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Query: UMLS:C0024523 (malabsorption)
 7,319 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In 44 normal subjects, in 89 patients with chronic pancreatitis, of whom 23 had elevated faecal fat, and in 19 patients with various diseases of the small gut investigations with 14C-tripalmitate and 3H-palmitic acid, dissolved in 1.0 g Indian corn oil/kg, were performed. Serum lipid activity of 14C and 3H was measured 4, 6, and 8 h later. Compared with absolute values of triglyceride absorption (percentage dose of 14C-lipid activity/l serum), relative values (14C/3H ratio of the serum lipids) led to a significantly better discrimination between the control group and patients, attributable to a much smaller normal range. Compared with fatty acid absorption, triglyceride absorption was lowered in all cases of pancreatic steatorrhoea, in most cases of chronic pancreatitis, and in some cases of intestinal malabsorption. While the proposed procedure seems to be sensitive and reliable in the detection of maldigestion, a distinction between maldigestion and malabsorption is apparently uncertain.
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PMID:Diagnosis of fat absorption with 14C-tripalmitate/3H-palmitic acid. 49 49

The authors discuss the main features of the complex pathophysiology of patients subjected to duodenocephalopancreatectomy, and particularly the difficulties inherent in clinical assessment of the digestive and metabolic impairment consequent upon the duodeno-gastro-pancreatic mutilation. Out of a total of 57 cases of this description, they singled out for recheck 23 patients who had undergone duodenocephalopancreatectomy not less than six months and not more than seven years before (chronic pancreatitis, 11 cases; various malignancies of the periampullar area, 10 cases; Zollinger-Ellison syndrome, 1 case; retroperitoneal lymphoma, 1 case). Seventy-six per cent of patients who had been gainfully employed were able to resume their jobs after surgery. Steatorrhea, assessed in terms of fecal fats, was present in all cases; notwithstanding, 70% of the patients gained weight (average increase 7 kg). All patients were on enzyme replacement therapy. Only 4% developed diabetes, and none developed postoperative peptic ulcers. Conversely there was a high incidence (65%) of bone structure reshuffling, signally osteoporosis, probably imputable to steatorrhea and vitamin D malabsorption, plus the often associated increase of serum alkaline phosphatase activity.
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PMID:[The biological results of duodenocephalopancreatectomy. Clinical evaluations based on a long-term follow-up]. 53 2

Significant changes on a standard barium follow-through examination in celiac disease have been determined by comparison with functional changes (irritable bowel syndrome), malabsorption without a villous lesion (chronic pancreatitis), and a villous abnormality without malabsorption (dermatitis herpetiformis). Patients with iron deficiency anemia formed the control group. Slight jejunal dilatation (26-30 mm) was found in 15% of the celiacs and 17% of the irritable bowel patients. Dilatation in excess of 30 mm and/or effacement of jejunal fold pattern occurred only with an abnormal jejunal biopsy, in 54% of the celiacs and 33% of the dermatitis herpetiformis patients. Patients with malabsorption by itself and 46% of the celiacs could not be distinguished from those with irritable bowel syndrome. The concept of a malabsorption pattern is considered invalid, and the diagnosis of celiac disease can be reliably established only by peroral jejunal biopsy.
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PMID:Relevance of the barium follow-through examination in the diagnosis of adult celiac disease. 55 35

Information from 72 patients from 7 families in England and Wales confirms that hereditary pancreatitis is inherited as an autosomal dominant conditions with limited penetrance. The degree of penetrance is approximately 80%. These patients have had recurrent attacks of abdominal pain starting from childhood or young adult life. The mean age of onset in the 7 families studied was 13.6 years. There were two peaks, with maximum numbers at 5 years and 17 years. The second peak was thought to represent genetically susceptible individuals having pain brought on by alcohol rather than representing evidence of genetic heterogeneity. Five of the 7 families had members with both childhood and adult ages of onset. Only 4 patients out of 72 had life-threatening disease and in the majority of cases the attacks of pain were of nuisance value only. Hereditary pancreatitis was implicated in only 1 patient's death and this was not definite. Patients appear to get better after a period of symptoms usually as they approach middle age, or after a severe attack. In older patients alcohol, emotional upsets, and fatty food appear to precipitate attacks. Pancreatic insufficiency (5.5%), diabetes mellitus (12.5%), pseudocysts (5.5%), and haemorrhagic pleural effusion are uncommon complications. Portal vein thrombosis occurred definitely in 2 patients and was suspected in 3 others. Carcinoma of the pancreas was not found in any of 72 patients studied in detail; however, 2 members from a family not visited personally had chronic pancreatitis and malabsorption going on to carcinoma. They may have suffered from a different disease. Genetic linkage information was too slight for many definite conclusions. However, there was no suggestion of linkage with any of the markers tested.
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PMID:Hereditary pancreatitis in England and Wales. 67 83

Very frequently in acute and chronic pancreatitis, the surgical treatment is indispensable. The disease itself is accompanied by metabolic disturbances, protein deficiency, hepatic lesion, by diabetes and malabsorption syndrome. Following the laboratory parameters we were able to perform partial or total hyperalimentation, correction of acid-base dis-equilibrium and to obtain the positive nitrogen balance, and in this way keep the patients in optimal conditions pre- and postoperatively.
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PMID:[Metabolic disorders and current treatment of the surgical patient with pancreatitis]. 85 52

For evaluation of 14CO2-breath-tests the three most employed tests, namely glycero-14C-tripalmitate-test, 14C-lactose-tolerance-test, and 14C-glycin-cholate-test, were performed in healthy volunteers (n = 69), patients with chronic pancreatitis (n = 18), manifest malassimilation (n = 8), lactase deficiency (n = 15), and patients, in whom a disturbed enterohepatic bile salt circulation was suspected (n = 19). Usefulness of malabsorption tests was limited by many false normal results. Cholylglycin-breath-test on the other hand was sensitive, but clinical significance remained questionable. In our opinion simple performance and lacking discomfort are no sufficient arguments for 14CO2-breath-test.
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PMID:[14CO2 exhalation tests. Diagnostic improvement in gastroenterologic diseases]. 96 89

Chronic pancreatitis has to be treated in the first line by medical means. Dietary procedures, absolute abstinence from alcohol, compensation of malabsorption and treatment of diabetes will do in most cases. Surgery is indicated in cases resistent to this form of therapy of when complications arise (cysts, persistent jaundice, portal hypertension). The patient has to be given high caloric parenteral nutrition preoperatively. Pancreato-jejunostomy with an Y shaped loop and surgical removal of various amounts of pancreatic tissue are the only efficient surgical procedures. In cases of dilatation of the pancreatic duct drainage has to be performed. Results of surgery are satisfactory in 2/3 of cases.
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PMID:[Medical and surgical management of chronic pancreatitis (author's transl)]. 100 87

Pancreozymin-secretin test (PS test) and intestinal absorption tests were performed in 21 patients with chronic calcific pancreatitis and 32 patients with chronic noncalcific pancreatitis to evaluate exocrine functions of the pancreas. And the following results were confirmed. (1) Fecal fat excretion increased in 33% of chronic pancreatitis (47% of calcific pancreatitis and 25% of noncalcific pancreatitis). Serum carotene leves showed significantly low levels in 44% of chronic pancreatitis (67% of calcific pancreatitis and 27% of noncalcific pancreatitis). (2) D-xylose tolerance test was abnormally low in only 6% of chronic pancreatitis, but Schilling test was evaluated abnormally low in 29% of chronic pancreatitis (50% of calcific pancreatitis and 11% of noncalcific pancreatitis). (3) Fecal fat excretion increased in cases of severe exocrine insufficiency of the pancreas with decreased amylase output and decreased maximum bicarbonate concentration in PS test. (4) Correlation of fecal fat excretion to maximum bicarbonate concentration was statistically significant, but those to amylase output or volume of pancreatic juice were not significant. (5) Antacid drugs combined with pancreatic extracts seems to be indispensable in the treatment of chronic pancreatitis as far as malabsorption in chronic pancreatitis is concerned.
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PMID:Studies on intestinal malabsorption in chronic pancreatitis. 101 98

Trying to find out the clinical elements that define the precise indication ofr a jejunal biopsy, 28 children with several pathological conditions were studied. They were 12 cases of kwashiorkor, 11 cases with chronic diarrhea, two cases of chronic pancreatitis, 2 cases with ferropenic anemia resistant to the oral treatment with iron and one case of chilous ascitis. It is concluded that only in those cases in which the biopsy is the precise medium for diagnosis is where it would be indicated, such as intestinal lymphangiectasis or in those cases with signs or evidence of malabsorption without diarrhea. The chronic diarrhea per se does not seem to be a formal indication for biopsy.
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PMID:[Diagnostic value of jejunal biopsy]. 113 14

This report deals with the onset of Giardia-induced, primary malabsorption in patients with chronic pancreatitis. To our knowledge, this association has been reported only once previously. A further review of the literature suggests that malnourished patients with chronic pancreatitis may be susceptible to G lamblia infection. Therapy for giardiasis rapidly reverses the diarrhea, malabsorption, and edema seen in these patients.
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PMID:Giardia-induced malabsorption in pancreatitis. 117 10


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