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

In a prospective study of 70 patients with duodenal diverticula and calculous biliary tract disease, bacteriocholia with typical intestinal bacteria was found in 69%, whereas in cholelithiasis without duodenal diverticula this complication was present in 30% of the cases. With growing distance between duodenal diverticula and the papilla of Vater the rate of bacteriocholia decreases. Rising age of patients results in augmentation of bacteriocholia. Bacteriocholia on the basis of duodenal diverticula seems to present an additional pathogenetic factor for inflammatory biliary tract disease in 69% and for pancreatitis in 20% of the cases. Consequently the pathologic value of diverticulas close to the papilla of Vater is more prominent than reported so far.
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PMID:[Bacteriological findings in patients with cholelithiasis and duodenal diverticuli]. 11 89

In acute pancreatitis the standard treatment is with antibiotics given prophylactically. Available studies indicate that the usefulness of such chemotherapy in the milder form of the disease (degree of severity I) has not yet been fully established. In the absence of contradictory results, prophylactic antibiotic treatment can, however, be recommended in severe pancreatitis (degrees II and III) and in those conditions induced by ethyl or of idiopathic origin. In all forms showing underlying biliary tract disease and in pancreatitis complicated by infection, antibiotic treatment should invariably be administered. Administration of broad-spectrum antibiotics which can be excreted via the bile duct, e.g. ampicillin or tetracycline, is preferable.
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PMID:[Prophylactic treatment of pancreatitis with antibiotics? (author's transl)]. 39 3

An experience with 68 patients with hemorrhagic pancreatitis identified at operation or autopsy is reported. Sixteen of the patients were subjected to operation, and 6 survived after celiotomy and peritoneal irrigation. There were no survivors in the unoperated group. Death when the pancreas is hemorrhagic and due to pancreatitis occurs an average of 10 days after the onset of symptoms or within 7 days of hospitalization. In eight patients who presented in coma, the diagnosis was not established before death. Early recognition of patients with hemorrhagic pancreatitis can be facilitated by the routine use of amylase and methemalbumin determinations and peritoneal lavage. Translocation of large volumes of albumin-rich fluid from the intravascular compartment to the retroperitoneum and pleural and abdominal cavities is in part responsible for many of the signs, symptoms, and complications of hemorrhagic pancreatitis. These include hemoconcentration, hypotension, tachycardia, tachypnea, ascites, abdominal distress, respiratory insufficiency, and renal failure. Adequate initial resuscitation and intensive follow-up are probably the most important elements in the management of patients with hemorrhagic pancreatitis. Careful monitoring of fluid and electrolytes and blood gases is required to avoid shock and renal and pulmonary failure. The need for careful monitoring is emphasized by the number of our patients in whom inadequacies of fluid replacement and ventilation were often not appreciated until the patient was in extremis from shock or respiratory or renal failure. Antibiotics are indicated in patients with biliary tract disease and penetrating ulcer in whom the risk of secondary infection is considerable. Associated diseases that initiated pancreatitis and that in themselves may be life-threatening, such as acute cholecystitis or cholangitis, should be promptly treated by operation. Diagnostic and therapeutic lavage are justified in the treatment of hemorrhagic pancreatitis. Resection of the necrotic pancreas should be considered when the patient fails to improve after lavage and nonoperative resuscitation.
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PMID:Hemorrhagic pancreatitis. 45 56

A series of 311 Chinese patients with acute pancreatitis admitted to Queen Mary Hospital, Hong Kong, over a 10-year period is reviewed. Biliary tract disease was associated with pancreatitis in 52.4 per cent of patients and 77.9 per cent of them had stones, mud or parasites in the common bile duct. Fever and jaundice were present in 55 per cent and 41.2 per cent of patients respectively. Because of the prevalence of recurrent pyogenic cholangitis among the indigenous population, emergency operation, with the aim of common duct decompression, was conducted in 54.3 per cent of patients during the acute episode, with a mortality rate of 14.8 per cent. Five of 142 patients (3.5 per cent) died whilst on conservative treatment and all 5 had haemorrhagic pancreatitis. The overall mortality rate was 9.6 per cent. Exploration of the common bile duct, which was carried out in 57.4 per cent of patients in the acute phase, was not associated with a higher mortality than when laparotomy alone was performed, and 19 patients had sphincteroplasty without any death. Subtotal pancreatectomy was performed in 2 patients with haemorrhagic pancreatitis with 1 death.
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PMID:Acute pancreatitis in Hong Kong. 46 20

The etiological factors in 130 cases of acute pancreatitis occurring in a community with a low alcohol intake were reviewed. Alcohol was an insignificant factor in the etiology of acute pancreatitis. So-called idiopathic pancreatitis, occurring mainly in the older age group, was diagnosed in 19% of the cases. This is in contradistinction to findings in populations with excessive alcohol intake, where idiopathic pancreatitis is seen in all age groups. Similar age and sex distribution, as well as biochemical evidence of cholestasis, were seen in both the group suffering from gallbladder disease and in the idiopathic group. A more aggressive diagnostic work-up, including surgical exploration, is warranted, in view of the clinical overlap of biliary tract disease and idiopathic pancreatitis.
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PMID:Acute pancreatitis in a community with a low alcohol intake. 53 46

The case history of an 81-year-old man who developed a large pancreatic abscess following pancreatitis is presented in depth. The underlying cause was biliary tract disease, and the patient successfully underwent cholecystectomy, choledocholithotomy, and drainage of the pancreatic abscess. Several important points in the management of this problem are emphasized.
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PMID:Pancreatic abscess: a case report. 54 Nov 85

Ten episodes of massive transaminase increase with hepatic necrosis were observed in 7 patients after infusion of megluminioglycamide (Biligram). The patients were 3 men and 4 women aged 49 to 65 years with biliary tract disease (n = 1), recurrent pancreatitis (n = 1), hyperlipidaemia and minimal toxic liver damage (n = 1), pyelonephritis (n = 1), , arteriitis (n = 1), and pseudo-LE (n = 1). In 6 patients there was an increase of the alkaline phosphatase without icterus before the investigation and a slight increase of transaminases in 3 patients. After infusion of 100 ml of Biligram in 5 patients and of 200 ml in 2 patients there was an abrupt increase of GPT (98-2202 U/l) with a lesser increase of GOT. The alkaline phosphatase activity remained unchanged. Three patients showed symptoms such as upper abdominal pain, fever erythema, or conjunctivitis. Histologically all patients showed centrolobular necroses. Transaminases should be checked 2 days after intravenous cholangiograms. In patients with a definite increase reexposure should be avoided.
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PMID:[Hepatic necroses after infusion cholangiography (author's transl)]. 63 57

Pancreatic fibrosis was found in 23 of 31 cases of acute necrotising and haemorrhagic pancreatitis; however, in the cases with a history of six days or less neither the extent nor the frequency of fibrosis differed significantly from those in controls. There was no histological evidence that duct or vascular lesions are necessary for the disease to occur. The liver was examined in 26 cases and showed cholestasis in 12, including 10 of 20 cases without a biliary aetiology and only two of six cases with biliary tract disease. In no case did the liver show specific features of alcoholic damage.
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PMID:The liver and pancreas in acute necrotising pancreatitis. 69 Feb 44

Twenty patients with longstanding alcoholism and biopsy-proven alcoholic liver disease presented with marked elevation of serum alkaline phosphatase (in excess of four times the upper limit of normal). None had a past or present history to suggest pancreatitis or biliary tract disease, nor had any of these patients recently taken medication which could be implicated in cholestatic jaundice. Thirteen (65%) of this group either had radiologic or post mortem confirmation of nonobstructed biliary systems. The histologic findings in this group of patients were compared with those of a group of patients with alcoholic liver disease and normal or only mild elevation of serum alkaline phosphatase. Significantly more hepatocellular necrosis (P less than 0.05), alcoholic hyaline (P less than 0.02), and cholestasis (P less than 0.002) were noted in the severely hyperphosphatasemic group. Minimal degrees of steatosis were found in both groups. These data indicate that intrahepatic cholestasis occurs in patients with alcoholic liver disease, and this may often be secondary to alcoholic hepatitis. Overemphasis has previously been given to alcoholic fatty liver as a cause of this syndrome.
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PMID:Alcoholic liver disease presenting with marked elevation of serum alkaline phosphatase. A combined clinical and pathological study. 73 13

The high incidence of calculous biliary tract disease accounts for surgical operation upon the biliary tract disease accounts for surgical operation upon the biliary tract being the most frequently performed within the abdomen. Untreated surgically critical sequelae tend to occur with advancing age and duration of the disease. The more common of these are: acute cholecystitis, choledocholithiasis, acute obstructive suppurative cholangitis, biliary enteric fistulas, liver abscess, related pancreatitis, and biliary cirrhosis. The greater the pathological changes in the biliary tract and the more debilitated the individual, the greater is the risk of surgery. However, the risk is even greater without operation.
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PMID:Critical sequelae in biliary tract disease. 78 79


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