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

Although the hazards of using Demerol for pain management is well documented, physicians at a 350-bed tertiary-care center in the upper midwest continued to follow the antiquated practice of ordering intramuscular Demerol and Vistaril to manage pain for patients with acute pancreatitis. Their reasoning was based on early evidence that Demerol, unlike morphine, does not cause biliary-tract spasms resulting in epigastric or right upper quadrant pain. In an effort to change practice patterns, a multidisciplinary team was formed to study the efficacy of using Transdermal Therapeutic System (TTS) fentanyl to manage pain in this patient population. Thirty-two subjects were enrolled in a double-blind, placebo-controlled study to evaluate the efficacy of using TTS fentanyl with intramuscular Demerol for breakthrough pain in comparison to using a placebo system and intramuscular Demerol. There was no statistically significant difference in self-reported pain intensity between the control and experimental groups on the first day of hospitalization. This finding would be expected because serum fentanyl concentrations rise gradually during the first 12 to 14 hours after application of the TTS fentanyl and plateau at 24 hours. There was a statistically significant difference between groups at 36 hours (exact p <.0154) and 45 hours (exact p <.0132) after application of the TTS fentanyl. This is probably because of greater serum fentanyl concentrations observed during the 36- to 48-hour period after application of TTS fentanyl. Although not statistically significant, trends in the data revealed that the experimental group had lower self-reported pain intensity scores than the control group throughout the course of hospitalization. Even though the experimental group had significantly more previous hospitalizations for acute pancreatitis and a higher pain intensity score on admission, this group had a significantly shorter length of stay in the hospital c2 (1, N = 31) = 4.3706 p <.05. There was no statistically significant difference between the two groups for self-reported satisfaction with pain management.
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PMID:Transdermal fentanyl for the management of acute pancreatitis pain. 1199 27

A 62-year-old man was admitted to receive extracorporeal shock wave lithotripsy (ESWL) for a right renal pelvic calculus. During the operation, the patient complained of right upper quadrant pain. Later in the day, laboratory data showed elevated serum amylase levels, and abdominal CT revealed an enlarged pancreas. These findings led to a diagnosis of acute pancreatitis. The following day, urine output had decreased, and pleural and ascitic fluid had accumulated. For these reasons, the patient was transferred to our hospital to receive combination therapy, including arterial infusion therapy with protease inhibitors, antibiotics and continuous hemodiafiltration. The condition of the patient improved, and he was discharged on day 30. Acute pancreatitis should be considered as an early complication after ESWL for urinary tract calculus.
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PMID:[A case of acute pancreatitis after extracorporeal shock wave lithotripsy for renal pelvic calculus]. 2069 59

Hydatid acute pancreatitis is a rare condition and always presents as consequence of acute edematous pancreatitis. Intrabiliary rupture of hepatic hydatid cysts and obstruction of papillary orifice with hydatid membrane is possible mechanism. A 49-year-old man was admitted with epigastric and right upper quadrant pain, nausea, and vomiting. Computed tomography scan showed 5 x 5 cm cyst in left hepatic lobe, which had ruptured into the biliary tract and caused necrotizing pancreatitis. Endoscopic retrograde cholangiopancreatography trial failed. Surgical choice was drainage of cyst, insertion of T-Tube, exploration of common bile duct and omentoplasty. No additional necessary surgical intervention was necessary for necrotizing pancreatitis. Clinical and laboratory findings resolved rapidly and there was no recurrent pancreatitis episode during 1 year of follow-up. Hydatid edematous and necrotizing pancreatitis have similar progress. Recovery is quick and uneventful after elimination of mechanical obstruction of papillary orifice.
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PMID:An unusual appearance of complicated hydatid cyst: necrotizing pancreatitis. 2826 78

Percutaneous Liver Biopsy is an often-required procedure for the evaluation of multiple liver diseases. The complications are rare but well reported. Here we present a case of a 60-year-old overweight female who underwent liver biopsy for elevated alkaline phosphatase. She developed acute pancreatitis secondary to hemobilia, with atypical signs and symptoms, following the biopsy. She never had the classic triad of RUQ pain, jaundice, and upper GI hemorrhage. There were also multiple negative imaging studies, thus complicating the presentation. She was successfully treated with ERCP, sphincterotomy, balloon sweep, and stent placement. Angiography and transcatheter embolization were not required.
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PMID:Acute Pancreatitis Secondary to Hemobilia after Percutaneous Liver Biopsy: A Rare Complication of a Common Procedure, Presenting in an Atypical Fashion. 3024 95