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

A case of acute pancreatitis associated with primary hyperparathyroidism is reported. There was none of usual causes of pancreatitis, which did not recur following the removal of a parathyroid adenoma. There are over one hundred of cases of acute or chronic pancreatitis associated with hyperparathyroidism in the literature, suggesting a causal relationship between the two entities. The pancreatic disease has been attributed either to the hypercalcemia or to the excess of circulating parathyroid hormone. However, some authors have recently questioned any link between these two diseases.
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PMID:[Acute pancreatitis associated with primary hyperparathyroidism]. 175 Oct 69

Gallstones are well known to cause acute pancreatitis. However, the role of gallstone disease in the causation of chronic pancreatitis is still controversial. Abnormalities of the pancreatic duct have been noted in about one-half of patients with calculous biliary disease undergoing endoscopic retrograde cholangiopancreatography (ERCP), but despite this, it is generally believed that gallstones rarely, if ever, cause chronic pancreatitis. The clinical significance and the natural history of the pancreatographic changes seen in patients with gallstone disease is not known. Studies of the pancreatic functions and long-term follow-up of patients with calculous biliary disease, especially those who have abnormal pancreatograms, and the effect of removal of the gallstone on the pancreatographic abnormalities and pancreatic functions are needed to clarify the issue.
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PMID:Do gallstones cause chronic pancreatitis? 175 35

The aim of this study was to review the pathology of acute pancreatitis, resolving acute pancreatitis and chronic pancreatitis in order to find an answer to the unresolved question as to whether chronic pancreatitis is a primary disease or may be due to recurrent acute pancreatitis. Our series consisted of 71 pancreatic resection specimens and 15 autopsy pancreases from 8 patients with acute pancreatitis, 5 patients with pancreatitis 5-7 weeks prior to examination (resolving acute pancreatitis), and 66 patients with chronic pancreatitis. Peripancreatic and intrapancreatic fat necrosis was the key finding in acute pancreatitis. Organization of fat necrosis with early perilobular fibrosis and/or peripancreatic pseudocysts characterized the pancreas with resolving acute pancreatitis. Pseudocysts were present in 52% of pancreases with an early stage of chronic pancreatitis that was characterized by a focally accentuated fibrosis of the perilobular and, to a lesser degree, intralobular type. Marked fibrosis, ductal distortions and presence of intraductal calculi were the main features of advanced chronic pancreatitis. Pseudocysts were less frequent (36%) than in the early stage of the disease. On the basis of these findings it is suggested that acute pancreatitis, if it is severe and also affects the intrapancreatic fat deposits, may evolve into chronic pancreatitis.
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PMID:Chronic pancreatitis: evolution of the disease. 176 57

Ultrasonic assessment of the pancreas is rendered difficult by interposed gas-containing loops of bowel and stomach. In 50% of the cases, meteorism and ileus prevent the diagnosis of acute pancreatitis. In the case of chronic pancreatitis, focal pancreatitis and carcinoma of the pancreas, too, further diagnostic procedures (CT, ERCP, fine-needle aspiration) are required. As a rule, the caliber of the pancreatic duct can readily be assessed, and may, for example, indicate a carcinoma in the head of the pancreas. Splenomegaly and focal or diffuse parenchymal lesions are detectable by ultrasonography, although an etiological differentiation is not usually possible. The most common lesions are the so-called "bland" splenic cysts. Of importance is the diagnosis of rupture of the spleen, which requires immediate treatment.
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PMID:[Diagnosis of gastroenterologic diseases with sonography. Part 3: Pancreas and spleen]. 176 39

Increasing surgical experience with the immediate consequences of pancreatic injuries has resulted from parallel growth in the volume of motor vehicle accidents and societal violence. However, few surgeons are aware that complications may be considerably delayed following pancreatic trauma, occurring in some cases months to years after apparent recovery from the original injury. In four patients with blunt pancreatic trauma initially treated by non-operative means, stricture of the main pancreatic duct developed over a period of months as a result of progressive fibrosis at the site of ductal injury. Pancreatic duct hypertension was demonstrated to be present in the obstructed duct, and secondary changes of chronic pancreatitis developed in the obstructed segment of the gland ("upstream" chronic pancreatitis). Seven similar patients with delayed onset of chronic obstructive pancreatitis after pancreatic trauma were found in the literature. Symptoms related to these acquired ductal strictures are most commonly those of abdominal pain and recurrent episodes of acute pancreatitis. Recognition of post-traumatic chronic obstructive pancreatitis principally involves awareness that injuries to the pancreatic duct can produce remote complications. Pancreatoenteric drainage, or resection of the obstructed segment of pancreas, provides prompt and effective relief.
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PMID:Chronic obstructive pancreatitis as a delayed complication of pancreatic trauma. 177 10

The authors studied experience with simultaneous operations in 39 patients with coexisting diseases of the stomach, duodenum, biliary tract, and pancreas. A total of 31 operations were carried out in 14 patients with various forms of acute pancreatitis and 54 in 25 patients with chronic pancreatitis. One patient died in the immediate postoperative period from destructive postoperative pancreatitis. Simultaneous operations can be conducted under conditions of modern anesthesiological and intensive care without increasing mortality rates, which contributes to improvement of the immediate and late results of treatment of patients with concomitant digestive diseases.
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PMID:[Pancreatitis associated with diseases of the stomach, duodenum and biliary tract]. 177 55

A comparison on fibrosis in between apparently uninvolved areas in acute pancreatitis (AP) and chronic pancreatitis (CP) was both histopathologically and immunohistochemically studied. Interlobular fibrosis in the apparently uninvolved areas (AP) was found in 7 out of 9 patients and accompanied by hemosiderin deposition in 6 patients, whereas that in only 2 out of 12 patients in CP. In the 2 remaining patients of AP without fibrosis, hemorrhage with inflammation was distributed in the interlobular spaces. Hence, AP was seldomly followed by CP. Interlobular fibrosis in CP immunostained positively to both anti-collagen Types I and III, whereas that in AP in four patients only. Fibrosis in the 3 remaining patients of AP whose illness was of less than one month's duration was positive against anti-collagen Type III only. Therefore, differences in both hemosiderin deposition and immunoreactivity against anti-collagen Type I in the interlobular fibrosis, except for longer surviving patients were observed in between acute and chronic pancreatitis.
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PMID:[A comparison on between acute pancreatitis and chronic pancreatitis, special references to their fibrosis]. 179 23

Since its introduction in 1968, ERCP has developed from being a purely diagnostic method, mostly used in the investigation of unexplained upper abdominal pain, to an invaluable tool for the management of patients with pancreatic disorders. In cases with severe gallstone pancreatitis, the biliary obstruction is disclosed and relieved by ERCP and ES. In patients with severe acute pancreatitis of other aetiologies, as well as in post-traumatic pancreatitis, ERCP is indispensable for revealing complications (e.g. pancreatic duct rupture) and/or for planning the treatment strategy. Furthermore, in cases of pancreatitis not related to alcohol or gallstones, it often demonstrates causes which may be treatable, and it is also useful for evaluation of the gland after massive pancreatic necrosis. Moreover, ERCP is helpful in establishing the diagnosis of chronic pancreatitis and its complications as well as in demonstrating morphological grounds for therapeutic intervention. Although the indications, limitations, and practicability of the different techniques of therapeutic ERCP in various pancreatic diseases still remain to be defined, the method appears to offer an alternative to surgery, particularly in cases in which operative treatment is technically difficult and the results are less favourable. Frequency and severity of complications associated with both diagnostic and therapeutic ERCP seem to be, at least in the hands of experts, reasonably low.
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PMID:Endoscopic management of pancreatic disease. 185 84

We report the case of a 34-year-old alcoholic who was initially seen in March 1985 because of acute pancreatitis. A mass was demonstrated in the head of the pancreas. Serial sonogram and computed tomography scans over 4 1/2 years revealed progressive encroachment of the duodenum without symptoms attributable to obstruction. In 1989, three separate endoscopies with multiple biopsies showed chronic inflammation and strictures. Hypotonic duodenography confirmed stricture and obstructed duodenum. Surgical intervention is being considered. Duodenal obstruction secondary to chronic pancreatitis is rare. It may proceed subclinically for several years independent of continued alcohol use. Only when obstruction became severe in our patient did the classic symptoms of postprandial nausea, emesis, and weight loss become manifest. Obstructive jaundice from chronic pancreatitis due to stricture in the pancreatic portion of the common bile duct is uncommon.
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PMID:Chronic pancreatitis progressing to duodenal obstruction in the absence of classic symptoms. 185 3

The pathology of chronic pancreatitis is reviewed in order to study the histology and incidence of pseudocysts in relation to the degree of pancreatic fibrosis and calcification. The series consisted of 57 resection specimens (49 partial pancreatectomy specimens and 8 total pancreatectomy specimens) and 9 autopsy pancreata. The histology of cystic lesions observed in the specimens was found to be identical to that of pseudocysts in acute pancreatitis. In 19 of 57, there was concomitant occurrence of focal autodigestive (fat) necrosis and pseudocysts. Pseudocysts were more common in specimens with focal fibrosis and few calcifications (13/25) than in those with diffuse advanced fibrosis and numerous calcifications (15/41). The findings indicate that sequelae of acute pancreatitis are frequently present in chronic pancreatitis, particularly in an early stage when fibrosis is still focal and calcification rare. This suggests that chronic pancreatitis may result from relapses of severe acute pancreatitis. A pathogenetic concept that relates acute pancreatitis with chronic pancreatitis is proposed.
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PMID:Pseudocysts in chronic pancreatitis: a morphological analysis of 57 resection specimens and 9 autopsy pancreata. 186 65


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