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

For a long time, echotomography of the pancreas was limited to the identification of pseudocysts. Little by little, those using ultrasound learnt how to construct images of the pancreatic gland itself, and faced with the changes in size and shape of the latter to recognize lesional processes. Analysis of the pancreatic echostructure represents an important step in the progress of the diagnosis of lesions. Echotomography, the results of which must be compared with those of roentgenological methods of exploration, as well as the clinical and laboratory data, enables the attainment of very fiable diagnoses of chronic pancreatitis with or without pseudo-cysts, of acute pancreatitis or of rare cystic tumors. The precision of the results however depends fundamentally on technical data: it is necessary to combine with the classical apparatus, with manual displacement of the wave, a tomo-echoscopic apparatus, with real time; above all, it is necessary to use the degraded intensity scale. This scale is innate in real time apparatuses. At present it takes the form of a complementary module, on the classical apparatuses. Without these technical conditions, real time and degraded intensity scale, it seems impossible to attack the problem of ultrasonic diagnosis of pancreatic conditions, except by exposing oneself to disappointments which would unmeritedly cast discredit on the method. Six years of experience, several thousands of pancreatic examinations, three hundred pancreatic lesions which were anatomically checked has however convinced us of the importance of echotomography in this field.
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PMID:[Ultrasonic diagnosis of pancreatic conditions: a new tentative at a rational approach based on the analysis of 300 cases which were checked (with real time and degraded intensity scale). (author's transl)]. 119 10

Over an 11-year period 693 patients with acute pancreatitis and 317 with chronic pancreatitis were seen at the Harbor General Hospital. Review of these cases revealed 9 patients with primary pancreatic lesser sac abscess and 11 with secondary abscess. The appropriate management for pancreatic abscess, whether primary or secondary, is early recognition and drainage; multiple drainage procedures may be necessary. Broad spectrum antibodies appear to be helpful and should be used until cultures indicate more appropriate antibiotic therapy. Successful management involves prolonged hospitalization, but contrary to previous reports the success rate is surprisingly high. Eight out of 9 patients with primary abscess and 8 out of 11 patients with secondary abscess survived.
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PMID:Septic complications of pancreatitis. 126 Feb 55

The experiments were performed on 34 dogs. The subcutaneous injection of boiled pancreatic juice was established to increase the survival of dogs in acute destructive pancreatitis (p < 0.001) and to decrease the specific volume damage to acinar (p < 0.01) and interstitial (p < 0.05) pancreatic tissue. It was also shown that boiled pancreatic autojuice exerted the therapeutic effect in chronic pancreatitis complicated by pancreatic fistulas. Five peptide components with a molecular mass from 4168 D to 1000 were discovered in the canine boiled pancreatic juice by liquid high pressure chromatography. Fractions with a molecular mass between 2187 and 1348 D were found to correspond to biologically active peptides, in particular to somatostatin. It is assumed that the therapeutic effect of boiled pancreatic juice used in acute pancreatitis may be due to somatostatin. Apparently pancreatic juice may turn an efficient therapeutic agent in acute pancreatitis and pancreatic fistulas.
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PMID:[Pancreatic juice peptides as possible regulators of reparative processes in the pancreas in acute and chronic pancreatitis]. 128 26

We classify pancreatic pseudocysts in 3 types: post-necrotic type I, related to acute pancreatitis; post-necrotic type II, related to an acute attack superimposed on chronic pancreatitis; and retention type III, due to chronic pancreatitis with ductal stricture. A prospective study on percutaneous catheter drainage of post-necrotic pseudocysts (type I and II) was undertaken from 1987 to 1990. Twenty-three pseudocysts in 21 patients were drained. Overall recurrence rate was 4%; 2 patients had fistulization of the catheter into bowel; no deaths occurred. The procedure was successful in all type I cysts; in type II cysts it was associated with prolonged drainage and increased risk of complications when cyst-duct communication was present. Percutaneous drainage has no role to play in type III retention cysts. Guidelines regarding indications for treatment and the techniques employed are described.
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PMID:Percutaneous drainage of pancreatic pseudocysts: a prospective study. 129 Feb 54

N benzoyl-L-tyrosil PABA was orally administered to 13 controls and 35 patients with pancreatic disease: 7 with chronic exocrine pancreatic disease, 7 patients after an attack of acute pancreatitis, 3 with carcinoma of the pancreas, 8 with biliary tract disease and 10 with diabetes. The amount of PABA excreted serves as parameter exocrine pancreatic function. PABA excretion in patients with chronic pancreatitis (p < 0.01) and diabetes (p < 0.05) was significantly less then in controls. The present data justify further investigation of this procedure as a possible new oral test of exocrine pancreatic function.
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PMID:[Diagnostic value of the NBT-PABA test in the functional evaluation of the exocrine pancreas]. 130 17

Coxsackie-B antibodies were examined in a study of 118 patients with acute and relapsing chronic pancreatitis. The rise in antibody titers was significant in 40 cases. Fourteen had acute, five relapsing acute, and 21 chronic pancreatitis. Among patients with acute pancreatitis, we detected infectious hepatitis in six cases. Two patients with persisting acute pancreatitis received levamisole as an immune adjuvant, which promoted their recovery. It seems that Coxsackie-B virus can cause acute pancreatitis, and it can also worsen chronic pancreatitis.
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PMID:Possible role of Coxsackie-B virus infection in pancreatitis. 131 13

A variety of receptors on pancreatic acinar and duct cells regulate both pancreatic exocrine secretion and intracellular processes. These receptors are potential sites of action for therapeutic agents in the treatment of pancreatitis. Cholecystokinin (CCK) receptor antagonists, which may reduce the level of metabolic "stress" on acinar cells, have been shown to mitigate the severity of acute pancreatitis in a number of models. Not all studies have shown a benefit, however, and differences may exist between different structural classes of antagonists. Because increased pancreatic stimulation due to loss of feedback inhibition of CCK has been proposed to contribute to the pain of some patients with chronic pancreatitis, CCK receptor antagonists could also be of benefit in this setting. Somatostatin and its analogs diminish pancreatic secretion of water and electrolytes and have been effective in treating pancreatic fistulas and pseudocysts. These agents are also being evaluated for their ability to reduce pain in chronic pancreatitis (perhaps by reducing ductal pressure by diminishing secretory volume) and mitigating the severity of acute pancreatitis (possibly by reducing the metabolic load on acinar cells). Recently described secretin receptor antagonists may also have therapeutic value as a means of selectively inhibiting pancreatic secretion of water and electrolytes.
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PMID:Receptor strategies in pancreatitis. 134 60

53 patients were controlled with CT after Whipple resection. The median age of the patients was 49 years, the median time after surgery nine years. Diagnostic criteria were the identification of the residual pancreas, signs of pancreatic atrophy and radiological signs of chronic pancreatitis. CT was performed with slice thickness of 4 mm and steps of 4 mm. The residual pancreas was visible in all 53 cases. Pancreatic atrophy was found in 26 cases, in four of these the residual pancreas was only 2 mm in size. Signs of chronic pancreatitis were found in 16 cases. By comparing preoperative and postoperative CT-scans, seven progresses of pancreatitis were detected. Signs of acute pancreatitis were not found in the 53 patients. Fatty liver degeneration was found in 7.5%. We found that CT is the most reliable technique to visualize the pancreas after Whipple resection. CT should be performed in all patients with clinical symptoms of an acute pancreatitis. CT should also be performed in patients with residual pancreas pseudocysts. There is no indication for CT in the routine examination of asymptomatic patients after Whipple resection.
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PMID:[Results of computerized tomography after Whipple operation of chronic pancreatitis]. 135 91

The diagnostic capacity of a semiquantitative latex test for lipase measurement was compared with the measurement of other pancreatic enzymes in 100 consecutive patients admitted to a general hospital for recent onset of severe abdominal pain. Positive results of the test were found in two patients with acute pancreatitis, and in one out of three chronic pancreatitis relapses. The test yielded false-positive results only in two patients who had no apparent pancreatic involvement. A marginal increase in other pancreatic enzymes was found in a few patients with acute biliary or appendicular problems. In conclusion, the lipase latex test can be suggested in an emergency setting as a quick and reliable alternative to serum amylase to rule out a diagnosis of acute pancreatitis.
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PMID:Lipase latex test for acute abdominal pain: comparison with serum lipase, trypsin, elastase and amylase. 137 75

Autopsy studies have shown that approximately 56% of patients on long-term continuous ambulatory peritoneal dialysis (CAPD) develop various pancreatic abnormalities, such as acute and chronic pancreatitis, fibrosis, and acinar dilatation. This prevalence of anatomical abnormalities is similar to that observed in patients on hemodialysis and higher than that in those with normal renal function. However, clinical acute pancreatitis is an uncommon complication of CAPD (0.9%), and this prevalence is similar to that (1.7%) of patients on hemodialysis. We can attribute acute pancreatitis in CAPD patients to no single factor. Perhaps preexisting anatomical abnormalities of the pancreas make the CAPD patient susceptible to acute pancreatitis when exposed to a variety of physiological and nonphysiological influences. The diagnosis of acute pancreatitis in CAPD patients is difficult, because symptoms and signs are similar to those of dialysis-associated peritonitis. Serum amylase values three times greater than the upper limit of normal and effluent amylase greater than 100 U/L suggest the diagnosis of acute pancreatitis. Serum lipase, isoamylase, and pancreatic secretory trypsin inhibitor are not helpful. In confirming the diagnosis, a computed tomography (CT) scan is more helpful than ultrasound, although it is positive in only 50-60% of cases. One should harbor a high index of suspicion concerning acute pancreatitis if a CAPD patient presenting with suspected peritonitis has either a negative effluent culture or does not respond to antibiotic therapy.
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PMID:CAPD and pancreatitis: no connection. 138 Aug 40


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