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

Reported is a case of a calcified mesenteric cyst that was causing obstruction of the small bowel. Because only roughly one case occurs per 100,000 hospital admissions, mesenteric cysts are rarely thought of and may be difficult to diagnose. The differential diagnosis includes such critical lesions as aortic aneurysm, pancreatitis, ovarian cysts, omental cysts, and lipomas of the mesentery. The proper treatment of these rare lesions is somewhat influenced by causative factors: embryonic, traumatic, neoplastic, infectious, or degenerative. Surgical excision or enucleation is preferred to internal or external drainage. Ultrasonography is becoming increasingly valuable as a diagnostic tool.
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PMID:Calcified mesenteric cyst. 62 6

After a short description of the physical principles of ultrasound, the indications and usefulness of the real time B-scan technique in the non-invasive diagnosis of cardiac and abdominal diseases are discussed. A correct diagnosis was made in 90% of the cardiac cases (valve abnormalities, pericardial effusion, cardiac aneurysm, cardiomyopathy), whereas the diagnosis by ultrasound was correct in only 81.1% of the abdominal cases (diffuse and localized liver diseases, pancreatitis, pancreatic cyst, carcinoma of the pancreas, cholelithiasis, renal cyst, renal tumours, aortic aneurysm). The advantages of the real time B-scan technique lie in the two-dimenstional clear representation of intracardiac and intraabdominal structures with the possibility of undertaking quantitative measurements. Furthermore, it is a non-invasive and safe method, which can be repeated as often as necessary and can complete the diagnositic spectrum of radiology, endoscopy and nuclear medicine.
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PMID:[Ultrasonic diagnosis of cardiac and abdominal diseases using real time b-scan technique (author's transl)]. 65 98

Knowledge of the appearance and location of the normal fascial structures surrounding the kidneys and the bladder is the key to proper CT analysis of extraperitoneal fluid collections. Recent studies have shown that the renal fascia and the perirenal space are more complex than previously recognized. An extracapsular renal hematoma, confined against the kidney by the posterior renorenal septum within the perirenal space, can entirely simulate a subcapsular hematoma. Pancreatitis fluid can dissect between the discrete layers that constitute the posterior renal fascia, allowing fluid in the anterior pararenal space to extend posterior to the kidney without directly involving the posterior pararenal space. The umbilicovesical fascia separates the small perivesical space from the potential large reservoir of the prevesical space in the extraperitoneal portion of the pelvis. Fluid in the prevesical space can communicate directly with the retroperitoneal spaces surrounding the kidney. In addition to compartmental localization, CT features of the fluid itself or the presence of ancillary findings such as aortic aneurysm, enlarged pancreas, renal mass, or hydronephrosis will frequently indicate the cause and the extent of most extraperitoneal fluid collections.
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PMID:CT of the extraperitoneal space: normal anatomy and fluid collections. 141 3

Changes in the pattern of disease managed by general surgeons in New Zealand, were assessed for the period 1940-80, using the public hospital admission and cancer incidence data of a representative selection of diseases. During the forty-year period, there was an increase in the incidence of four of the five cancers studied, and an increase in admission rate for non-specific abdominal pain, head injury (indicated by skull fracture), peripheral arterial disease (indicated by aortic aneurysm), gall-stone disease and pancreatitis, large bowel disorders and breast diseases. There was a decline in admission rate for appendicitis, stomach disorders and goitre.
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PMID:Changes in the pattern of disease managed by general surgeons in New Zealand, 1940-80. 659 23

Case-report of a 54 year-old patient who was admitted with the clinical picture of an acute abdomen on the basis of intraabdominal haemorrhage. X-ray investigation discounted the diagnosis of ruptured aortic aneurysm, the CAT scan showed a suspected acute haemorrhagic necrotising pancreatitis. At laparotomy, a fatty, bleeding kidney tumour was found growing into the retroperitoneal tissue. The histological frozen-section showed a leimyo liposarcoma of the kidney. Bourneville-Pringle's disease was only afterwards known to be the basic illness of the patient, as was verified at postmortem examination. From the knowledge of these new facts, both the CAT-scan and the intra-operative and histological findings could be correctly interpreted.
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PMID:[Massive retroperitoneal haemorrhage in the Bourneville-Pringle syndrome (author's transl)]. 710 20

Five cases of pathologic rupture of the spleen in patients with hematologic malignancy are presented along with a review of the 48 cases previously described in the English literature. Pathologic splenic rupture occurred most commonly in patients with acute leukemia but has been well documented in chronic leukemias and in lymphoma as well. Nearly all patients experience abdominal pain at the time of rupture; however, this pain was frequently confused clinically with that of biliary tract obstruction, aortic aneurysm, perforated viscus, pancreatitis, and angina pectoris. Pain referred to the left shoulder (Kehr's sign) was present in only 17% of patients. Hypotension was documented in 66%, fever in 74%, and tachycardia in 75%. The most effective diagnostic procedure was paracentesis, which confirmed intraabdominal hemorrhage in each of the nine cases in which the procedure was used. A correct preoperative diagnosis of splenic rupture was reported in only 10 of the 53 cases reviewed. Fifty-two percent of the patients underwent laparotomy; 48% died without operation. Of those that underwent surgery, 78% survived the procedure and the immediate postoperative period. The survival rate of all patients was 38%. There was no correlation of the type of hematologic malignancy, occurrence or type of treatment, peripheral blood counts, or spleen size to survival. The most important factor in predicting survival was appropriate surgery.
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PMID:Splenic rupture in patients with hematologic malignancies. 730 28

Renal fusion or ectopia can present formidable challenges during aortic surgery. To evaluate morbidity and define optimal management, the clinical histories of 20 patients with renal fusion or ectopia who underwent 21 aortic procedures at the authors' institution over a 37-year period were reviewed. Indications for surgery included aortic aneurysm in 16 patients (infrarenal in 15 and thoracoabdominal in one) and aortoiliac occlusive disease in five (with renovascular hypertension in two). The abnormal kidney was detected before surgery in 13 patients (65%) by excretory urography, arteriography, computed tomography, or ultrasonography. Arteriography revealed multiple and/or anomalous renal arteries in nine of 12 patients studied. At surgery, 15 patients (75%) were found to have multiple or anomalous renal arteries. Six required renal revascularization (reimplantation four, endarterectomy one, aortorenal bypass one). The renal symphysis was divided in two patients. There were no operative deaths. Six major complications included bleeding requiring reoperation, renal failure requiring short-term dialysis, pancreatitis, gastrointestinal bleeding, pneumonia and thrombophlebitis. Preoperative aortography is recommended in patients with renal fusion or ectopia because of the high incidence of associated renal artery anomalies. The surgeon must be prepared to preserve or revascularize these anomalous renal arteries. Division of the renal symphysis is rarely required. Although perioperative morbidity is raised, aortic reconstruction in patients with renal fusion or ectopia can be safely performed without increased mortality.
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PMID:Renal artery anomalies in patients with horseshoe or ectopic kidneys: the challenge of aortic reconstruction. 758 97

Pancreatic ischemia is a very rare etiology of clinical acute pancreatitis, complicating cardiac surgery, hemorrhagic shock, and transplantation of the pancreas. In this article, we present two patients with acute ischemic necrotizing pancreatitis, complicating a generalized atheromatous disease with extensive lesions in the splanchnic circulation (patient 1) and repair of a descending thoracic aortic aneurysm (patient 2). Diagnostic approach and management of ischemic necrotizing pancreatitis are discussed.
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PMID:Ischemic necrotizing pancreatitis. Two case reports and review of the literature. 981 45

A 72-year-old man underwent resection of an infrarenal aortic aneurysm; during postoperative recovery, multiorgan failure developed secondary to cholesterol emboli in several arteries. The initial sign consisted of patches of livedo in the lower limbs with pedal pulses, hematuria and hyperdynamic shock with high cardiac output and reduced vascular resistance. The clinical picture progressed to multiple organ failure with non-cardiogenic pulmonary edema, oliguric kidney failure, coagulopathy, necrotizing pancreatitis and colic ischemia. The patient died 15 days after surgery. The formation of multiple cholesterol emboli is a rare complication after aortic surgery, vascular catheterization or anticoagulant treatment. It is caused by cholesterol crystals measuring 100 to 200 mu that embolize and block small arteries. Diagnosis is difficult because the organs involved can be many and various. No specific treatment is available and the rates of morbidity and mortality are high.
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PMID:[Multiple cholesterol athero-embolisms after resection of an abdominal aortic aneurysm]. 1117 70

A 44-year-old man underwent reoperative repair for ascending aortic aneurysm at our hospital. He had received aortic valve replacement due to severe aortic regurgitation 4 years previously. The cardiopulmonary bypass was set up through the femoral arterial and venous cannula. An unusual experience of rupture of the abdominal inferior vena cava was encountered after total-body retrograde perfusion. The tragic situation was successfully salvaged by recannulation into the intrapericardial inferior vena cava and repair of the several perforations on abdominal inferior vena cava. The patient recovered smoothly except for mild pancreatitis. The causes of rupture of the inferior vena cava are discussed here.
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PMID:Successful salvage of inferior vena cava rupture during reoperative repair for ascending aortic aneurysm. 1475 73


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