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

The presentation of ampullary carcinoma as acute pancreatitis has been documented only in scattered reports but may be more common than is generally appreciated. More typically this uncommon gastrointestinal neoplasm presents with obstructive jaundice, weight loss, anorexia, and nonspecific abdominal pain. A case of ampullary carcinoma is presented in which the clinical features and computed tomographic appearance were those of relapsing, acute pancreatitis. Only after various clinical and radiographic features indicated on ampullary lesion was the etiology of the pancreatitis finally established and a curative resection performed.
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PMID:Carcinoma of the ampulla of Vater presenting as acute pancreatitis. 669 May 7

Percutaneous transhepatic biliary drainage (PTBD) was performed on 85 patients with obstructive jaundice. Four patients developed an acute pancreatitis after internal drainage of which one died. To our knowledge this serious complication has not yet been described in detail. These four cases are, therefore, reported and the possible causes are discussed.
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PMID:Acute pancreatitis in obstructive jaundice following combined internal and external percutaneous transhepatic bile duct drainage (PTBD). 687 70

The serum levels of a poly-[C]-specific acid ribonuclease (RNase) found in the pancreas was measured in 40 normal persons and 137 patients with pancreatic cancer, other cancers, obstructive jaundice, acute pancreatitis or chronic pancreatitis. Serum RNase increased by as much as 800 percent above normal in 69 percent of patients with pancreatic cancer. Analysis of the serum isoenzymes of RNase by isoelectric focusing did not reveal any unique RNases produced by the tumours. In contrast, serum RNase rose in only 8 percent of patients with other cancers, 11 percent of other patients with obstructive jaundice and in no patients with chronic pancreatitis. These data suggest that the finding of increased serum RNase is of adjunctive value inthe diagnosis of pancreatic carcinoma and may be particularly helpful in distinguishing it from other causes of biliary obstruction and from chronic pancreatitis.
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PMID:Sensitivity and specificity of serum ribonuclease in the diagnosis of pancreatic cancer. 735 Aug 42

The levels of serum secretory component (SC) were measured in 147 patients with digestive disease. Decreased levels were found patients with acute hepatitis, HBs-antigen associated chronic hepatitis, HBs-antigen associated liver cirrhosis and hepatoma. Normal levels were observed in patients with diabetes mellitus, gastric cancer and colonic carcinoma. Elevated levels were found in patients with cholecystitis, obstructive jaundice and acute pancreatitis. The serum SC level in almost all disease groups showed no correlation with immunoglobulin levels.
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PMID:Studies on secretory component in digestive disease. III. Levels of serum secretory component in digestive disease. 743 18

The spontaneous disappearance of limy bile from the gallbladder causing transient obstructive jaundice and acute pancreatitis is extremely rare. Only five cases causing obstructive jaundice alone have so far been reported. We report a patient with obstructive jaundice and acute pancreatitis in whom the initial abdominal film showed limy bile in the gallbladder, which subsequently disappeared in the following abdominal films.
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PMID:Spontaneous disappearance of limy bile. A cause of acute pancreatitis? 803 19

Endoscopic retrograde cholangio-pancreatography presents the only method which not only produces exact results concerning the morphology of the pancreatic and biliary ducts but also enables therapeutic access to these structures. In childhood ERCP is indicated if other non invasive diagnostic procedures do not help to establish a diagnosis or if further informations concerning indication or planning of an operation can be expected. In 25 children and 13 adolescents ERCP established the correct diagnosis in 95%. The success rate in newborns after the second month reaches 90%. For children before the age of 2 months a pediatric duodenoscope with a diameter of 7-9 mm is necessary. In obstructive jaundice, after trauma of the upper abdomen and especially in pancreatitis of unknown origin ERCP should be performed liberally, because a lot of exploratory laparotomies can be prevented, and significant findings for operative intervention can be collected. Moreover the causes of pancreatitis can be evaluated and treated definitely. With EST impressive improvements in the clinical course of obstructive jaundice, cholangitis and acute pancreatitis even in children and adolescents can be reached. In our own series 9 children (3 acute biliary pancreatitis, 3 chronic obstructive pancreatitis, 1 acute pancreatitis, 2 biliary duct stones with cholangitis or ampullary stenosis) were treated successfully without any significant complications. In acute pancreatitis an ERCP should be performed as early as possible (during 24-48 hours after onset of symptoms) because only in this instance the etiologic factors can be evaluated reliably and using endoscopic sphincterotomy of the sphincter proprius choledochi and/or the sphincter proprius pancreatis be treated adequately and with the lowest risk in time.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Indications, findings and complications of ERCP in pediatrics]. 831 Jul 29

To evaluate the rationale of using antibiotics in acute pancreatitis and to determine whether the indication for their use depends upon the etiology of the pancreatitis, the records of 202 patients with acute pancreatitis were retrospectively reviewed. The incidence of abnormal body temperature, leukocytosis, bacteremia and the results of biochemistry tests in different etiologies of the disease were investigated. Pancreatitis was found to be alcohol-related (47 patients), gallstone-related (105 patients), idiopathic (26 patients) and miscellaneous (24 patients). On admission, 83 patients had abnormal body temperature and 146 patients showed leukocytosis. Bacteremia occurred in 20 patients. Of these, 15 had gallstone-related pancreatitis, two had pancreatic cancers and one developed bacteremia after endoscopic retrograde cholangio-pancreatography (ERCP). These 18 patients had abnormal biochemistry results (including high serum levels of direct bilirubin, alkaline phosphatase and gamma-glutamyltransferase) and dilated bile ducts on imaging studies, indicating biliary infections. The remaining two patients with bacteremia included one alcoholic patient and one patient with idiopathic pancreatitis. The most commonly involved pathogens were Escherichia coli and Klebsiella pneumoniae. In addition, eight patients (4%) developed secondary pancreatic infections during hospitalization; the blood cultures of seven of these patients were negative on admission. Although fever and leukocytosis are not good predictors of infection in acute pancreatitis our results showed that bacteremia is common in patients whose pancreatitis is related to gallstones, ERCP or pancreatic malignancy with obstructive jaundice. We recommend that antibiotics be used only in this subset of acute pancreatitis patients.
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PMID:Bacteremia in acute pancreatitis of different etiologies. 854 31

A 93-year-old woman admitted because of epigastralgia. Cholelithiasis, obstructive jaundice, acute suppurative cholangitis and acute pancreatitis were diagnosed on blood chemistry and ultrasonography on admission. We performed emergency PTCD. A calculus 4 cm in diameter was detected at the papilla of Vater and marked dilatation of the common bile duct and pancreatic duct. ESWL was performed because of her age and because endoscopical operation seemed to be difficult. After lithotripsy, PTC and endoscopy demonstrated a diverticulum at the peripapillary portion of the duodenum. Based on analysis of PTC result before and after ESWL, we diagnosed this case as Lemmel's syndrome (obstructive jaundice, acute suppurative cholangitis and acute pancreatitis) caused by a large diverticular enterolith at the peripapillary portion of the duodenum. ESWL treatment of aged patient with an enterolith is safe.
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PMID:[A case of Lemmel's syndrome caused by a large diverticular enterolith at the peripapillary portion of the duodenum]. 886 45

A 58-year-old man visited our hospital because of back pain. Blood examinations revealed the presence of acute inflammation and an increase of pancreatic enzymes. Abdominal computed tomography indicated pseudocysts in the pancreas. The patient was diagnosed as having acute pancreatitis with pseudocysts formation. During the course of the disease, a newly formed pseudocyst in the pancreatic head compressed the common bile duct, leading to the obstructive jaundice. In addition, the rupture of a pseudocyst in the pancreatic tail caused intraperitoneal hemorrhage. This is an interesting case of acute pancreatitis with pseudocysts in which two rare complications developed.
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PMID:A rare case of severe acute pancreatitis complicated with pancreatic pseudocysts, obstructive jaundice and intraperitoneal hemorrhage. 893 87

A personal series is reported of 52 patients who underwent proximal pancreatoduodenectomy for severe chronic pancreatitis between 1979 and 1994. There were 13 women and 39 men of median age 42.2 (range 12-70) years. Disease predominantly affected the head of pancreas, with calcification present in 37 patients. Indications for operation were chronic pain (47 patients), obstructive jaundice (19) and duodenal stenosis (six); cancer was suspected in 12. In addition, 14 patients had a pseudocyst, two pancreatic endocrine failure and 20 exocrine failure. Aetiology was chronic alcohol abuse in 34, recurrent acute pancreatitis in five and unknown in 13. Pylorus-preserving proximal pancreatoduodenectomy was performed in 45 patients, while the remaining seven had partial gastrectomy. Drainage of a dilated distal pancreatic duct by side-to-side pancreaticojejunal anastomosis was included in 15 patients. Mean operating time was 6.2 (range 4.5-9.5) h and mean blood loss was 2.7 (range 0.2-13.0) litres. There were no hospital deaths, but three patients required a second operation and five had percutaneous drainage of infected collections. During a median follow-up of 54 months, six patients required completion distal pancreatectomy for renewed pain and four others had persistent pain. Four patients required intervention for stricture at the biliary-enteric anastomosis. Ten patients have died from causes not directly related to chronic pancreatitis. Proximal pancreatoduodenectomy is a relatively safe procedure, effectively palliating pain in 80 per cent of patients with chronic pancreatitis.
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PMID:Proximal pancreatoduodenectomy for chronic pancreatitis. 894 65


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