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

The physiology and pathophysiology of the sphincter of Oddi are poorly understood. The relationships of functional disorders of the sphincter to biliary and pancreatic disease and of organic lesions of the papilla to pancreatic inflammatory disease are subjudice to say the least. The efficacy of sphincter section in the treatment of chronic pancreatitis is unproved. Section of the sphincter may be necessary to treat biliary tract pathology but its use should not be routine or indiscriminative since, there is morbidity as well as mortality. Finally, the price of sphincterotomy is: 1. hemorrhage; 2. duodenal perforation; 3. pancreatic duct damage--a. acute pancreatitis; b. chronic pancreatitis; 4. sphincter incompetence--a. common duct regurgitation--cholangitis; b. pancreatic duct regurgitation--pancreatitis; 5. sphincter stenosis--obstructive jaundice; 6. stasis cholecystitis; 7. diarrhea; 8. morbidity 10%; 9. mortality 1.9%.
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PMID:The sphincter of Oddi, sphincterotomy and biliopancreatic disease. 39 44

Choledochal cysts are being recognized with an increasing frequency among the adult population. In this series a correct preoperative diagnosis was established in eight of the ten patients. The clinical tirad of obstructive jaundice, right upper abdominal pain, and a palpable flactuant mass was noted in only two cases but at least one of these symptoms was present in all patients. Acute pancreatitis, cholecystitis, and biliary calculi were the commonly associated findings. New etiologic and clinical concepts of choledochal cysts are reviewed and the spectrum of radiographic features in adults is presented.
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PMID:Choledochal cyst in adults. A clinical and radiological study in ten cases. 61 81

Extrahepatic biliary obstruction due to mechanical obstruction of the common bile duct is a relatively rare complication of pancreatic pseudocyst. When jaundice does occur, clinical or laboratory evidence of associated primary hepatobiliary disease or acute pancreatitis has invariably been present. The patient described had a 3-month history of painless juandice, 40-lb weight loss, pruritus, and hepatomegaly, but no clinical or biochemical evidence of acute or chronic pancreatitis. After initial evaluation, including an abdominal echogram and a transhepatic cholangiogram, carcinoma of the head of the pancreas was diagnosed preoperatively. At laparotomy, a small pancreatic pseudocyst obstructed the terminal portion of the common bile duct. This case illustrates that a pancreatic pseudocyst should be considered in the differential diagnosis of obstructive jaundice, even in the absence of clinical evidence of pancreatitis or pseudocyst formation.
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PMID:Silent pancreatic pseudocyst. An unusual cause of extrahepatic biliary obstruction. 113 Mar 80

The distinction between 'medical' and 'surgical' jaundice is often difficult due to the lack of specificity of biochemical liver function tests, and the difficulty in assessing hepatocellular function and biliary tract patency in the jaundiced patient. We present a noninvasive isotopic technique which gives reliable information on these parameters, resulting in a high degree of accuracy in the classification of jaundice. 131I Rose Bengal, which is handled by the liver like bromsulphthalein, is administered intravenously and count rates during hepatic uptake and biliary excretion are recorded over the liver, biliary tract and duodenum using a gamma camera/computer system, into which is built an electronic light pen, so that particular areas of interest can be studied. Blood clearance of the iostope is simultaneously measured, and from these data the T 1/2 of uptake, the plasma retention and the excretion quotient are determined. The results of the first 80 examinations show that by qualitative assessment of the uptake and excretory phases of the 'hepatogram' and by determination of the T 1/2 and excretion quotient, jaundice has been classified with an 86 per cent accuracy in cases where the diagnosis is not apparent from clinical and biochemical data. The T 1/2 of uptake correlates well with bromsulphthalein retention in the non-jaundiced patient, and when applied to patients with obstructive jaundice enables the progress of hepatocellular impairment with time to be studied, and its recovery after relief of the obstruction. Preliminary results suggest that the technique may also have applications in the study of biliary tract dynamics in patients with post-cholecystectomy syndromes and relapsing acute pancreatitis.
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PMID:The value of the radio-isotope hepatogram in the jaundiced patient. 119 37

A case of obstructive jaundice associated with acute pancreatitis is reported. The underlying cause was a dilated long pancreaticobiliary common channel impacted with stones and bile debris. There was no stone in the rest of the biliary system except for one in the lowest part of the common bile duct and the overall appearance of the stones suggested that they originated within the common channel itself. A long common channel may be an underlying cause of various pathological conditions in the pancreaticobiliary system. Early operative intervention is recommended when such a diagnosis is made.
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PMID:Stones in a long pancreaticobiliary common channel: a rare cause of obstructive jaundice and pancreatitis. 150 99

We report the case of a 34-year-old alcoholic who was initially seen in March 1985 because of acute pancreatitis. A mass was demonstrated in the head of the pancreas. Serial sonogram and computed tomography scans over 4 1/2 years revealed progressive encroachment of the duodenum without symptoms attributable to obstruction. In 1989, three separate endoscopies with multiple biopsies showed chronic inflammation and strictures. Hypotonic duodenography confirmed stricture and obstructed duodenum. Surgical intervention is being considered. Duodenal obstruction secondary to chronic pancreatitis is rare. It may proceed subclinically for several years independent of continued alcohol use. Only when obstruction became severe in our patient did the classic symptoms of postprandial nausea, emesis, and weight loss become manifest. Obstructive jaundice from chronic pancreatitis due to stricture in the pancreatic portion of the common bile duct is uncommon.
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PMID:Chronic pancreatitis progressing to duodenal obstruction in the absence of classic symptoms. 185 3

The authors give an account of their favourable experience with endoscopic treatment of choledocholithiasis in 414 patients (320 cholecystectomies and 94 with the gallbladder in situ). Removal of concrements from the ductus choledochus was achieved on the first attempt in 80% of the patients, during the second to fourth attempt in 20%. Immediate complications (acute pancreatitis, haemorrhage, perforation) were recorded in 4.1% of the patients, the mortality was 1.2%. The authors emphasize the importance of endoscopic treatment of choledocholithiasis with obstructive jaundice in particular in old and risk patients.
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PMID:[The importance of interventional endoscopy in biliary tract surgery]. 233 95

A rare case of pancreatic candidiasis is described. The patient presented with weight loss, obstructive jaundice and a mass in the head of the pancreas. Intra-operative fine-needle aspiration cytology was consistent with a well-differentiated adenocarcinoma of the pancreas and a radical pancreaticoduodenectomy was performed. However, histological examination of the resected specimen revealed acute-on-chronic pancreatitis complicated by candidiasis with no evidence of malignant disease. The association between this variety of pancreatic candidiasis and pancreatic abscesses due to Candida albicans in acute pancreatitis is discussed.
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PMID:Pancreatic candidiasis. A case report. 233 3

Chronic pancreatitis of biliary origin, frequently located in the cephalic portion of the organ, etiopathogenically dependent on biliary lithiasis, the anatomoclinical evolution of which is complicated by their presence, have a better prognosis, and are usually reversible following therapy of the biliary affections. Persistent chronic pancreatitis proper, usually of the recurrent type, associated with calcification and the development of pancreatic stones, and with pseudocysts, although rare in our country, raise diagnostic difficulties from the standpoint of surgery, and have a reserved prognosis. The authors have evaluated a total of 321 cases hospitalized between 1960 and 1987 with chronic pancreatitis of biliary origin (252 cases--78.5%), and chronic pancreatitis proper, not associated to biliary affections (69 cases--21.5%). Male patients totalled 33.6% of all cases. The authors stress the high frequency of chronic pancreatitis associated to biliary lithiasis (181 cases), in contrast with pancreatitis associated to nonlithiasic cholecystopathies (38 cases), or to postoperative cholecystic disturbances (33 cases). Chronic pancreatitis non-associated to biliary affections totalled 69 cases, of which 24 were of the persistent type, 13 were of the recurrent type, one had calcifications, two had pancreatic stones, four followed acute pancreatitis, six were complicated by pancreatic abscesses, and 9 were complicated by pseudocysts. The duration of biliary and pancreatic disturbances was between 3 and 5 years in 43.9% of the cases, and between 6 and 10 years in 21.3%. Chronic pancreatitis achieves a complex clinical syndrome, the dominant feature being the painful biliopancreatic syndrome associated to obstructive jaundice (42.4%), angiocholitis (47.6%), weight loss (46%), hepatic and renal failure (10.9%), diabetes (8.4%), and a tumoral mass (15.7%). Indirect surgical interventions aimed at suppressing the biliary factor were carried out in 291 patients, with very good results in 56% of the cases, good results in 32%, mediocre in 7%. In 2.4% of the cases surgery failed to improve the condition of the patients. Direct interventions on the pancreas, which consisted either in pancreatic decompression or in exeresis of the gland have been performed in 30 patients. Drainage of pancreatic abscesses was done in 6 patients (2 deaths), cystic-digestive anastomoses were performed in 8 patients, Wirsung-jejunostomy in 3 patients (1 death), cystostomy in one patient, distal pancreatectomy in one patient (deceased), viscerolysis and novocaine infiltration in 11 patients. In the 321 cases of chronic pancreatitis operated by direct and indirect procedures very good
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PMID:[Chronic pancreatitis: anatomico-clinical and surgical therapy characteristics. Our experience with 321 cases]. 252 82

Two cases of Caroli's disease confined to the left lobe of the liver are described. One patient is a 13-yr-old who presented with acute pancreatitis. The second patient presented with obstructive jaundice at age 60. In the latter case, the diagnosis was made by percutaneous transhepatic cholangiography, in the former by postoperative T-tube cholangiography. The diseased bile ducts were not resected in either patient. Both remain well at 4 and 5.5 yr postoperatively. Monolobar involvement in Caroli's disease has been described previously in only 34 published cases, and these are reviewed in detail.
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PMID:Monolobar Caroli's disease. 268 44


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