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Query: UMLS:C0007097 (carcinoma)
152,788 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Extrahepatic biliary obstruction due to mechanical obstruction of the common bile duct is a relatively rare complication of pancreatic pseudocyst. When jaundice does occur, clinical or laboratory evidence of associated primary hepatobiliary disease or acute pancreatitis has invariably been present. The patient described had a 3-month history of painless juandice, 40-lb weight loss, pruritus, and hepatomegaly, but no clinical or biochemical evidence of acute or chronic pancreatitis. After initial evaluation, including an abdominal echogram and a transhepatic cholangiogram, carcinoma of the head of the pancreas was diagnosed preoperatively. At laparotomy, a small pancreatic pseudocyst obstructed the terminal portion of the common bile duct. This case illustrates that a pancreatic pseudocyst should be considered in the differential diagnosis of obstructive jaundice, even in the absence of clinical evidence of pancreatitis or pseudocyst formation.
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PMID:Silent pancreatic pseudocyst. An unusual cause of extrahepatic biliary obstruction. 113 Mar 80

Pancreatic function tests were performed in 15 patients with advanced renal insufficiency. Pancreatic secretion was stimulated with CCK/PZ and secretin and 60 minutes later with bile given intraduodenally and CCK/PZ and secretin intravenously. The Wilcoxon-test showed that there were significantly higher lipase levels in serum and lower amylase amounts in duodenal juice compared to normal volunteers. No differences could be demonstratd for volume, maximal bicarbonate concentration, lipase and trypsin outputs. It could be shown by nonlinear discriminant analysis that pancreatic secretion might specifically be changed in patients with chronic renal failure. These patients can be definitely differentiated according to the secretion pattern from normal controls and patients with chronic pancreatitis, pancreatic carcinoma, chronic and acute duodenal ulcer.
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PMID:[Pancreatic secretion of patients with chronic renal insufficiency (author's transl)]. 114 6

Chronic pancreatitis and carcinoma of the pancreas are being diagnosed with increasing frequency throughout the world. When both occur together, the question of their causal relationship arises. Secondary chronic pancreatitis following carcinoma of the pancreas is relatively frequent and can be proven histologically in at least 10% of pancreatic cancers. How often primary chronic pancreatitis develops into carcinoma is controversial. So far, there are only a few prospective clinical studies of chronic pancreatitis which cover this problem. We have followed 146 cases of chronic pancreatitis for an average of 8.7 years. Two thirds of our patients show pancreatic calcifications. Our series includes a family with congenital pancreatic insufficiency. So far only one adenocarcinoma of the head of the pancreas has been diagnosed in a 58-year-old male. Another 57-year-old male patient died from a solid metastatic carcinoma, probably of pancreatic origin. Therefore, the incidence of pancreatic cancer in our series is 0.7 and 1.4% respectively. However, 8 more patients suffering from extrapancreatic malignancies have turned up during the follow-up period: 2 cancers of the tongue, 2 colonic carcinomas, 2 bladder papillomas, and 1 bronchial and 1 gastric carcinoma. Our studies indicate that carcinoma of the pancreas probably does not occur more frequently in chronic non-hereditary pancreatitis than in the average population. A review of the literature suggests that there may be a higher incidence of carcinoma in families with hereditary chronic pancreatitis. The frequency of extrapancreatic cancer in our patients is remarkable. As pancreatic carcinoma is rare in chronic pancreatitis there is no reason for early aggressive surgery, e.g. pancreatectomy, in these patients.
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PMID:[Pancreatic carcinoma in chronic pancreatitis]. 114 57

The endoscopic retrograde pancreaticography demonstrates - when suspecting "pancreas anulare" - the part of the pancreatic duct system that forms a ring around the duodenum, helping to recognize this anomaly. In chronic pancreatitis deformities of the pancreatic ducts may be visualized 2-3 years after the onset of the disease. There are deformities of the outlining and the course of the ducts as well as solitary and multiple stenosis and -most important- dilatation of the main duct and its branches. In pancreas abscess, necrotic cavities, and pseudocysts the retograde pancreaticography visualizes solitary or multiple perforations of the duct and pooling of contrast medium in cavities. Carcinoma of the pancreas presents stenosis, occlusion and deviation of the main duct and its branches and sometimes with lakes of contrast medium in ares of necrosis. Pancreaticography following trauma demonstrates similar to chronic pancreatitis laking of contrast medium following perforation. The endoscopic retrograde pancreatico-cholangiography has - like angiography and ultrasound - its special indications in diagnosis of the pancreas. They are important in cases which have affected primarily or secondarily the duct system. Its reliability in confirming and differentiating a disease increases with more accurate indication. In this journal in 1965 a critical review of roentgenologic examinations of the pancreas presumed that development of a valid preoperative pancreaticography would lead to priority of this method. This priority has become true in chronic pancreatitis, calculous pancreatitis and visualization of necrotic cavities. In those examples the endoscopic retrograde pancreatico-cholangiography is still not dominating all cases.
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PMID:[Pancreaticography and its correlation with angiography and ultrasonography in diagnosis of the pancreas (author's transl)]. 117 42

Viral studies were performed on sera from 54 patients with recent acute pancreatitis, 10 with recurrent acute pancreatitis, seven with chronic pancreatitis, and 10 with pancreatic carcinoma, and on sera from 81 age- and sex-matched controls. In 29 of the acute pancreatitis patients from whom paired sera were obtained no convincing evidence of recent viral infection was found. A higher incidence of raised antibody titres against Coxsackie B3 and B4 was observed in the group of acute pancreatitis patients compared with their controls. The possible signficance of these observations and their relationship to the aetiology of the pancreatitis and to other immunological findings are discussed.
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PMID:Viral antibody studies in pancreatic disease. 119 16

Carcinoma of the pancreas is seen in 1.2 percent of autopsies. Often it is not possible to determine definitely: whether it is a carcinoma of the head of the pancreas, of the papilla, or of the distal part of the common bile duct (periampullary carcinoma). 90 percent of these carcinomas arise in the small ducts. They cannot be recognized by ERCP until spreading into the main duct has occurred. Differential diagnosis is concerned mainly with differentiating between chronic pancreatitis and carcinoma of the pancreas. Chronic pancreatitis and carcinoma of pancreas are not mutually exclusive; on the contrary they are closely related in diagnosis and pathogenesis. There can be no carcinoma of the pancreas without pancreatitis. For an accurate diagnosis which is vital, a diagnostic laparotomy should be performed at an early stage.
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PMID:[Carcinoma of the pancreas: pathologic anatomy (author's transl)]. 120 2

The results of 611 Lundh-tests performed on 546 patients over a period of 4 1/2 years have been evaluated. The test was highly reliable in the diagnosis of exocrine pancreatic deficiency. False-normal results were seen in 2.04% and false-abnormal in 3%. The test does not differentiate between chronic pancreatitis and carcinoma. Extrapancreatic factors depressing duodenal tryptic activity are discussed.
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PMID:[Evaluation of the Lundh test in the diagnosis of exocrine pancreas insufficiency]. 121 66

X-rays of the pancreatic duct can now be obtained by a nonoperative endoscopic approach (endoscopic retrograde cholangiopancreatography-ERCP). After more than 2 years experience we have found that the pancreatic duct can be visualized in 85 to 90% of patients. This test is used to detect pancreatic carcinoma in the symptomatic patient and in searching for an operative pancreatic lesion in a patient with known recurrent or chronic pancreatitis. Many of these patients have pain or a transiently elevated amylase; a few have steatorrhea or abnormalities of the duodenal sweep on barium meal. Stenosis or obstruction of the main pancreatic duct with or without proximal duct dilation are the characteristic abnormalities noted in pancreatic carcinoma. A rare pancreatic tumor which is not in juxtaposition with the duct will have a normal pancreatogram although the common duct may be obstructed by cholangiography as it passes through the head of the pancreas. In patients with chronic pancreatitis it may be difficult to differentiate an inflammatory from a neoplastic stricture by either operative or endoscopic pancreatography. In the future, cytologic and biochemical examination of the pancreatic secretions obtained at ERCP may increase the accuracy of diagnosing carcinoma.
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PMID:Operative and endoscopic pancreatography in the diagnosis of pancreatic cancer. 124 76

Salivary and pancreatic isoamylases in duodenal aspirates obtained during assessment of pancreatic function after test meal stimulation were separated by agarose gel electrophoresis. Salivary amylase was found to be a constituent of the duodenal aspirates in more than 75% of the tests. The mean relative contribution of salivary amylase to the total amylase activity of the aspirates varied from about 15% in normals to about 40% in patients with chronic pancreatitis and pancreatic carcinoma. The amount of salivary amylase varied widely not only between the individuals but also within the samples of the same test series. Specific determination of the pancreatic isoamylases instead of determination of the total amylase increased the discrimination between normals and patients with pancreatic dysfunction.
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PMID:Salivary amylase in duodenal aspirates. 125 Nov 29

Pancreatic function was investigated in 43 patients using a combination of conventional and subtraction scans of the pancreas and duodenal aspiration of the 75Se-Selenomethionine injected, in the time periods 60-150 minutes, 90-120 minutes and 105-150 minutes after injection. Patients with chronic alcoholism, chronic pancreatitis, pancreatic carcinoma, extrahepatic biliary obstruction and liver disease were included. Seven patients with no evidence of gastro-intestinal disease served as controls. Pancreatic scanning provided eight false positive and two false negative results (23.3%) and with 75Se-Selenomethionine excretion at 105-150 minutes, six false results were obtained (14%). In only one patient was a false positive result obtained with both scans and the 75Se-Selenomethionine test. The performance of conventional and subtraction scans of the pancreas with measurement of 75Se-Selenomethionine activity in the duodenal aspirate collected from 105-150 minutes after injection provides a convenient means of testing pancreatic exocrine function in a single three hour session.
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PMID:Tests of pancreatic function using 75Se-selenomethionine. 127 19


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