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

A retrospective study has been made of all adult patients admitted to Manchester Royal Infirmary with exocrine pancreatic disease between 1968 and 1974, in order to define the factors which influence the variable mortality and morbidity rates in published accounts of patients with acute pancreatitis. The most plausible explanation is that some series with low mortality rates include a variable number of patients with relapsing acute pancreatitis and acute exacerbations of chronic pancreatitis. Both these pathological entities have a negligible mortality and morbidity rate compared with single attacks of acute pancreatitis. The difficulties encountered by the clinician in determining the prognosis of acute pancreatitis at the time of admission to hospital are discussed. Attention is drawn to the differing role of alcohol as an aetiological factor in relapsing chronic pancreatitis and acute pancreatitis.
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PMID:Pancreatitis--a retrospective study. 101 14

In order to classify a patient with pancreatitis according to the Marseille clasiffication the following criteria must be fulfilled: (a) an acute attach of pancreatitis must be observed, (b) the cause of pancreatitis has to be established, (c) the patient has to be followed over longer periods of time in order to find out, whether the process becomes chronic (involving progredient endocrine and exocrine insufficiency). Diagnostic problems of acute pancreatitis, relapsing pancreatitis, and chronic pancreatitis are discussed taking into account the author's own results. It is concluded, that repeated tests of pancreatitis function and demonstration of pancreatic calcification are more important for establishing the diagnosis of chronic pancreatitis than studies of pancreatic morphology including endoscopic retrograde pancreatography (ERP). ERP may help to find the cause of relapsing pancreatitis of unknown origine; it may help as well preoperatively to diagnose local changes of the pancreatic duct system in chronic pancreatitis.
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PMID:[Diagnosis and differential diagnosis of pancreatitis--diagnostic relevance of clinical and biochemical changes during the course of the disease and of endoscopic retrograde pancreatography (author's transl)]. 102 74

New tests and test methods aid in the diagnosis of pancreatic disorders. Pancreatic carcinoma, especially, may have an improved prognosis with earlier detection as a result of refinements in arteriography, cytology, pancreatic radioisotopic scanning, and endoscopic retrograde cholangiopancreatography. Acute pancreatitis results most commonly from alcoholism, biliary tract disease, and trauma. Management is directed primarily at decreasing pancreatic exocrine secretion. Surgery is usually best avoided in the acute phase. Chronic pancreatitis is most often a result of recurrent attacks of acute pancreatitis. Diabetes and malassimilation become manifest as pancreatic destruction progresses. Management consists of replacement of pancreatic enzymes and diet supplements. Once chronic pancreatitis is established, surgery can only be directed at complications of the disease. Pancreatic ascites is usually associated with a break in the pancreatic ductal system. Ascites caused by trauma responds well to surgical intervention, but the alcoholic type is less amenable to treatment.
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PMID:Pancreatic disease. 107 54

Sixty-two pancreases were dissected at autopsy. In 55 of them, the pancreatic ducts were filled with 50 per cent Hypaqje and roentgenograms were made prior to dissection. Clinical information (available in every case) was correlated with the gross and microscopic findings and findings on the pancreatograms. The anatomically and functionally predominant duct was considered the "main pancreatic duct" regardless of its embryologic development. The common bile and main pancreatic duct opened independently into the duodenum in 8 of the 62 cases (13 per cent). The accessory pancreatic duct had a patent orifice into the duodenum in 12 of 57 cases (21 per cent). The ampulla of Vater was well developed in only 4 of the 62 cases (6 per cent), but an ampullary dilatation was present twice as often at the end of the acessory pancreatic duct, in both those that ended blindly and those that opened into the duodenum. The orifices for the accessory duct were often tiny pinhole openings. There were 2 primary carcinomas of the pancreas, one in the head and one in the tail. The pancreatic duct was almost completely obstructed in each case. Both tumors were undifferentiated adenocarcinomas, and extravasation occurred into each one of them. Extravasation also occurred into a necrotic lymphoma involving the tail of the pancreas, and into two areas of abscess formation in another case. Diffuse, dense, fluffy opacification of pancreatic parenchyma, due to alteration in cell membrane permeability, was demonstrated in acute pancreatitis, infarction, autolysis, and overfilling of the ducts by vigorous injection. Three pancreases showed microscopic changes of chronic pancreatitis. The pancreatogram on one was normal, but the microscopic changes were minimal, and pancreatitis was not suspected clinically. The other 2 cases were symptomatic, and their pancreatograms showed strictures and irregularities of the main pancreatic duct as well as saccular ectasia was present in three additional pancreases, two of which showed squamous metaplasia of ductal epithelium without other microscopic stigmata of chronic pancreatitis and no clinical features to suggest pancreatitis. The possibilities exist that ectasia of secondary ducts and squamous metaplasia of ductal epithelium are manifestations of low-grade injury and that "subclinical pancreatitis" may be common in the general population.
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PMID:Retrograde pancreatography in autopsy specimens. 111 12

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

Data have been presented correlating changes of blood coagulability, capillary permeability, blood electrolyte content with electrocardiographic abnormalities and symptoms of coronary insufficiency. In acute pancreatitis and in acute exacerbation of chronic pancreatitis, accentuation of these vascular factors may induce symptoms of coronary disease. Data are also presented indicating abnormal blood coagulability and blood electrolyte content in patients with chronic pancreatitis. Minimal augmentation of these abnormalities may account for the "yoke" syndrome.
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PMID:Cardiovascular lesions in pancreatitis. 114 95

The authors report the case of a pseudo-aneurysm of the right hepatic artery following a difficult cholecystectomy in a patient with sub-acute pancreatitis. Angiography, two years later, showed spontaneous regression of the pseudo-aneurysm and the development of chronic pancreatitis.
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PMID:[Post-cholecystectomy pseudo-aneurysm. Spontaneous regression demonstrated by angiography]. 117 74

Using the optical and electron microscope, the authors studied the effects in the rate of cathetersiation of the pancreatic ducts after laparotomy. 62 rats underwent operation, 42 of which received an injection of 30 p.cent urinary radioselectan, 10 an injection of simple isotonic saline and in 10 of which simple catheterisation without injection was carried out. With injection under high pressure, regardless of the substance used, lesions of acute pancreatitis occurred in almost all cases in the short term and in the long term lesions of localised chronic pancreatitis were fairly common. For these reasons, the authors feel that routine parenchymography is contraindicated and that only opacification of the main pancreatic ducts is permissible.
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PMID:[Pancreatic injection of a tri-iodinated contrast medium. Optic and electron microscopic analysis. Experimental study in the rat]. 117 59

Clinically evident diabetic microangiopathy (retinopathy and nephropathy) occurred in 18% of diabetic patients with acute pancreatitis and 14% of diabetic patients with chronic pancreatitis. The presence of diabetic retinopathy and nephropathy in patients with pancreatitic diabetes without a family history of diabetes mellitus suggests that these patients have "primary" diabetes mellitus unmasked by the pancreatitis. The occurrence of diabetic microangiopathy is significantly correlated with the duration of diabetes. The frequency of these diabetic complications seems to increase when there is a family history of diabetes in patients whose pancreatitis is simultaneous with or precedes the onset of diabetes. The majority of patients with diabetic microangiopathy were on insulin therapy, but the need for insulin treatment is an indication of the severity of the diabetes, rather than the insulin being a causative factor of the microangiopathy. The degree of steatorrhea in diabetic patients with chronic pancreatitis did not protect against the development of microangiopathy.
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PMID:Diabetic microangiopathy in patients with pancreatitic diabetes mellitus. 118 65

Viral studies were performed on sera from 54 patients with recent acute pancreatitis, 10 with recurrent acute pancreatitis, seven with chronic pancreatitis, and 10 with pancreatic carcinoma, and on sera from 81 age- and sex-matched controls. In 29 of the acute pancreatitis patients from whom paired sera were obtained no convincing evidence of recent viral infection was found. A higher incidence of raised antibody titres against Coxsackie B3 and B4 was observed in the group of acute pancreatitis patients compared with their controls. The possible signficance of these observations and their relationship to the aetiology of the pancreatitis and to other immunological findings are discussed.
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PMID:Viral antibody studies in pancreatic disease. 119 16


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