Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030305 (pancreatitis)
 16,014 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Trypsin and chymotrypsin concentrations were determined in 180 spot stool specimens from 110 control patients in hospital. The lower limit of normality for each enzyme was placed at the 5% level: 95% of this population excreted feces containing more than 100 mug. of chymotrypsin and 30 mug. of trypsin per g. of feces. Chymotrypsin concentrations appeared to be a more reliable guide to pancreatic function than trypsin concentrations.Fecal chymotrypsin concentrations were subnormal in five patients with chronic pancreatitis, borderline in one patient with relapsing pancreatitis, subnormal in one patient after pancreatectomy, and subnormal in five of nine with carcinoma of the pancreas. Subnormal concentrations of fecal chymotrypsin were found in seven of 21 patients with chronic liver disease related to alcoholism, eight of 32 with a partial gastrectomy, three of 10 with adult celiac disease and five of 16 with psoriasis.It appears that the determination of fecal chymotrypsin concentrations provides a valuable screening test for pancreatic exocrine deficiency. However, normal results may be found in some patients with pancreatic disease and subnormal values may occur in some patients with other conditions.
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PMID:Fecal chymotrypsin and trypsin determinations. 555 Mar 76

We report an alcoholic patient with acute relapsing pancreatitis in whom the intravenous infusion of a fat emulsion precipitated a bout of acute pancreatitis. The various relationships between pancreatitis, alcoholism, and hyperlipemia are not clear, and guidelines for the use of intravenous fat emulsions in patients with pancreatitis should take into account their complex interrelationship.
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PMID:Pancreatitis induced by intravenous infusion of a fat emulsion in an alcoholic patient. 619 52

Ultrasound has proven invaluable in detecting and evaluating pancreatic pseudocysts, and it is now a standard test to rule out complications of pancreatitis. In reviewing the authors' experience with 122 patients treated surgically for a pancreatic pseudocyst, five patients were identified in whom an ultrasound demonstrated a pseudocyst that was associated with an unexpected cancer at the time of operation. A sixth patient, with a pseudocyst documented by ultrasound, died prior to surgery and was found at autopsy to have metastatic common bile duct carcinoma. There was little difference in presenting symptoms, age, frequency of alcoholism, or physical findings compared with patients with pseudocysts secondary to pancreatitis. In two patients, pseudocysts were found in the tail of the pancreas at operation, in addition to carcinoma. In the other three patients, no pseudocyst was found; however, a subcapsular splenic hematoma was present in one. Five patients had metastatic disease, three from pancreatic adenocarcinoma, one from islet cell carcinoma, and one from a common bile duct carcinoma. One patient with a pancreatic adenocarcinoma confined to the head underwent a Whipple procedure and has no evidence of disease 6 months later. Malignancy may cause or coexist with pancreatic pseudocysts. Ultrasound is often not helpful in distinguishing pseudocysts associated with malignancy from those associated with pancreatitis. Biopsy should be performed to rule out malignancy when operating for pancreatic pseudocysts.
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PMID:Carcinoma masquerading as a pancreatic pseudocyst on ultrasound. 620 50

The role of surgical treatment in the management of chronic pancreatitis has increased, mainly because of improved diagnostic methods. In the present study, 83 consecutive patients who were operated upon for chronic alcohol induced pancreatitis between 1970 and 1980 are reviewed. The results indicate that the best results with regard to pain relief were achieved with lateral drainage operation in patients with dilated pancreatic ducts. A sufficient pancreatic resection gives satisfactory results in patients with nondilated ducts. Patients with severe pancreatic changes and a long history of alcoholism are best treated by extended pancreatic resections with regard to pain relief; however, most of the patients are still unable to work after the operation. A constant follow-up and active surgical attitude at the early stage of the disease before the circulus vitiosus of pain, drugs, inability to work and disturbances in social life are of paramount importance.
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PMID:Elective operations in chronic alcohol induced pancreatitis. 620 92

Alcohol has at least two actions on essential fatty acid (EFA) and Prostaglandin (PG) metabolism. It enhances the conversion of dihomogammalinolenic acid (DGLA) to PGE1 but it blocks the activity of the delta-6-desaturase, an enzyme necessary for replenishment of DGLA stores from dietary precursors. The acute effect of ethanol is therefore an increased production of PGE1 but chronic consumption will lead to depletion of DGLA and PGE1. Withdrawal from alcohol will lead to a precipitous fall in PGE1. PGE1 is known to have profound effects on the nervous system and behaviour. Patients with mania produce more PGE1 than normal while those with depression make less. Alcoholics may drink to maintain a normal PGE1 level, something which will require more and more ethanol as DGLA is depleted. In both animals and humans PGE1 or its precursor, gamma-linolenic acid (GLA) have been shown to attenuate the acute withdrawal syndrome. PGE1 injections prevent the development of fatty liver in alcohol-treated animals. Defective EFA and PGE1 metabolism are known to lead to increased fibrosis, reproductive failure, cardiomyopathy, cardiovascular disorders, gastritis and pancreatitis and could therefore be the basis for these disorders in alcoholics. A PGE1 deficiency could also be responsible for the fetal alcohol syndrome. Three other agents are known to produce constellations of fetal defects very similar to those found in the alcohol syndrome. These other factors are dihphenylhydantoin, lithium, and a deficiency of zinc. These three factors and excessive alcohol consumption all lead to PGE1 deficiency by different routes. If this concept is correct, the key to the management of alcoholism and its medical complications lies in the provision of GLA or DGLA, fatty acids which by-pass the alcohol blocked step and which are unfortunately unlikely to be present in any normal diet. Unlike many concepts of alcoholism and alcohol damage, the EFA/PGE1 idea is very readily testable and already has considerable experimental support.
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PMID:A biochemical basis for alcoholism and alcohol-induced damage including the fetal alcohol syndrome and cirrhosis: interference with essential fatty acid and prostaglandin metabolism. 625 73

Eighty-seven patients underwent distal subtotal or near-total (80% to 95%) pancreatectomy (NTP) during a 25-year period for management of intractable pain resulting from chronic pancreatitis. Alcoholism affected the majority of patients and 20% of cases were idiopathic in origin. Ten patients (12%) exhibited insulin-requiring diabetes before operation. The perioperative mortality rate was 3.4%. Significant improvement or complete pain relief was achieved in 75% of patients while 14% remained narcotic dependent. Forty-four patients (51%) required insulin postoperatively, with an average insulin requirement of 35 U per day. Thirty late deaths occurred 2 to 15 years after operation, 12 (40%) of which were related to complications of pancreatic insufficiency or persistent alcoholism. Five patients (8.5%) required completion pancreatectomy 6 months to 4 years after NTP for complications relating to persistent pancreatitis. NTP provides effective pain relief in the majority of patients with chronic pancreatitis. While this procedure can be performed with a low operative mortality rate, the high incidence of endocrine and exocrine insufficiency after operation may contribute to late deaths. Consequently, this procedure should be performed only when the underlying disease has functionally destroyed the pancreas or when lesser procedures have failed to provide adequate pain relief.
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PMID:Near-total pancreatectomy for chronic pancreatitis. 648 4

In order to detect early pancreatic changes in chronic alcoholism, we reviewed pancreatograms (ERP) in 35 patients with alcoholic chronic liver disease who had no clinical evidence of pancreatitis. The patients were grouped by the length of history of alcohol intake (group 1: 5-15 years; group 2: more than 15 years), and on the basis of daily alcohol intake (group 1: 100-150 g/day; group 2: 150-200 g/day; group 3: more than 200 g/day). Pancreatic changes were present at ERP in 48.6% of patients, suggesting mild pancreatitis in 15 patients and advanced pancreatitis in two. Pancreatic lesions were significantly more frequent (p less than 0.01) in those who took more than 200 g of alcohol each day. There was no correlation with the length of history of alcoholism or with hepatic lesions. Our data confirm that asymptomatic pancreatitis is frequent in chronic alcoholism and that ERP can detect pancreatic lesions not otherwise demonstrable.
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PMID:Early detection of pancreatic lesions in chronic alcoholism: diagnostic accuracy of ERP. 651 28

Per capita consumption of alcohol rose steadily in the U.K. from 1970 to 1979, but fell by 11% between 1979 and 1982. This fall in consumption was followed by a 19% fall in first admissions for alcohol dependence, a 16% fall in drunkenness convictions, a 7% fall in drinking and driving convictions and a 4% fall in cirrhosis mortality. Between 1970 and 1982 there were highly significant (P less than 0.01) correlations between per capita consumption and convictions for drunkenness and drinking and driving, first admissions to hospital for alcohol dependence, and mortality from cirrhosis, pancreatitis and cancer of the oesophagus. These findings add weight to the argument that per capita consumption is the crucial variable determining the magnitude of the burden imposed on the community by the harmful effects of excessive drinking.
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PMID:The beneficial consequences of the United Kingdom's declining per capita consumption of alcohol in 1979-82. 653 63

To investigate the role of heredity in alcoholic pancreatitis, an HLA typing study has been performed. Patients with alcoholic pancreatitis exhibited an increased frequency of HLA Bw 39 when compared with the general population [13.6% vs 3.3%, P (corrected) less than 0.02; relative risk 4.7]. Alcoholics without pancreatitis did not differ from the general population with respect to HLA status, indicating that the increased incidence of HLA Bw 39 was related to alcoholic pancreatitis rather than to alcoholism itself. Thus, this study has provided evidence for a genetic predisposition to alcoholic pancreatitis.
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PMID:Evidence for an inherited predisposition to alcoholic pancreatitis. A controlled HLA typing study. 658 50

Seven cases of gastrointestinal bleeding originating from peripancreatic blood vessels seen between 1977 and 1982 are presented. The bleeding originated either from true aneurysms, formed when the pancreatic inflammatory processes weaken the walls of peripancreatic blood vessels, from pseudoaneurysms which occurred after vascular leakage into pancreatic pseudocyst, or from veins. Gastrointestinal bleeding occurs when these entities rupture into gastrointestinal viscera. Hemorrhage of this nature must be considered in the clinical setting of patients who have a history of alcoholism, chronic relapsing pancreatitis, and known pseudocysts. Endoscopy, bleeding scans, and barium contrast studies are only occasionally helpful in diagnosis. Selective visceral angiography during acute hemorrhage is often diagnostic and concomitant arterial embolization techniques may offer a temporizing or permanent modality for hemostasis. This technique may be especially useful in the unstable, acutely ill patient with alcoholic hepatitis, sepsis, or an immature pseudocyst who poses a poor operative risk.
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PMID:Major gastrointestinal hemorrhage from peripancreatic blood vessels in pancreatitis. Treatment by embolotherapy. 660 4


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