulceration. Gastrointestinal obstruction is unusual and is associated with predominantly muscular disease. We present five unusual cases of EG associated with gastric outlet and duodenal obstruction. Two cases presented with acute pancreatitis and one had a history of pancreatitis. Four cases responded well to medical therapy and one had recurrent gastric outlet obstruction that required surgery. Four out of the five cases had endoscopic and histological evidence of esophagitis and two had colitis. Two patients had ascites. These cases reaffirm that EG is a disorder with protean manifestations and may involve the entire gastrointestinal tract. Gastric outlet and/or small bowel obstruction is an important though uncommon presentation of EG. It may also present as esophagitis, gastritis with polypoid lesions, ulcers or erosions, colitis and pancreatitis and may mimic malignancy.
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PMID:Unusual presentations of eosinophilic gastroenteritis: case series and review of literature. 1941 90

Intramural duodenal hematoma is an uncommon condition, which usually develops after blunt abdominal trauma. It is also reported as a complication of anticoagulant therapy, blood dyscrasia, pancreatic disease, and diagnostic and therapeutic endoscopy. The typical clinical pictures of intramural duodenal hematoma consist of upper abdominal pain, vomiting, fever, and hematochezia, and it is rarely accompanied by intestinal obstruction, peritonitis, and pancreatitis as its complication. We report a case of intramural duodenal hematoma extended to peritoneal cavity, and accompanied by acute pancreatitis following therapeutic endoscopy for duodenal ulcer bleeding in a 32-year-old man who was on maintenance of anti-coagulation therapy after valvular heart surgery.
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PMID:[A case of intramural duodenal hematoma accompanied by acute pancreatitis following endoscopic hemostasis for duodenal ulcer bleeding]. 1945 68

We describe an afferent loop obstruction in a patient who had a subtotal gastrectomy with Roux-en Y gastrojejunostomy for postvagotomy syndrome. The clinical presentation and initial studies suggested acute pancreatitis. A computed tomography scan showed a small bowel obstruction distal to the jejunojejunal anastomosis. The patient was taken to the operating room for an exploratory laparotomy, lysis of adhesions, and closure of her jejunostomy. Surgery was successful at resolving her obstruction. In any Roux-en-Y gastric reconstruction or gastric bypass patient presenting to the emergency department with abdominal pain and elevated transamines or pancreatic enzymes, a small bowel obstruction must be considered. Additional imaging with a computed tomography scan is advocated, as well as surgical consultation.
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PMID:Markedly elevated lipase as a clue to diagnosis of small bowel obstruction after gastric bypass. 1993 76

Acute pancreatitis in children is rare and is characterized by clinical, biological, and etiological polymorphism. We report the case of a 6-year-old child who underwent surgery for intestinal obstruction. The diagnosis of acute pancreatitis was made after the surgical exploration. Initial laboratory tests showed hyperlipasemia and mild hypertriglyceridemia. After 2 weeks of hospitalization, we found severe hypertriglyceridemia, which was considered the cause of acute pancreatitis. Based on a review of the literature, we emphasize the importance of considering acute pancreatitis in the diagnosis of abdominal pain in children. Hypertriglyceridemia is one of its rare causes and must be detected because specific treatments are needed. Blood triglyceride concentration in the initial phase can be misleading and the assay should be repeated after the acute episode.
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PMID:[Unusual presentation of hypertriglyceridemic acute pancreatitis in a child]. 2226 15

Nutritional therapy has an important role in the management of patient with severe acute pancreatitis. This article reviews the endoscopist's approach to manage nutrition in such cases. Enteral feeding has been clearly validated as the preferred route of feeding, and should be started early on admission. Parenteral nutrition should be reserved for patients with contraindications to enteral feeding such as small bowel obstruction. Moreover, nasogastric feeding is safe and as effective as nasojejunal feeding. If a prolonged course of enteral feeding (> 30 d) is required, endoscopic placement of feeding gastrostomy or jejunostomy tubes should be considered.
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PMID:Endoscopist's approach to nutrition in the patient with pancreatitis. 2329 22

The maximum tolerated dose for intraperitoneal injection and oral ingestion of thymoquinone was determined in male and female Wistar rats. A range of dose levels of thymoquinone: 20, 30 and 40 mg/kg body weight for intraperitoneal injection and 200, 300 and 500 mg/kg body weight for oral ingestion were tested for acute toxicity in rats. The results showed that the maximum tolerated dose for intraperitoneal injection was 22.5 mg/kg in male rats and 15 mg/kg in females, whereas for oral ingestion it was 250 mg/kg in both male and female rats. There were different signs of toxicity shown in rats which received intraperitoneal injection from those that received oral ingestion of thymoquinone. Rats which received intraperitoneal injection of thymoquinone showed toxicity signs which were related to acute pancreatitis. Meanwhile, rats which received oral ingestion of thymoquinone showed transient toxicity signs. Two deaths were reported at dose of 500 mg/kg as a result of bowel obstruction complications. The data presented in this study indicate that the route of administration of thymoquinone could have an influence on thymoquinone toxicity outcome in both genders.
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PMID:The effect of route of administration in thymoquinone toxicity in male and female rats. 2344 Jul 4


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