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

During the period 1974-1983, Yersinia enterocolitica infection was diagnosed in 458 hospitalized patients by antibody response or isolation of the micro-organism. Eight (1.75%) patients showed signs of acute pancreatitis with elevated serum or urine levels of amylase; two patients had acute insulin-dependent diabetes. The patients were followed up for 4-14 years (until 1987). Four patients were readmitted with chronic pancreatitis, and one with acute pancreatitis. Diabetes developed in two males and nine females; in seven cases this was associated with chronic conditions of possible autoimmune aetiology. In 1987 a significantly higher than expected prevalence of diabetes was demonstrated among female subjects aged 30-54 years. Yersinia enterocolitica infection constitutes a differential diagnosis in acute pancreatitis, and might be related to the development of chronic pancreatitis and diabetes.
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PMID:Acute and chronic pancreatic disease associated with Yersinia enterocolitica infection: a Norwegian 10-year follow-up study of 458 hospitalized patients. 160 90

We reviewed our experience with 90 patients with pancreatic pseudocysts to determine if the cause of pancreatitis influenced the patients' outcome. Acute pancreatitis (AP) occurred in 57 (63%) patients due to alcoholic (n = 15), postoperative (n = 14), biliary (n = 12), and other etiologies (n = 16). Thirty-three (37%) patients had chronic pancreatitis (CP) secondary to alcohol use (n = 27) or other causes (n = 6). Multiple pseudocysts were significantly more frequent in patients with acute alcoholic pancreatitis than in patients with chronic pancreatitis (47% versus 19%, p < 0.05). Spontaneous resolution occurred within 8 weeks in 10 (11%) patients with pseudocysts (AP = 9%, CP = 15%, p = NS). However, no patient with pseudocyst associated with biliary or postoperative pancreatitis underwent spontaneous resolution. Although pseudocysts associated with chronic pancreatitis were smaller in size (8.0 +/- 4.7 versus 5.7 +/- 3.8 cm, p < 0.05), a similar proportion of them required operation compared with AP pseudocysts (56% versus 58%). There were significantly more deaths in patients with postoperative pancreatitis compared with all other groups (29% versus 7%, p < 0.05). The outcome of pseudocysts was similar regardless of size (greater than 6 cm versus less than 6 cm) and presentation (acute versus delayed). Thus, the etiology of pancreatitis was a more important determinant of pseudocyst outcome than pseudocyst size or presentation.
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PMID:Influence of the etiology of pancreatitis on the natural history of pancreatic pseudocysts. 167 Feb 19

A 32-year-old woman with a choledochal cyst (Todani type I) developed recurrent acute pancreatitis leading to calcific chronic pancreatitis. She had previously been treated with two cyst drainage procedures and subtotal cyst excision. This association between choledochal cyst and chronic pancreatitis has not been previously reported. Severe continuing symptoms led to pylorus-preserving proximal pancreatoduodenectomy, which was undertaken to prevent future carcinoma in the cyst remnant and progression of the chronic pancreatitis.
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PMID:Choledochal cyst and chronic pancreatitis--treated by proximal pancreatectomy. 168 90

A fluorometric immunoassay has been established to quantitate pancreatic stone protein providing a sensitivity for concentrations from 0.015 to 0.5 micrograms/mL. When concentrations of pancreatic stone protein were determined from pancreatic secretions obtained either from patients suffering from chronic pancreatitis (n = 31) [including the calcifying forms (n = 10)], pancreatic cancer (n = 22), or nonpancreatic diseases (n = 17), no significant differences were found. In contrast, increased concentrations were found in serum samples from patients with chronic (39/66) and acute pancreatitis (16/20) compared with control patients. The differences between these diagnostic groups and controls were highly significant (P less than 0.0001) and independent of pancreatic enzyme activity. Immunochemical analyses of serum pancreatic stone protein showed an isoelectric point (pH 9) similar to that reported for the pancreatic thread protein. With respect to recent communications, these data do not support the etiopathogenic role postulated for pancreatic stone protein in chronic pancreatitis and chronic calcifying pancreatitis by other investigators.
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PMID:Immunochemical characterization and quantitative distribution of pancreatic stone protein in sera and pancreatic secretions in pancreatic disorders. 188 8

Fecal isoamylase activity was studied in 93 consecutive patients (26 in the recovery stage of acute pancreatitis, 24 with chronic pancreatitis, 13 with pancreatic cancer, and 30 with other gastrointestinal diseases) and compared with fecal chymotrypsin activity and the results of the secretin test. Seventy-six healthy subjects were studied as controls. Both pancreatic (p)-type and salivary (s)-type isoamylase activities in stool were determined by inhibitor assay as well as cellulose acetate electrophoresis. The mean fecal amylase activity in healthy subjects was 757 +/- 88 IU/g (p-type isoamylase: 77 +/- 2%, s-type isoamylase: 23 +/- 2%). There was a good correlation between fecal p-type isoamylase and chymotrypsin activities (r = 0.625, p less than 0.001). Fecal p-type isoamylase activity in patients with chronic pancreatitis and pancreatic cancer was significantly lower than in healthy subjects (p less than 0.001). Patients with moderate and severe exocrine pancreatic insufficiency as determined by the secretin test had significantly lower fecal p-type isoamylase activity. Daily fat intake did not affect fecal amylase or isoamylase activities. Fecal s-type isoamylase activity in patients with hypoacidity was significantly higher than in patients with hyperacidity, but no difference in fecal p-type isoamylase activity was observed. It is concluded that analysis of fecal isoamylase activity is useful in the assessment of pancreatic function.
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PMID:Fecal isoamylase activity in patients with pancreatic diseases. 170 33

The diagnostic significance of serum immunoreactive pancreatic phospholipase A2 (PLA2) was studied in 119 patients with pancreatic disease, 200 with various non-pancreatic disease, and 203 healthy controls using radioimmunoassay (RIA) specific to human pancreatic PLA2. This newly developed RIA using monoclonal antibody was satisfactorily sensitive and reliable. Serum PLA2 was elevated in all six patients with acute pancreatitis. Frequency of abnormal serum PLA2 levels was 60% in chronic pancreatitis (n = 52) and 67% in pancreatic cancer (n = 61). Serum PLA2 levels were low in chronic pancreatitis with severe exocrine insufficiency and advanced pancreatic cancer. In chronic pancreatitis, patients with low serum PLA2 level showed lower enzyme output in secretin test than patients with normal or high serum PLA2 level. Frequency of abnormal PLA2 levels was 27% in non-pancreatic disease and, in particular, patients with renal failure showed high PLA2 levels. Sensitivity (62%) and efficiency (69%) of serum PLA2 assay in pancreatic disease were superior to those of amylase. In conclusion, serum PLA2 determination using RIA was useful for the diagnosis of acute pancreatitis by high serum PLA2 levels and the diagnosis of severe exocrine pancreatic insufficiency by low serum PLA2 levels.
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PMID:The diagnostic value of serum pancreatic phospholipase A2 (PLA2) in pancreatic diseases. 170 72

Pancreatic cysts and pseudocysts had to be treated by surgery until 15 years ago. Nowadays they can be aspirated (or drained) either endoscopically or by ultrasonic and computed tomographic guided punctures. The aim of this study was to see if these non-surgical treatments were efficient enough among the actual treatments. From 1984 to 1988, 33 patients were admitted in one single institution with a pancreatic cyst or pseudocyst, 22 of which were a consequence on an acute pancreatitis and 11 complicated a chronic pancreatitis. Ten cysts were connected with the Wirsung channel while 11 others were not, but the ERCP failed to give any accurate information on this point in 12 cases. As a first treatment, we abstained of any invasive procedure in 9 cases, 18 were treated by percutaneous aspiration guided by ultrasound and 6 patients underwent surgery. The mean follow-up was 30 months. All the patients who had no treatment remained symptom free; their cysts improved in 5 cases and disappeared in 4 cases. Among the cysts treated by percutaneous aspiration, 4 had to be operated, 5 disappeared, 3 improved and 6 recurred; the percutaneous aspiration obtained a lasting symptoms' relief for these patients, whatever the connection the cyst had with the Wirsung channel. This study suggests that percutaneous aspiration or drainage guided by ultrasound may be a treatment of the highest quality for acute and chronic pancreatitis cystic formations. However, it seems to act upon the symptoms rather than upon the cystic formations themselves.
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PMID:[Non-surgical treatment of cysts and pseudocysts of the pancreas. A study of a series of 33 cases]. 170 46

The prospective examination and quantitative determination of concentration of serum elastase 1 using RIA method were performed in 75 patients with pancreatic diseases at the Clinic of General and Vascular Surgery and the Institute of Nuclear Medicine of the M.M.A. in the period 1988-1989. The values of serum elastase 1 concentration were compared with values of amylase in serum and urine. The greater diagnostical importance of serum elastase 1 was found compared to values of amylase in serum and urine, not only in patients with acute pancreatitis but also in exacerbation of chronic pancreatitis. The level of serum elastase 1 concentration enables more reliable follow up of the evolution of the disease and therapeutical effects in patients with acute pancreatitis.
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PMID:[Clinical evaluation of serum elastase-1 levels in patients with acute pancreatitis]. 172 May 94

We measured serum level of alpha 2-macroglobulin-trypsin complex (alpha 2M-T complex) using a colorimetric assay with a synthetic chromogenic substrate, D-gamma-tert-butyloxy-Gly-Arg-3-carboxy-4-hydroxyanilide dihydrochloride. Serum level of alpha 2M-T complex was greater in acute pancreatitis patients than in chronic pancreatitis or pancreatic cancer patients. In severe acute pancreatitis patients, both mean level and frequency of abnormal value of serum alpha 2M-T complex were significantly greater than in mild acute pancreatitis patients (13.1 +/- 12.9 vs 2.9 +/- 3.5 U/L, p less than 0.01; 100 vs 41%, p less than 0.01). In conclusion, the determination of serum level of alpha 2M-T complex can be useful for the diagnosis of severe acute pancreatitis.
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PMID:[Diagnostic value of serum level of alpha 2-macroglobulin-trypsin complex in pancreatic diseases using a colorimetric assay with a synthetic chromogenic substrate]. 172 22

The aim of this study was a prospective search for splenoportal venous obstruction (SPVO) in a medical-surgical series of 266 patients with chronic pancreatitis who were followed up a mean time of 8.2 years. SPVO was systematically searched for using ultrasonography and then confirmed by angiography or computed tomography. SPVO was found in 35 patients (13.2%) but was symptomatic in only two. Initial obstruction involved the splenic vein in 22 patients, the portal vein in 10, and the superior mesenteric vein in three. Since venous obstruction extended from the splenic to the portal vein in five patients, the prevalence of portal obstruction was 5.6% (15/266). Acute pancreatitis and pseudocysts were the probable cause of SPVO in 91.4% of our cases. Half the cases of splenic venous obstruction were related to pseudocysts of the caudal pancreas. Esophageal varices were found in two patients and gastric varices in four at the time of diagnosis and during follow-up. At the end of follow-up, 12 patients had undergone splenopancreatectomy (N = 11) or splenectomy (N = 1). Only one patient was operated on for massive esophageal variceal bleeding, and another patient died due to intractable colic variceal bleeding. In four of six patients operated on with portal vein obstruction, surgery was difficult due to venous collaterals. Ten patients were not operated on and 13 patients operated on were not treated for SPVO. The mean follow-up after diagnosis of SPVO for these final 23 patients was 28.9 months. None of these patients bled.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Splenic and portal venous obstruction in chronic pancreatitis. A prospective longitudinal study of a medical-surgical series of 266 patients. 848 82


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