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Query: UMLS:C0030305 (pancreatitis)
 16,014 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Three hundred patients with acute pancreatitis have been studied. Pancreatitis was associated with alcoholism in 207, biliary tract disease in 51 and other conditions in 42. Twenty-two patients died, and an additional 34 patients required more than one week of treatment in the intensive care unit. Retrospective analysis of the first 100 patients identified 11 objective findings which correlated with the occurrence of serious illness or death. They were, on admission, age over 55 years, blood glucose level over 200 milligrams per cent, white blood count over 16,000 per cubic millimeter, serum lactic dehydrogenase level over 350 International units per liter and serum glutamic-oxalacetic transaminase level over 250 Sigma Frankel units per cent. During the initial 48 hours of therapy, the findings were hematocrit value decrease over 10 percentage points, serum calcium level below 8 milligrams per cent, base deficit over 4 milli-equivalents per liter, a blood urea nitrogen level increase over 5 milligrams per cent, estimated fluid sequestration over 6 liters and arterial oxygen tension less than 60 millimeters of mercury. Prospective application of these signs in the latter 200 patients permitted the accurate early identification of those with severe pancreatitis. Only one of 162 patients with fewer than three of these early features was seriously ill or died, while 24 of 38 patients with three or more early positive findings were seriously ill or died. The objective early identification of patients with severe pancreatitis permits more vigorous management of this group and also provides a basis for the selection of patients for the evaluation of proposed improved therapies. Percutaneous peritoneal dialysis in severe pancreatitis was evaluated in ten patients, with three or more positive early signs, who were randomly assigned to dialysis or continued conventional care. Morbidity was strikingly reduced in patients who underwent dialysis, and while death or more than nine days of intensive care occurred in two of five patients who did not receive dialysis, all five patients having dialysis recovered after fewer than nine days of intensive care treatment. Serious illness or death occurred in 31 of the first 100 patients but in only 26 of the more recent 200 patients. There has been a similar fall in mortality from 15.0 to 3.5 per cent. Factors which may contribute to this improvment include the objective early identification of patients with severe disease, the avoidance of early laparotomy whenever practical, the prolongation of nasogastric suction until all evidence of pancreatic inflammation has resolved, careful monitoring of respiratory function and early treatment of pulmonary complications and peritoneal dialysis in patients with severe disease.
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PMID:Prognostic signs and nonoperative peritoneal lavage in acute pancreatitis. 94 Oct 75

During a five-year period, 82 patients were treated for acute pancreatitis, 63 of whom were proved to have associated biliary tract disease. In 18 of the 63, the accepted preoperative diagnostic measures failed to demonstrate pathologic findings in the biliary system. In 16 of the 18 patients, stones were discovered at the time of operation, although in five they were so small as to be demonstrable only filtering the aspirated bile through gauze. In the two of the 18 without stones, cholecystitis was present. In 14 patients the ducts choledochus and the pancreatic duct had a common path. All patients had no further pancreatitis two to eight years cholecystectomy. In Israel, where alcoholism is rare, three fourths of the cases of acute pancreatitis are associated with gallbladder disease.
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PMID:Gallstone pancreatitis. Exploration of the biliary system in acute and recurrent pancreatitis. 97 Oct 87

Comparative assessments of the endocrine and exocrine functions of the pancreas associated with gallstone pancreatitis or alcoholic pancreatitis were performed in a series of 86 patients, 20 with cholelithiasis, 12 with chronic alcoholism, 24 with chronic gallstone pancreatitis and 30 with chronic alcoholic pancreatitis and 32 healthy subjects were served as controls. The patients with cholelithiasis showed exocrine hypersecretion of the pancreas. In the patients with gallstone pancreatitis, all the assessed parameters of exocrine function were depressed. On the other hand, no pancreatic exocrine dysfunction was dispalyed in cases with chronic alcoholism. In the non-calcifying alcoholic pancreatitis, both the volume output and the the maximum concentration and output of bicarbonate were diminished but depression in amylase output was not seen. All these parameters were lowered in patients with calcifying pancreatitis. Elevation of hexosamine concentration in the pancreatic juice was evident in alcoholic pancreatitis as compared with gallstone pancreatitis, being particularly prominent in cases of non-calcifying pancreatitis. Patients with alcoholic pancreatitis were observed to secrete viscous pancreatic juice richer in amylase and hexosamine content, than those in the patients with gallstone pancreatitis. Endocrine dysfunction of the pancreas is more frequent and intense in alcoholic pancreatitis than in gallstone pancreatitis.
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PMID:Comparison of pancreatic dysfunction in chronic alcoholic pancreatitis and chronic gallstone pancreatitis. 97 91

The authors analyze the surgical indications and procedures for cases of chronic pancreatites. There were but few cases and the procedures were chosen for minimal harm ; there were : 4 external marsupialisations, 1 resection of a true cyst, 5 cystoanastomoses, 2 biliary bypasses, 4 left pancreatectomies. Postoperative courses were normal in 12 patients; 2 had recurrent pancreatitis because of alcoholism. Our attitude towards chronic pancreatic lesions is thus as follows: 1. Cautions and reserved indications. 2. Ad minima procedures.
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PMID:[Surgery for chronic non neoplastic diseases of the pancreas (author's transl)]. 101 76

Using a two stages screening method the prevalence in the general population of hyperlipoproteinemias (HLP), separated in the five types proposed by Fredrickson, Levy and Lees, and adopted by WHO has been studied. The study included 7,085 subjects of both sexes, aged 25-65 years, representing 84,52 % of a population taken at random within a district of Bucarest. HLP was found in 1,013 cases, i.e. 14,29 % of the investigated population. 48.37 % were men and 51.63 % women. The prevalence of HLP was lowest in the first decace of age studied (25-35 years) and highest in the last two decades (45-65 years). Overweight was more frequently encountered in these patients (64.46 %) than in the total population (32.3 %). Of the 1,013 cases with HLP, 42.35 % (6.05 % of the total population) were of type IV, 27.05 % (3.86 % of the total population) of type II-b, 22.80 % (3.26 % of the total population) of type II-a, 4.74 % (0.67 % of the total population) of the type III and 3.06 % (0.43 % of the total population) of the type V. 22.70 % of the HLP patients were considered primary familial HLP, 66.54 % primary non-familial HLP and 10.76 % secondary HLP; IN 109 secondary HLP, the most frequently encountered disease was diabetes mellitus (42.20 %), followed by hypothyroidism (24.77 %), alcoholism (12.84 %), obstructive liver diseases (9.17 %), pancreatitis (5.50 %), nephrotic syndrome (2.75 %) and treatment with estrogens and steroids (2.75 %).
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PMID:The epidemiology of hyperlipoproteinemia in a Rumanian general population sample. Study of 7,085 cases. 101 36

Neuropsychiatric and psychosomatic disorders occurring the exocrine pancreatic diseases are not rare, nevertheless didn't it seem to be very interesting in research and there exists no summarizing work of this disorders. Therefore we tried to give a comprehensive representation of those neuropsychiatric problems which are connected with the function of this organ. At first we give a description of psychopathology and pathogenesis of the functional pancreatic psychosis. The problematic of the reciprocal relationship of nervous system and pancreatitis, alcoholism and pancreatitis are demonstrated as well as the psychic disorders occurring the pancreas insufficiency, cystes of pancreas and congenital pancreatic diseases. Psychosomatic and mental disorders of pancreas carcinoma and mucoviscidosis are shown in detail. The question of the interrelation between pancreatic function and amyotrophic lateral sclerosis or parathyreotic diseases are discussed just as themes of neuropsychiatric pharmacotherapie and pancreatic function and mental disorders in pancreatic treatment.
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PMID:[Neuropsychiatric disorders of the diseases of exocrine pancreas (author's transl)]. 105 12

Twelve patients (11 men, one woman), aged 18 to 68 years, had major arterial hemorrhage as a direct complication of pancreatic pseudocysts and chronic pancreatitis. Chronic alcoholism (11 patients) and blunt abdominal trauma (one patient) were the basis for pancreatic disease. Spontaneous hemorrhage occurred in eight patients. Bleeding occurred into the gastrointestinal tract (eight patients), into the peritoneal cavity (four patients), and was intracystic (one patient). Splenic, pancreaticoduodenal, gastroduodenal, and gastroepiploic arteries were sources of hemorrhage. Operative procedures included local control of bleeding (six patients), distal pancreatectomy (three patients), and pancreaticoduodenectomy (one patient). Four patients died of hemorrhagic complications of pancreatic disease, including one not subjected to operation. Extirpation of diseased pancreatic tissue may lessen the morbidity and mortality attributed to this complication of pancreatitis.
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PMID:Major arterial hemorrhage: a complication of pancreatic pseudocysts and chronic pancreatitis. 108 31

Pseudocysts are fascinating lesions of the pancreas which present as upper abdominal masses in about 80 per cent of cases, but also as obstructive jaundice, intrasplenic and intra-left-renal masses, mediastinal masses, flank abscess, pleural effusions, and ascites rich in amylase. They are diagnosed by urine amylase with greater sensitivity than by serum amylase. Cysts must be differentiated from pancreatic abscesses, indolent phlegmonous pancreatitis, cystadenomas, and carcinomas of the pancreas, as well as lymphomas and other rare tumors. They may be satisfactorily treated by large sump tube drains to the outside but about one third will require a further operation. Internal drainage by cystogastrostomy is the simplest and best current procedure, but not applicable to all cases. A good alternative is Roux-en-y cyst-jejunostomy. Caution is needed in the preoperative workup since all procedures are accompanied by an operative mortality approaching 10 per cent, mostly due to hepatic disease, portal hypertension, stress ulcerations, and hemorrhage. The follow-up shows 85 per cent good results from proper drainage but 40 per cent are diabetics and in many patients the ravages of alcoholism continue unabated.
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PMID:Pancreatic pseudocysts. 109 66

A review of acute pancreatitis occurring over a 20-year period in the Bristol clinical area is reported. A total of 590 cases were available for analysis. The yearly incidence was 53-8 per million population at risk, with a mortality of 9-0 per million. This compares favourably with 11-4 deaths per million for England and Wales as a whole during the same period but the difference is not statistically significant. When the deaths occurring in the Bristol clinical area were expressed in terms of case mortality rate the figure was 17%. In contrast the mortality for recurrent acute pancreatitis was only 1-5%, and the benign nature of this second condition is confirmed. Aetiological factors and age and sex distribution were also analysed in relation to each other and to mortality. An increase in acute pancreatitis secondary to chronic alcoholism was confirmed and steroid pancreatitis also emerged as a definite entity in this survey. The pattern of recurrence in patients with idiopathic pancreatitis was studied in detail and is analysed on an actuarial basis.
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PMID:Patterns of incidence in acute pancreatitis. 112 32

Pancreatic pseudocyst is a complication of pancreatitis or pancreatic trauma. A review of the experience with surgical treatment of pseudocyst of the pancreas at the University of Iowa was carried out. Pancreatitis associated with alcoholism accounted for a smaller percentage of the pseudocysts than is usually reported and reflects the nature of the population. Internal drainage of the pseudocyst obviates the development of pancreatic fistula which is often associated with external drainage; however, the mortality for each method of drainage was comparable.
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PMID:Surgical management of pancreatic pseudocysts. 114 5


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