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

42 cases of pancreatic cyst in acute (22 cases) pr chronic (20 cases) pancreatitis were seen between 1962 and 1976. Analysis of the case data revealed the following: (1) exact assignment of the cyst to acute or chronic pancreatitis is often possible only by long-term observation; (2) the cysts of chronic pancreatitis are not a uniform group: some (8 cases) apparently occurred in acute pancreatitis through necrotic episodes (pseudocysts), others (12 cases) by a retention mechanism; these "retention cysts" develop later in the course of chronic pancreatitis than the pseudocysts and produce a different clinical picture with better prognosis; (3) barium meal and retrograde cholangiopancreatography proved of diagnostic value' (4) if the cysts persist for more than six weeks operation is indicated because of the high incidence of complications.
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PMID:[Pseudocysts and retention cysts in acute and chronic pancreatitis (author's transl)]. 75 56

Calcium enters the pancreatic juice from two sources, one fraction associated with enzyme protein and another small fraction presumably by diffusion. The calcium concentration in pancreatic juice is lower than in plasma. It decreases with high flow rates and increases asymptotically to plasma concentration with low rates. In chronic pancreatitis calcium concentration is raised in the secretin-stimulated juice. After pancreozymin in moderate chronic pancreatitis it is low but in severe stages of the disease it is high signalling total dissociation from the entrance of enzyme protein, which is very low in these cases. Hypercalcemia stimulates enzyme secretion in the pancreas, hypocalcemia inhibits it. Calcium is essential for intracellular processes associated with secretion, the exact place in the sequence of "stimulus-secretion-coupling" still being unknown. Calcitonin as one of the hormones which regulates calcium homeostasis, inhibits secretion of enzymes but not of fluid and bicarbonate. The action of the parathyroid hormone on the exocrine pancreas is unknown. In primary hyperparathyroidism with chronic hypercalcemia acute and chronic pancreatitis occur 10 to 20 times more frequently than in the general population. In acute pancreatitis of whatever origin hypocalcemia is atypical feature of the disease indicating bad prognosis. The mechanism of its development is still unclear. In chronic pancreatitis the forming of calcified stones in the ducts is typical in cases associated with alcoholism, with protein malnutrition and with primary hyperparathyroidism. But it occurs also in cases with unknown etiology signalling a more general pathophysiological phenomenon. The calcium salts form a precipitate on protein plugs in the juice, which have been observed even in early stages of the disease in the small and larger ducts of the gland.
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PMID:The role of calcium in pancreatic secretion and disease. 77 77

Computed tomography (CT) has proven useful in diagnosing inflammatory and neoplastic disease of the pancreas. Neoplasms of the pancreas produce enlargement of the gland and loss of surrounding fat planes. Acute pancreatitis also produces enlargement but correct diagnosis can be made with the clinical correlation. The usefulness of CT in chronic pancreatitis depends upon the state of the disease. Distinction between an inflammatory and a neoplastic mass is not possible on the basis of a CT scan alone. CT is also useful for needle guidance for aspiration biopsy of the pancreas.
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PMID:Computed tomography of the pancreas. 78 27

Antinuclear factors in serum were determined in 37 patients with acute and 50 with chronic pancreatitis. Of the 5 with acute pancreatitis of unknown etiology, 4 had serum antinuclear factors in high titers; of the 16 with chronic pancreatitis of unknown etiology, 10 had serum antinuclear factors in high titers and 4 in low titers.
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PMID:[Immunopathological genesis of pancreatitides]. 80 56

Jaundice or biliary stasis occurred in 32 of 82 patients with acute and 58 of 152 patients with chronic pancreatitis. A biliary cause was present in only 12 patients with acute and 19 with chronic pancreatitis. In the case of mild acute pancreatitis the cause of the jaundice lay in oedema of the head of the pancreas, while in the severe forms there was necrosis of the head. In chronic pancreatitis the jaundice is caused by tube-like, long stenosis of the choledochal duct or its compression by a cyst within the head of the pancreas. In acute pancreatitis treatment depends on the severity of the inflammation; in the biliary form the biliary tracts are attended to. In chronic pancreatitis resection of the head of the pancreas is preferred, biliodigestive anastomosis being practised if there is likely to be poor cooperation by the patient.
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PMID:[Causes and treatment of jaundice associated with inflammatory pancreatic disease (author's transl)]. 85 70

Pancreatic reflux during radiomanometry is more frequent during acute and chronic pancreatitis. In acute pancreatitis, it is due in 1 case out of 3, to distal obstruction which must be overcome very rapidly. There is no prognostic significance. Santorini's duct when opacified and when it opens into the duodenum, permits one to suggest a better prognosis than in cases of canalicular pancreatitis. In chronic pancreatitis, reflux is twice as common and 3 times more often organic. When Wirsung's duct is dilated, there is almost always a distal obstacle at the level of the sphincter of Oddi due to a gall stone. If chronic pancreatitis is associated with gall stones, sphincterotomy should be carried out.
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PMID:[Pancreatic reflux into Wirsung's duct during peroperative biliary radiomanometry in acute and chronic pancreatitis (author's transl)]. 88 26

Eighty-seven examinations of the pancreas in 52 patients with acute or chronic pancreatitis and 31 examinations in 31 normal subjects were reviewed. Demonstration of the portal and splenic veins served as a guidepost to the pancreas. The normal pancreas was indistinguishable from the surrounding tissues in a substantial minority of examinations, and the ultrasonic characteristics of the normal pancreas were quite variable. Acute pancreatitis was found to be characterized by swelling, loss of internal echoes, and loss of distinction between the pancreas and splenic vein. In 50% of patients with chronic inactive pancreatitis, the pancreas could not be identified. Ultrasound should precede endoscopic retrograde cholangiopancreatography whenever a pseudocyst might be present.
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PMID:Gray-scale ultrasonic properties of the normal and inflamed pancreas. 94 1

The authors report 200 examinations and discuss the role of radio-isotope scans of the pancreas with electronic subtraction of the liver image in acute and chronic pancreatitis. As an emergency, the examination is of definite diagnostic value, the absence of fixation with a suggestive clinical context, is strong evidence of pancreatic disease and normal uptake eliminates the latter. On the other hand, in painful syndromes in which chronic pancreatitis is suggested, the diagnostic interest is very limited for the low uptake on radio-isotope scan occurs at a late stage and is not specific. Radio-isotope scans are worth a place in exploration of the pancreas in acute pancreatitis.
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PMID:[Contribution of scintigraphy in acute and chronic pancreatitis. Apropos of 200 examinations]. 95 87

Different methods available for investigating patients for pancreatic disease are discussed. They first include measurement of pancreatic enzymes in biological fluids. Basal amylase and/or lipase in blood are truly diagnostic in acute pancreatitis but their utility is low in chronic pancreatic diseases. Evocative tests have been performed to increase the sensitivity of blood enzyme measurement. The procedure is based on enzyme determination following administration of pancreozymin and secretin, and offers a valuable aid in diagnosis of chronic pancreatitis and cancer of the pancreas. They are capable of discerning pancreatic lesions but are not really discriminatory because similar changes are observed in both diseases. The measurement of urinary enzyme levels in patients with acute pancreatitis is a sensitive indicator of disease. The urinary amylase excretion rises to abnormal levels and persists at significant values for a longer period of time than the serum amylase in acute pancreatitis. The fractional urinary amylase escretion seems to be more sensitive than daily urinary measurement. The pancreatic exocrin function can be assessed by examining the duodenal contents after intravenous administration of pancreozymin and secretin. Different abnormal secretory patterns can be determinated. Total secretory deficiency is observed in patients with obstruction of excretory ducts by tumors of the head of the pancreas and in the end stage of chronic pancreatitis. Low volume with normal bicarbonate and enzyme concentration is another typical pattern seen in neoplastic obstruction of escretory ducts. In chronic pancreatitis the chief defect is the inability of the gland to secrete a juice with a high bicarbonate concentration; but in the advanced stage diminution of enzyme and volume is also evident. Diagnostic procedures for pancreatic diseases include digestion and absorption tests. The microscopic examination and chemical estimation of the fats in stool specimens in different conditions of intake are still important screening tests. Isotopic estimates of steatorrhea and distinction between labeled triolein and oleic acid absorption do not provide greater diagnostic discrimination than traditional procedures. 131I labeled proteins permit a good evaluation of a negative nitrogen balance. Sophisticated procedures to estimate exocrine pancreatic insufficiency are based on the study of endoluminal digestive processes at several times and different level of the small intestine. They permite esclusion of extrapancreatic factors interfering in digestion and absorption functions. The endocrin pancreatic function is evaluated by mean of oral tolerance test an radioimmunoassay of blood insulin. It is generally agreed that "diabetes" caused by insulin deficiency and digestion and absorption defects are the result of diffuse pancreatic destruction. Many methods are now available investigating patients with pancreatic disease but the single use of one of them is never satisfactory...
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PMID:[Clinical significance of the tests used in the diagnosis of pancreatic diseases]. 99 11

This study involved 14 cases or pleural effusions or ascites rich in amylase and unrelated to chronic pancreatitis, a pseudo-cyst of the pancreas or acute pancreatitis. A pleural effusion rich in amylase may be secondary to a pancreatic neoplasm but this possibility seems rare. Amylase-containing effusions related to a nonpancreatic neoplasm are more common. The lesion is in general an advanced pleuro-pulmonary carcinoma, frequently an adenocarcinoma. The amylase activity of neoplastic effusion fluid is significantly increased but although levels similar to those of certain pancreatic effusions may be seen, very high figures would appear to be rare. Finally, two cases of amylase-rich pleural effusions were related to a pleuro-digestive fistula and one left-sided effusion was secondary to abdominal trauma.
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PMID:[Effusions rich in amylase without pancreatitis. 14 cases]. 99 7


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