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

A series of 116 nonselected and consecutive patients with acute pancreatitis with a fatal outcome underwent necropsy and have been analyzed with special attention paid to hepatic findings and the cause of death. This series includes the total fatalities caused by the disease during a 15 year period from 1956 to 1970. All but two patients died in the first attack of acute pancreatitis. The patients were divided into four etiologic groups: gallstone disease, 43 per cent; alcoholism, 25 per cent; idiopathic origin, 18 per cent, and postoperative origin, following abdominal operations, 14 per cent. Over the three five-year periods, the frequency of alcohol abuse as a predisposing factor increased, while gallstone disease showed a corresponding decrease. About 75 per cent of the patients had hyperbilirubinemia. Half of these showed signs of cholestasis. Macroscopic steatosis of the liver was recorded in 62 per cent of the alcohol addicts and in about 25 per cent of the patients in the other etiologic groups. Shock and late sequelae of shock were the dominating immediate causes of death in 72 per cent. About 50 per cent of the fatalities occurred within the first week. Most of these early deaths were caused by intractable circulatory failure. Early death was most commonly caused by alcoholism, followed in frequency by gallstone disease. It is possible that impaired hepatic function contributes to the fatal outcome in both early and late phases of the disease.
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PMID:A study of autopsies upon 116 patients with acute pancreatitis. 94 Oct 80

A patient with a long history of alcohol abuse had diminished vision. The clinical and angiographic findings were consistent with Purtscher's retinopathy. Subsequently, the patient was hospitalized for acute pancreatitis. To our knowledge, this is the first reported case of pancreatic retinopathy preceding the systemic findings of acute pancreatitis.
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PMID:Purtscher's retinopathy preceding acute pancreatitis. 154 21

Gastrointestinal parasites, although an uncommon cause of biliary and pancreatic problems in western medicine, can produce fatal complications. A Swiss patient presented with acute pancreatitis, with no evidence of gall stones or history of alcohol abuse. He died after a short fulminant illness. At necropsy, an Ascaris lumbracoides was found impacted within the ampulla of Vater and serves as a reminder that non-indigenous causes of biliary tract obstruction should not be overlooked.
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PMID:Fatal ascaris pancreatitis: an uncommon problem in the west. 156 64

Two male patients with recurrent acute pancreatitis due to alcohol abuse were admitted with pancreatic ascites (high concentration of amylase, raised protein concentration, no specific cytologic features). Ultrasound (US) and computed tomography (CT) confirmed gross ascites and inflammation of the pancreas in both patients, and a pseudocyst in the head of the pancreas in one of them. Treatment with total parenteral nutrition (TPN) and a H2-blocking agent was instituted and continued for 4 and 2 wk, respectively. Due to lack of improvement, somatostatin infusion (250 micrograms/h) was started. During the next few days, there was a rapid improvement of the clinical status, and the production of ascites ceased. We conclude that somatostatin infusion should be tried before any invasive diagnostic or therapeutic intervention in patients with pancreatic ascites.
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PMID:Pancreatic ascites: treatment by continuous somatostatin infusion. 167 89

In 427 samples of serum and urine, collected during their stay at hospital from 40 patients affected with acute pancreatitis, the sensitivity and the specifity of total amylase and lipase in serum, total amylase and pancreas isoamylase in urine, as well as the amylase-/creatinine clearance were determined. The pancreas isoamylase in serum was used as reference value. It appeared that the sensitivity of the lipase was next to that of the pancreas isoamylase in serum, even in limit ranges. Usually the lipase stayed pathological the longest and could therefore be used to identify in the best way even an easing-off pancreatitis. The diagnostic accuracy of the total amylase in serum and urine, of the pancreatic isoamylase in urine and of the amylase-/creatinine clearance was found to be obviously less reliable. The specifity of all examined tests was reduced in patients with renal insufficiency, liver disease, alcohol abuse and in patients with abdominal pains of non pancreatic origin. Concluding form our results and with regard to the expenditure of laboratory technique and to the time required by the methods of determination, we found that of all the examined parameters, the lipase was the most convenient for both emergency and routine diagnose of an acute pancreatitis.
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PMID:[Diagnostic value of various laboratory parameters in acute pancreatitis]. 169 1

From 1981 to 1990, 14 of 70 patients hospitalized at our institution for severe acute pancreatitis were selected to undergo percutaneous drainage of pancreatic abscess, under computed tomographic (CT) scan guidance. Pancreatic abscess was defined, on contrast-enhanced CT scan, as an infected fluid collection without pancreatic necrosis. There were nine men and five women, ranging in age from 28 to 46 years. The main cause of pancreatitis was alcohol abuse (eight patients). Other causes were gallstones (two patients), hyperlipidemia (two patients), postoperative (one patient) and one unknown. Ranson criteria were available in ten patients and ranged from three to six. Percutaneous drainage was performed as the primary treatment in 13 patients and for removal of a residual collection postoperatively in one patient. In two critically ill patients, percutaneous drainage was performed as a temporizing measure. In 12 patients with well-limited hypodense collections, percutaneous drainage was expected to result in the definitive cure of the abscess. Pigtail drains (No. 14F), were inserted using local anesthesia and CT scan guidance. Two patients had two drains and 12 patients had only one drain. Two patients were definitively cured by percutaneous drainage and all other patients were operated upon for removal of infected necrosis. In this study, the lack of accuracy of contrast-enhanced CT scan in the diagnosis of peripancreatic necrosis is highlighted and that percutaneous drainage has a better efficiency in the treatment of residual collections postoperatively than as a primary treatment of infected fluid collections is illustrated.
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PMID:Failure of percutaneous drainage of pancreatic abscesses complicating severe acute pancreatitis. 173 73

This article review newer concepts of diagnosis and therapy for patients with acute pancreatitis. Although the pathogenesis are incompletely understood, much progress has recently been made in treatment of symptoms and medical support of the critically ill patients. The most common associate factors include: biliary tract disease (lithiasis), alcohol abuse, trauma and hyperlipoproteinemia. Most patients have abdominal pain, nausea and vomiting, fever, abdominal tenderness and hypovolemia of varying degrees. Renal clearance of amilase is increased, the ratio of renal clearance to that of creatinine is very important in patients with hypovolemia or an underlying renal disease. The definition of risk factors, with regard to morbility or mortality. Those patients at great risk require critical care treatment in an ICU and meticulous pulmonary, cardiac, hematological and metabolic monitoring and treatment of any the abdominal complications.
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PMID:[Acute pancreatitis]. 182 Jan 83

This paper reports three cases of acute pancreatitis that occurred after repair of an abdominal aortic aneurysm. The aneurysms were ruptured in two patients and asymptomatic in one. No patient had biliary disease or history of pancreatitis or alcohol abuse. Two of the patients required operation for drainage and debridement; one died. The etiology and diagnosis are discussed.
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PMID:Acute pancreatitis following aortic aneurysm repair: report of three cases. 187 95

We report here a case of diabetic ketoacidosis associated with hyperlipidemia and acute pancreatitis following alcohol abuse. A 23-year-old man was admitted to the hospital because of right upper abdominal and back pain developing into a state of unconsciousness and shock. He had been drinking 720 ml of whisky daily for 4 years. Laboratory data on admission revealed metabolic acidosis (pH 7.01, PaO2 84.6 mmHg, PaCO2 41.1 mmHg, HCO3- 16.3 mmol/l, BE-16.4 mmol/l), a high blood glucose level (640 mg/dl), strongly positive urinary ketone bodies, hypercholesteremia (913 mg/dl) and hypertriglyceridemia (8500 mg/dl). Furthermore, the levels of pancreatic enzyme including serum amylase (770 U/l) and elastase I (2721 ng/dl) were elevated. After successful treatment of the diabetic ketoacidosis with insulin and fluid supplementation, serum cholesterol, triglyceride and pancreatic enzyme levels decreased concomitantly with stabilization of the blood glucose level. From these findings, it is suggested that hyperlipidemia might have caused the acute pancreatitis which developed into diabetic ketoacidosis in this patient.
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PMID:[A case of non-insulin-dependent diabetes mellitus associated with diabetic ketoacidosis after the onset of hyperlipidemia and acute pancreatitis following alcohol abuse]. 193 46

The majority (about 75%) of patients who suffer from acute pancreatitis do so as a consequence of gallstones or alcohol abuse. The other 25% of patients often present difficult diagnostic problems. Over several years the author has accumulated a series of patients with remedial causes of pancreatitis. They include a group of congenital conditions such as pancreas divisum, choledochal cysts and congenital abnormalities of the pancreatic ductal system. Patients who have had pancreatitis and who have an intact gallbladder often have stones that are difficult to identify. Repeated attacks of pancreatitis in the absence of any other apparent cause justifies cholecystectomy, which will often identify the cause so that recurrence can be prevented. A group of nonanatomic causes are also known. They include hyperlipidemia, drugs and toxins, certain systemic illnesses such as systemic lupus erythematosus, pregnancy, hypercalcemia, hereditary causes and occasionally cancer. In his lecture the author reviews the various etiologies of acute pancreatitis and describes an algorithm that can be used when the diagnosis is difficult.
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PMID:Recurrent acute pancreatitis--rarely idiopathic: 1989 Du Pont lecture. 226 8


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