Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0001339 (acute pancreatitis)
 10,593 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Biliary obstruction by non-malignant lesions can be treated either by biliary-enteric anastomosis or by sphincterotomy or sphincteroplasty. In the present report, 153 jaundiced patients operated on by sphincterotomy, were retrospectively examined. Proper indications for surgical sphincterotomy have been considered as follows: stones in the common bile duct (49.7%), biliary stones with secondary stenosis of Oddi (26.8%), impacted ampullary stones (17.6%), primary stenosis of Oddi (3.9%), stenosis of Oddi by perivaterian chronic pancreatitis (2.0%). Preoperative early diagnosis was recognized by US, ERCP, PTC, CT. The overall operative mortality was 2.6% and determined by acute renal failure in 2.0% and acute pancreatitis in 0.6%. Postoperative complications occurred in 4.6% and consisted in acute pancreatitis in 3.3% and bleeding from sphincterotomy in 1.3%. One hundred and twenty-three patients (82.5%) were followed up by questionnaire and by both X-ray studies and ultrasonography. Good results were observed in 80.5%, fair results in 17.1% and poor results in 2.4%. The presents study suggests further indications for surgical sphincterotomy in the treatment of benign biliary obstruction. The effectiveness of this procedure in the early management of non-malignant jaundice is also stressed.
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PMID:Surgical sphincterotomy in the early management of non-malignant obstructive jaundice. Indications and results. 667 93

A 93-year-old woman admitted because of epigastralgia. Cholelithiasis, obstructive jaundice, acute suppurative cholangitis and acute pancreatitis were diagnosed on blood chemistry and ultrasonography on admission. We performed emergency PTCD. A calculus 4 cm in diameter was detected at the papilla of Vater and marked dilatation of the common bile duct and pancreatic duct. ESWL was performed because of her age and because endoscopical operation seemed to be difficult. After lithotripsy, PTC and endoscopy demonstrated a diverticulum at the peripapillary portion of the duodenum. Based on analysis of PTC result before and after ESWL, we diagnosed this case as Lemmel's syndrome (obstructive jaundice, acute suppurative cholangitis and acute pancreatitis) caused by a large diverticular enterolith at the peripapillary portion of the duodenum. ESWL treatment of aged patient with an enterolith is safe.
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PMID:[A case of Lemmel's syndrome caused by a large diverticular enterolith at the peripapillary portion of the duodenum]. 886 45

The present study aimed to investigate early risk factors for hyperlipidemic acute pancreatitis (HLAP) in order to open up novel routes for its prevention and treatment. Demographics, laboratory data obtained within 48 h, enhanced computed tomography (CT) imaging data and the modified CT severity index (MCTSI) for 111 patients with HLAP who were assessed at Ordos Central Hospital (Ordos, China) between January 2015 and October 2017 were retrospectively analyzed. Of these, 17 patients progressed to infectious pancreatic necrosis (IPN) and 14 patients progressed to organ failure (OF), the occurrence of which were the study outcomes. The patients were divided into pairs groups: IPN and non-IPN, as well as OF and non-OF, and differences between the groups were determined regarding various clinicopathological parameters. Furthermore, univariate and multivariate regression analyses were performed to identify parameters associated with the risk of progression to IPN or OP. On univariate analysis, the following parameters were deemed as being significantly associated with the risk of IPN: Serum calcium ions, C-reactive protein (CRP), extent of necrosis, procalcitonin (PTC) and the MCTSI. Furthermore, calcium ions, red cell distribution width (RDW), extent of necrosis and the MCTSI were significantly associated with the risk of OF on univariate analysis. Multivariate logistic regression analysis for these parameters then indicated that CRP (P=0.014), RDW (P=0.025) and the extent of necrosis (P=0.022) were significant and independent predictors of progression; thus, these are early risk factors for patients with HLAP. Receiver operating characteristic curves were generated to evaluate the predictive value of these factors, and the area under the curve for the three parameters was 0.863 [95% confidence interval (CI), 0.646-0.886], 0.727 (95% CI, 0.651-0.803) and 0.833 (95% CI, 0.739-0.936), respectively. Therefore, CRP, RDW and the extent of necrosis are early predictive indexes for the risk of progression in HLAP.
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PMID:Early predictors of hyperlipidemic acute pancreatitis. 3034 98