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

Gastrointestinal complications, such as ileus, bleeding, stenosis and fistula formation, were retrospectively analysed on 180 patients with acute pancreatitis. Paralytic ileus occurred in only a quarter of patients with acute oedematous pancreatitis and only one had bleeding from a gastric ulcer. Complications occurred in the early but also postacute stage in patients with the haemorrhagic-necrotizing form. Even with early and delayed operation and adequate treatment of most complications, renewed gastrointestinal complications were not uncommon and required re-operations.
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PMID:[Gastrointestinal complications of acute pancreatitis (author's transl)]. 30 3

Serum amylase level was determined in 129 cases (225 episodes) of chronic respiratory failure at acute exacerbation and in 59 cases (62 episodes) of pneumonia without respiratory failure as control. Cases with accompanying diseases, such as acute pancreatitis, parotiditis, ileus and renal dysfunction, which were expected to develop hyperamylasemia were excluded. The 225 episodes were divided according to the causes of acute exacerbation into 4 groups: pneumonia, bronchitis, right heart failure without infection, and others (e. g. hemoptysis). Hyperamylasemia (greater than 400 S-U) was observed in groups of pneumonia (15/40 = 35.5%) and bronchitis (12/95 = 12.6%), respectively but not in those of right heart failure without infection (0/73 = 0%) and other causes (0/17 = 0%). As a result, hyperamylasemia was found only under conditions of inflammation of lung parenchyma and bronchi with acute exacerbation of respiratory failure. On the other hand no hyperamylasemia was observed in 62 episodes of pneumonia alone without respiratory failure. It was concluded that both respiratory tract infection and acute respiratory failure are necessary factors for development of hyperamylasemia originating from lung or bronchi.
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PMID:[Hyperamylasemia in acute exacerbation of patients with chronic respiratory failure]. 138 26

Hypophosphatemia and decreased content of ATP, 2,3-DPG in erythrocytes were found in 147 patients operated upon organs of the abdominal cavity. Hypophosphatemia was more pronounced after operations for ulcer disease of the stomach and duodenum, acute pancreatitis and commissural ileus. An intravenous injection of potassium dihydrogen phosphate++ prevents the development of hypophosphatemia and concomitant decrease of the content of nonorganic phosphorus, ATP, 2,3-DPG in erythrocytes and may improve the postoperative period in these patients.
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PMID:[Correction of disorders of phosphorus metabolism after operations on the abdominal organs]. 165 8

This is the fourth reported case of acute pancreatitis associated with acetaminophen overdose. The patient had ingested the smallest amount of acetaminophen (9.75-13 g) that has been reported to produce acute pancreatitis. This patient also suffered liver and renal impairment and developed an ileus and ascites. Despite late therapy and laboratory tests that indicated a poor prognosis the patient made a complete recovery without sequelae.
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PMID:Acetaminophen induced pancreatitis. 167 95

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

The effect of a fractional epidural blockade on acute pancreatitis was investigated in a prospective study. PATIENTS AND METHODS. Thoracic (20 patients) or lumbar (six patients) epidural blockade was carried out in 26 patients with severe abdominal conditions comprising sub-ileus in 100%, pancreatic edema indicated by sonography/computer tomography in 57.8%, and necrosis of the pancreas in 34.6%. RESULTS. On average, 3.4 (1-6) injections with single doses of 6-20 ml 0.25% bupivacaine were injected per day. In four patients, morphine (up to 4 mg per 24 h) was added to the local anesthetic. The duration of treatment was between 1 and 15 days. After 10.5% of the injections, the systolic pressure decreased by more than 20%, and after 12.8% of the injections the blood pressure decreased by more than 30%. Hypotension of more than 30% was treated with 0.3 to 0.5 ml theodrenaline (Akrinor) and/or 0.1 to 0.2 mg dihydro-ergotamine (Dihydergot). General analgesics had to be administered in addition on 21.8% of the treatment days and intensive care treatment (artificial ventilation) on 32% of the treatment days. The duration of epidural analgesia varied between 1 and 15 days depending on the intensity of symptoms (pain, ileus). Within 4 days, the enzyme activity of the lipase fell from 8120 to 427 IU, and that of alpha amylase fell from 1401 to 143 IU. In 3 patients laparotomy (for drainage) was performed. An ERCP was carried out in 16 patients. Cardiopulmonary failure necessitated artificial ventilation over a period of 1-15 days in 6 patients; the epidural blockade was continued during the artificial ventilation. Cholecystectomy was carried out as an interval operation in 6 patients. No neurological complications were observed. All patients survived and were discharged from hospital.
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PMID:[Epidural blockade for analgesia and treatment of acute pancreatitis]. 178 Apr 89

Early recognition of severity of acute pancreatitis is very uncertain. For this reason it is necessary to have objective criteria to predict with accuracy the course of the disease. The aim of this study was to examine the value of the determination of the acute phase reactants: C reactive protein (CRP), alpha 1-antitrypsin (alpha-AT) and alpha 1-glycoprotein acid (alpha-GA) as prognostic indicators of acute pancreatitis on admission and on the third day. We have studied 40 patients with acute pancreatitis and serum concentrations of CRP, alpha-AT and alpha-GP were related to the Ranson Index. On admission the median levels of CRP: 74 mg/L, alpha-AT: 208 mg% and alpha-GA: 303 mg% were significantly higher (p less than 0.001) in patients with Ranson Index greater than or equal to 3 than in those with Ranson Index less than or equal to 2 (CRP: 166 mg/L, alpha-AT: 303 mg% and alpha-GA: 121 mg%). The values which differentiated patients with better and worse prognosis were: CRP 100 mg/L (sensitivity 100% and specificity 86%); alpha--AT 275 mg% (sensitivity 71% and specificity 85%); and alpha-GA 90 mg% (sensitivity 87.5% and specificity 57.9%). CRP, and to a lesser degree the alpha-AT and alpha-GA, were related to the duration of the ileus, and to the severe complications of the acute pancreatitis.
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PMID:[Prospective study of the prognostic value of C reactive protein, alpha 1-antitrypsin and alpha 1-acid glycoprotein in acute pancreatitis]. 186 21

Plain film of the abdomen is widely used in the diagnostic evaluation of intestinal occlusion. Even though this technique can yield a panoramic and high-resolution view of gas-filled intestinal loops, several factors, such as type and duration of occlusion, neurovascular status of the intestine and general patient condition, may reduce the diagnostic specificity of the plain film relative to the organic or functional nature of the occlusion. From 1987 to 1989, fifty-four patients with intestinal occlusion were studied combining plain abdominal film with abdominal ultrasound (US). This was done in order to evaluate whether the additional information obtained from US could be of value in better determining the nature of the ileus. US evaluation was guided by the information already obtained from plain film which better demonstrates gas-filled loops. The results show that in all 27 cases of dynamic ileus (intestinal ischemia, acute appendicitis, acute cholecystitis, acute pancreatitis or blunt abdominal trauma) US demonstrates: intestinal loops slightly increased in caliber, with liquid content, or loops containing rare hyperechoic particles, intestinal wall thickening and no peristalsis. In 27 cases of acute, chronic or complicated mechanical ileus (adhesions, internal hernia, intestinal neoplasm, peritoneal seedings) US shows: 1) in acute occlusion: hyperperistaltic intestinal loops containing inhomogeneous liquid; 2) in chronic occlusion: liquid content with a solid echogenic component; 3) in complicated occlusion: liquid stasis, frequent increase in wall thickness, moderate peritoneal effusion and inefficient peristalsis. In conclusion, based on the obtained data, the authors feel that the combination of plain abdominal film and abdominal US can be useful in the work-up of patient with intestinal occlusion. The information provided by US allows a better definition of the nature of the ileus.
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PMID:[Plain radiographic examination and abdominal echography in intestinal occlusion syndrome. Preliminary note]. 201 34

Painless acute hemorrhagic pancreatitis, manifested only by an ileus, is described in two of nine patients after ingestion of parathion, a poisonous anticholinesterase insecticide. Other investigators have shown in animal experiments that parathion increases pancreatic intraductal pressure and stimulates pancreatic secretion. Such described cases may be designated pathologically as clinical examples of acute obstruction pancreatitis. Hemoperfusion is usually chosen to treat parathion intoxication, but carries the risk of causing hemorrhages in acute hemorrhagic pancreatitis. Clinically, it is therefore important to determine, by way of enzyme estimations and imaging procedures, whether acute pancreatitis has occurred following parathion intoxication, so that the prognosis for the poisoned patient is comprehensive enough and the antidated measures applied do not aggravate the pancreatic condition.
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PMID:Painless acute pancreatitis subsequent to anticholinesterase insecticide (parathion) intoxication. 237 89

A 48-year-old patient presented with a 24 hour history of diffuse abdominal pain and diarrhea. Based on elevated serum amylase and lipase levels, a CT-scan, and a history of chronic alcohol intake, acute alcoholic pancreatitis was diagnosed. The patient clinically improved under conservative therapy, but after restarting enteral nutrition on the fourth day, he developed full blown mechanical ileus. Intraoperatively, an adhesive band and acute edematous pancreatitis and fat necrosis was found. Retrospectively, the initial clinical symptoms and plain abdominal x-ray findings suggest coincidence of obstructive ileus and acute pancreatitis. We hypothesize that obstructive ileus had triggered pancreatitis.
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PMID:Obstructive ileus and acute pancreatitis. 239 51


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