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

Forty-nine patients with clinical signs of acute cholecystitis underwent conventional and computed tomographic cholangiography. Among 39 patients with signs of contrast medium in the biliary system at both examinations there was a diagnostic discrepancy in only one patient. Conventional radiography demonstrated cholecystopathy in this patient while contrast medium in the gallbladder and an acute pancreatitis were found at computed tomography. Ten patients with an indeterminate conventional cholangiography had a conclusive computed tomographic examination. Twenty of 30 patients with an abnormal computed tomographic cholangiography underwent cholecystectomy and all had diseased gallbladders. All 17 patients with histopathologically confirmed acute cholecystitis had signs of subserosal edema and/or changes in the omental fatty tissue adjacent to the gallbladder at computed tomography. A layer of tissue of water-density adjacent to the gallbladder and/or changes in omental fatty tissue were also seen in one patient with congestive heart failure and in one with a penetrating duodenal ulcer. None of the 19 patients with a normal computed tomographic cholangiography had a proven acute cholecystitis.
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PMID:Intravenous computed tomographic cholangiography in acute cholecystitis. A comparison with conventional cholangiography. 648 61

In eight patients without a history of gallbladder disease, cholecystostomy was performed for acute pancreatitis (four patients) and blunt abdominal trauma (four patients). In one case only, acute cholecystitis developed after discontinuation of the cholecystostomy. Six patients were followed for a mean period of 3.9 years, after which the gallbladder function was evaluated. Cholecystography and ultrasonography demonstrated good visualisation of the gallbladder without signs of gallstones. The contraction of the gallbladder produced by cholecystokinin varied. This could be due to adhesions impairing the motility of the gallbladder. After cholecystostomy in a previously normal gallbladder, its function will become normal in most patients. If no signs of gallbladder disease develop within the first year after cholecystostomy, the risk of late complications is minimal.
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PMID:Long-term effects of cholecystostomy on gallbladder function. 650 82

Radiographs taken on the day of admission on 52 patients with acute pancreatitis have been compared with similar radiographs of 30 patients with acute cholecystitis and 22 patients with perforated duodenal ulcer. Two radiologists, who were unaware of the clinical features, looked specifically for the presence of 30 radiological signs. The only abdominal signs seen more frequently in acute pancreatitis were fluid levels in the stomach and duodenum, usually associated with dilatation. Duodenal abnormalities were seen in 42% of patients with acute pancreatitis and 21% of the controls (P less than 0.05) while gastric dilatation with a fluid level was seen in 29% of cases of acute pancreatitis compared with 12% of controls (P less than 0.05). Seventy per cent of the patients with severe acute pancreatitis had an abnormal chest radiograph on admission compared with 18% of those with mild disease. Left pleural effusion was the most common abnormality in severe pancreatitis (43%) and was seen significantly more often than in mild pancreatitis (P less than 0.01) and the control group (P less than 0.05). Therefore, consideration of the admission chest radiograph may help at an early stage to distinguish patients with severe pancreatitis from those with mild disease.
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PMID:Do plain films of the chest and abdomen have a role in the diagnosis of acute pancreatitis? 682 95

In 346 patients followed up 6, 12, 24 and 48 months after cholecystectomy the clinical results (VISICK and self-assessment) were very good in over 80%, 1% had symptoms due to organic disturbances and 15-20% had mostly mild symptoms (pain, fullness, food tolerance) without detectable causes. These functional disorders were found frequently in female patients with long preoperative history and frequent attacks of pain. Age of patient, character of pain, therapy before the operation, postoperative complications or change of body weight showed no correlation with later results. The results were almost always good in patients with acute pancreatitis or acute cholecystitis before the operation, or who underwent choledochotomy.
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PMID:[What determines the prognosis following cholecystectomy: anamnesis, surgical findings, postoperative complications?]. 685 98

Early surgery for biliary pancreatitis has resulted in a need for an accurate method of gallstone detection in acute pancreatitis. Fifty patients with acute pancreatitis were studied prospectively to assess the diagnostic value of Radionuclide Biliary Scanning (RBS) performed within 72 hours of an attack. To assess the general accuracy of RBS a further 154 patients with suspected acute cholecystitis or biliary colic were similarly studied. There were 34 patients with biliary pancreatitis and 18 (53%) had a positive scan (no gallbladder seen). There were 16 patients with non-biliary pancreatitis and 5 (31%) had a positive scan. All 51 patients with acute cholecystitis had a positive scan, as did 82% of the 51 patients with biliary colic. There were 52 patients with no biliary or pancreatic disease and none of these had a positive scan. RBS is highly accurate in confirming a diagnosis of acute cholecystitis or biliary colic. However, it cannot be relied on to differentiate between biliary and non-biliary pancreatitis and should certainly not be used as the basis for biliary surgery in these patients.
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PMID:A prospective study of radionuclide biliary scanning in acute pancreatitis. 685 81

Two series from greater Stockholm consisting of 726 (1960 to 1968) and 1,000 (1977 to 1978) patients over age 70 years with acute abdominal complaints are presented. Almost two thirds were women. Acute cholecystitis dominated both series, but its incidence decreased from 40.8 to 26 percent in the later series. The incidence of malignant disease increased from 3 to 13.2 percent. About one third of the patients were operated on; 50 percent had postoperative complications. Some frequently occurring aberrations of the usual symptoms and signs in acute appendicitis, ileus, and perforated gastric duodenal ulcer are discussed. The overall therapeutic results improved, as judged by postoperative mortality (series I, 23.1; series II, 16 percent) and mortality associated with individual diseases (except for acute pancreatitis). However, total mortality only decreased from 14 to 11.3 percent due to the large number of malignant diseases in series II, which were associated with a mortality of 37.9 percent. In series II the median duration of stay was 10.5 days and 75 percent of the patients were discharged home.
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PMID:Acute abdominal disease in the elderly: experience from two series in Stockholm. 709 11

Serum trypsin levels have been estimated by radioimmunoassay in 26 healthy controls (248 +/- 94.9 micrograms/l; mean +/- s.d.), 12 patients with chronic renal failure (1100 +/- 584 micrograms/l), 34 with acute pancreatitis (1399 +/- 618 micrograms/l) and 23 with acute non-pancreatic abdominal conditions. Mean serum trypsin in acute pancreatitis and in chronic renal failure was significantly higher than in control group (P less than 0.001). Serum trypsin levels were well above the upper limit of normality in all patients with acute pancreatitis and in all but one with chronic renal failure. Serum trypsin was markedly raised in one patient with a traumatic haemoperitoneum and in one of the 11 with peptic ulcer perforation, and moderately raised in 3 of the 6 with acute cholecystitis. Determination of serum trypsin seems to be a specific test for acute pancreatitis, provided renal failure has been excluded. However, the authors suggest it should be prospectively measured in a larger series of acute non-pancreatic abdominal conditions.
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PMID:Serum trypsin levels in acute pancreatic and non-pancreatic abdominal conditions. 729 Oct 99

Fifty-two patients in nine Austrian hospitals were treated with biliary self-expanding metal endoprostheses (Wallstents) for malignant biliary obstruction, and followed up retrospectively using questionnaires, answered by the endoscopists. Stent placement was successful in all patients. The technical failure rate at the first attempt was 7.7%, and stenting-associated mortality was 3.8% due to mispositioning of stents, leading in two cases to death. The 30-day mortality was 13.5%, and early complications occurred in 15.4%. The median survival was 216 days, and the median stent patency was 291 days. During follow-up, stent occlusion was observed in ten patients, acute cholangitis in 12 patients, acute pancreatitis in three patients, acute cholecystitis in one patient, and duodenal ulceration due to stent erosion in one patient. Routine use of biliary self-expanding metal endoprostheses by averagely experienced endoscopists can be recommended. Attention has to be paid to the correct placement of the guidewire and stent.
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PMID:Malignant bile-duct obstruction: experience with self-expanding metal endoprostheses (Wallstents) in Austria. 752 35

Hospital admission rates for many gastrointestinal, hepatobiliary and pancreatic diseases were much higher in Aboriginals aged 15 to > 65 years than among the rest of the population of that age in Western Australia in 1989-91. Alcohol-related conditions were particularly prominent: the relative rate (RR) for alcoholic gastritis was > 30; for acute alcoholic hepatitis in young adults > 20; for alcoholic cirrhosis at 30-64 years the RR was about 4 to > 10; the RR for haematemesis and melaena was > 3; for acute pancreatitis at 30-64 years the RR ranged from about 3 to 20. Admissions for cholelithiasis in Aboriginal males were 1.5-2 times as frequent as in other males; for Aboriginal females the RR was > 2; acute cholecystitis was much commoner in Aboriginal patients from 30 to 64 years of age than in other patients of the same age. Illnesses coded as 'non-infectious enteritis and colitis' were the commonest diagnostic category in the International Classification of Diseases (ICD 9) classification of digestive system disorders among Aboriginal patients; admissions for these conditions occurred at double to more than seven times the rates that occurred in the same age groups in non-Aboriginal patients. Many of these illnesses were probably due to undetected gastrointestinal infections and parasitic infestations. This study shows that Aboriginal adults have disproportionately high rates of morbidity from many diseases of the digestive system. The findings have important implications for clinical services as well as for the development of preventive and promotional health strategies for Aboriginal people.
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PMID:Hospitalization of Aboriginal adults for digestive disorders in Western Australia, 1989-91. 754 9

Although cholecystectomy is routinely performed as a part of treatment for gallstone pancreatitis, detailed histopathologic features of the gallbladder have not been described. In this study, the pathologic findings of 53 gallbladders from patients with clinical and laboratory evidence of gallstone pancreatitis are described. The presence of intraepithelial neutrophilic aggregates, a histologic finding associated with common bile duct obstruction, was identified in 32 (60.4%) cholecystectomy specimens and was the most common pathologic findings. Changes of acute cholecystitis and chronic cholecystitis were found in 15 (28.3%) and 6 (11.3%) gallbladders, respectively. Fat necrosis, which is characteristically associated with acute pancreatitis, was the most specific histologic change, but it was seen in the adventitia of only four gallbladders. The similarities of pathologic findings in gallstone pancreatitis and common bile duct obstruction emphasize the role of choledocholithiasis in the pathogenesis of pancreatitis associated with cholelithiasis.
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PMID:Pathology of the gallbladder in gallstone pancreatitis. 772 28


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