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

Primary familial forms of chylomicronemia can lead to acute life-threatening complications, especially acute pancreatitis. The main aim of therapy is to avoid this so-called chylomicronemia syndrome. In 12 patients with primary chylomicronemia due to familial hypertriglyceridemia, the addition of 2.16 g omega-3 fatty acids over 4 weeks and 4.32 g for 8 weeks resulted in a decrease of serum triglyceride levels from 1,624 +/- 333 to 894 +/- 241 mg/dL after 12 weeks. Cholesterol and triglyceride levels in the chylomicron fraction were reduced concomitantly, the apolipoprotein B-100/B-48 ratio increased, very--low-density lipoprotein (VLDL) triglycerides, VLDL cholesterol, and total cholesterol levels decreased, and low-density lipoprotein (LDL) cholesterol showed a tendency to increase, but this finding did not reach significance. High-density lipoprotein (HDL) cholesterol levels remained unchanged, as did the levels of apolipoproteins A-I, A-II, and E, and lipoprotein(a). Apolipoprotein B levels decreased significantly. The decrease of triglyceride levels to still-elevated concentrations was accompanied by a substantial decrease in plasma and whole-blood viscosity and erythrocyte aggregation, which reached normal values. As in chylomicronemia, complications usually occur at triglyceride levels higher than 1,500 mg/dL; patients can still profit from treatment with omega-3 fatty acids, even though triglyceride levels are still substantially elevated. No clinically relevant side effects occurred, with the exception of the manifestation of diabetes mellitus in one patient, which could be reversed after discontinuation of treatment.
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PMID:Treatment of primary chylomicronemia due to familial hypertriglyceridemia by omega-3 fatty acids. 140 95

Biliary sludge is a collection of mucus, calcium bilirubinate, and cholesterol crystals that is usually recognized by characteristic echoes on ultrasonography. Its pathogenesis, clinical significance, and ultimate prognosis remain uncertain. We therefore studied the origin of biliary sludge ultrasonic echoes, using an ex vivo liver-gallbladder preparation, and determined the outcome of a group of patients identified to have gallbladder sludge by ultrasonography. Echoes were not generated by either an increase in the total solid concentration or by the graded addition of partially purified mucus glycoprotein. Cholesterol monohydrate crystals (greater than 50 micron) mixed with mucus produced echoes that were indistinguishable from gallbladder sludge observed in patients. To determine the natural evolution of gallbladder sludge in patients, we prospectively followed 96 patients found to have biliary sludge for a mean of 37.8 mo by serial ultrasound scans every 6 mo. In 17 patients (17.7%) biliary sludge disappeared and did not recur for at least 2 yr, in 58 patients (60.4%) biliary sludge disappeared and reappeared, and in 8 patients (8.3%) asymptomatic gallstones developed. There were 12 cholecystectomies performed: six were done for symptomatic gallstones (6.3%) and the other six for sludge associated with severe biliary pain attacks with or without recurrent acute pancreatitis. The finding of sludge represented precipitates being formed in bile. In some patients, it was a precursor form of gallstone disease.
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PMID:Origin and fate of biliary sludge. 195 47

Cholesterol emboli usually occur after vascular surgery or angiographic procedures in patients with extensive arteriosclerosis. Atheroemboli also occur spontaneously in patients receiving anticoagulant drugs. Ischemic colitis, gastric hemorrhage, and acute pancreatitis are the more common gastrointestinal manifestations of cholesterol emboli. Here I report, for apparently the first time, cholesterol emboli in a colonic polyp.
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PMID:Cholesterol emboli in a colonic polyp. 780 35

Cholesterol (TC) and triglyceride (TG) plasma levels physiologically increase during pregnancy. The lipid increment is respectively 23%-53% above pregravidic level for TC and two-three fold the pre-pregnancy level for TG. If the TC and TG are higher than normal values in pregnancy the patient must be carefully monitored. Acute pancreatitis is the main consequence of hyperlipidemia and it can occur either during pregnancy, in the third trimester, or in the puerperium. Mortality is high both for the mother (21%) and the fetus (20%). The authors report a case of 37-year-old pregnant woman at 35 week gestation with hypercholesterolemia (TC = 425 mg/dl) and severe hypertriglyceridemia (TG = 3315 mg/dl). The patient was admitted to the hospital for treatment with an appropriate diet and drug lowering lipid levels (gemfibrozil). The baby was delivered by cesarean section at week 36. The neonatal weight at birth was 2670 g and the Apgar score was 9 at the first minute. After delivery the maternal triglyceride levels showed a remarkable reduction. According to a review of the literature, severe hypertriglyceridemia in pregnancy should be treated with a careful restriction of calories and fat; for preventing acute pancreatitis hospitalization for intravenous fluid therapy and plasma exchange must be required.
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PMID:[Severe hypertriglyceridemia in pregnancy. A clinical case report]. 902 53

Migraine is periodical disorder which is characterized by recurrent headache seizures different in intensity, frequency and duration. Amylases L-1,4 glycol: gluckanohidrolises, (EC.3.2.1.1) are enzymes from hydrolase's group which dissolve starch meaning glycogen. Activity of amylases in serum grows: at acute pancreatitis, at carcinoma of pancreas, heavy necroses of pancreas. Total number of examinees was 92 out of which 45 were male (48.9 %) and 47 female or 51.1 %. Average age of the examines was 42.9. Neuroticism scale which was tested by Cornell scale was 55,03. Out of the total number of examinees 30 or 32,6 were non-smokers while 62 or 67,4 % smoked regularly. The aim of this work is to perform hematological-biochemical test of blood in patients with migraine. In the beginning of this research it was planned for all the patients to have hematological blood test done (sedimentation of erythrocytes, trombocytes, complete blood test and differential blood test) and biochemical blood test (hepatogram, transamynase, amylase, Lactal dehydrogenase, Alkalic phosphatase, ferrum in serum, Glucose, Cholesterol, Calcium and Phosphorus in serum. After reviewing the received values of hematological and biochemical tests, all values were within the borders of normal values. Amylases had higher values at 49 or 53,3 % of patients, and 43 or 46,7 % of patients had normal values of amylases. Normal values of amylases are to 220 U/l measured by I.F.C. at 37 degrees C. Medium value in tested group is 219.09. It means that every second examinee had increased values of amylase in blood; there is no statistics difference of amylase value between sexes.
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PMID:[Hematological-biochemical tests in patient with migraine]. 1642 33

Acute pancreatitis during pregnancy is an uncommon complication. The usual cause is biliary tract disease. Cholesterol and triglyceride plasma levels physiologically increase during pregnancy. Pregravidic hypertriglyceridemia (as much primary as secondary) may be exacerbated and occasionally act as the trigger. Early diagnosis and treatment are the keys because related morbidity and mortality are high. We report a case of diabetic ketoacidosis and hypertriglyceridemia-induced gestational pancreatitis (tryglicerid level of 12,100 mg/dL) treated successfully with conservative management. The clinical, biochemical and therapeutic aspects comment in addition of this pathology, as well as its prevention
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PMID:[Hypertriglyceridemic pancreatitis during pregnancy. A report of a case]. 1688 60

Of the cases of acute pancreatitis, 1-7% are caused by severe hypertriglyceridemia and can be treated with plasma exchange (PE). We report on a large series of patients with acute hyperlipidemic pancreatitis (HLP) treated with PE. In the 1992-2008 period, 50 patients (45 +/- 8 years old, 92% male) with acute HLP were treated with PE, during which 1-2 plasma volumes were exchanged. Heparin was used as anticoagulant in 85% of the procedures, and citrate in the rest. Cholesterol and triglycerides were measured before and after PE. In the 2003-2008 cohort of 40 patients, we retrospectively recorded an Acute Physiology and Chronic Health Evaluation II (APACHE II) score at the first PE session, hospital mortality, and length of hospital stay. A total of 79 PE treatments were done, 1-5 per patient. The volume exchanged was 4890 +/- 1300 mL over a duration of 3.5 +/- 2 h. During the first PE, the triglycerides were lowered from 58.9 +/- 40.8 to 10.8 +/- 10.8 mmol/L, and the total cholesterol was lowered from 20.0 +/- 7.6 to 5.7 +/- 4.3 mmol/L. In 10% of the procedures the plasmafilter was replaced, and in 3% the filter was clotted. Hypotension occurred in 3% of PE and there was one case of gastrointestinal bleeding after PE with heparin anticoagulation. In the 2003-2008 cohort, the median APACHE II score was 5 (range 0-15), the median overall hospital stay was 18 days (range 3-142 days) and the hospital mortality was 15%. To conclude, in acute hyperlipidemic pancreatitis, one to two plasma exchanges effectively reduce the serum triglyceride level. There is a low rate of procedure-related complications. A mortality rate of 15% is considerable.
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PMID:Treatment of hyperlipidemic acute pancreatitis with plasma exchange: a single-center experience. 1969 66

Cholesterol crystal embolization (CCE) can result in end-organ ischemia. Retrospective review of clinicopathologic data. The first patient was anticoagulated with coumadin for chronic atrial fibrillation and presented subacutely with a solid mass. The second patient suffered from coronary artery disease post-angioplasty/stenting and presented with acute pancreatitis and pancreatic cystification. CCE should be considered in patients with significant vascular disease, arrhythmias or vascular manipulation who present with a pancreatic mass.
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PMID:Cholesterol crystal embolization presenting as either solid or cystic pancreatic lesion. 2097 33

Gallstones form when there is an imbalance in the composition of bile resulting in precipitation of one or more of its components. Between 37 and 86% of gallstones are cholesterol-rich stones, 2-27% are pigment stones and 4-16% are mixed. Cholesterol-rich gallstones are more common in Europe and North America. This has been attributed to obesity and diets containing a high proportion of refined carbohydrates and fat. Low-calorie diets and rapid weight loss are also associated with cholesterol-rich gallstones. Gallstone disease increases with age. Women have a higher prevalence of gallstones than men, which is attributed to exposure to oestrogen and progesterone. Of those with gallstones, around 1 to 4% will develop symptoms annually. Most patients (> 80%) will remain asymptomatic throughout their lifetime and the likelihood of developing symptoms diminishes with time. Liver function tests and an abdominal ultrasound should be offered to patients with symptoms suggestive of gallstone disease (e.g. abdominal pain, jaundice, fever). They should also be considered in patients with less typical but chronic abdominal or gastrointestinal symptoms. In patients with acute pancreatitis and evidence of ongoing bile duct obstruction and/or cholangitis, endoscopic retrograde cholangio-pancreatography and biliary sphincterotomy is recommended within 24-72 hours of the onset of symptoms. Patients with acute cholecystitis should be referred for laparoscopic cholecystectomy.
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PMID:Diagnosis and treatment of gallstone disease. 2645 13