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

Precise relationships between pancreatic ductal obstruction and pancreatic secretory capacity have not been established. In this study, we describe the quantitative relationships between the lengths of opacified ducts obtained at retrograde pancreatography and the secretory capcity of the gland for volume, bicarbonate, lipase, and trypsin. Forty-five patients (17 with pancreatic cancer, 6 pancreatitis, 5 other malignancies, and 17 nonmalignant, nonpancreatic disease found at laparotomy) were studied with a method of duodenal intubation and perfusion with basal saline perfusion alone or with continuous intravenous infusion of secretin or of cholecystokinin-pancreozymin. Secretory outputs of volume, bicarbonate, and enzymes compared with the length of opacified ducts showed a significant (P less than 0.05) linear relationship for patients with pancreatic cancer, pancreatitis, and other cancers. The resulting data imply that obstruction of the pancreatic duct is important in decreasing secretion of the pancreas in pancreatic disease. The relationship between obstruction and pancreatic secretion demonstrates that a decrease in exocrine pancreatic secretion cannot be detected until more than 60% of the total length of the main pancreatic duct has been obstructed.
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PMID:The relationships between pancreatic ductal obstruction and pancreatic secretion in man. 43 Nov 21

The longitudinal fold of the duodenum can be visualized by computed tomography (CT). Visualization of the fold helps localize the hepatopancreatic duct entrance into the duodenum. Many pathological processes of the head of the pancreas such as pancreatitis or malignancy can produce swelling involving the longitudinal fold, which can be visualized by CT.
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PMID:Visualization of the longitudinal fold of the duodenum by computed tomography. 43 75

To evaluate diagnostic usefulness for pancreatic cancer, serum ribonuclease (RNase) level was determined in three groups of subjects; 1) normal volunteers as control, 2) patients with histologically determined pancreatic cancer, and 3) patients with miscellaneous diseases other than pancreatic cancer. A small increase of RNase values was recognized with age in the normal subjects and in the patients with nonpancreatic diseases, if renal function was normal. The mean RNase level in the control subjects was 97 +/- 41.2 units. A marked elevation of serum RNase level was demonstrated in the patients with pancreatic cancer (p less than 0.001) and in the patients with renal dysfuction, but no significant rise was noticed in the patients with pancreatitis. Mean values of RNase in the patients with pancreatic cancer and renal dysfuncton were 368 +/- 146 units and 342 +/- 78.1 units respectively. RNase values above 300 units were recognized in 15(71%) out of 21 patients with pancreatic cancer. Seven cases with elevated RNase over 300 units other than non-pancreatic malignancy and renal dysfunction were noticed in 6 instances of obstructive jaundice and in one instance of early gastric cancer (an 84-year-old male). The above-stated findings indicate that serum RNase determinations can be utilized as a diagnostic indicator for pancreatic cancer.
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PMID:Assessment of the clinical usefulness of serum ribonuclease assays: an indicator for the detection of pancreatic cancer. 44 87

Rapid tumor lysis may produce acute complications including systemic metabolic disturbances and hemorrhage in sites involved by tumor. We have observed two cases of acute pancreatitis induced by the lysis of lymphoma that involved the pancreas. This previously unreported cause of pancreatitis must be added to the list of potential complications associated with effective cancer chemotherapy.
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PMID:Tumor lysis pancreatitis. 50 73

The clinical, biochemical and radiological findings in 16 patients with carcinoma of the head of the pancreas were compared with that of 13 with cholestatic jaundice due to chronic pancreatitis. Patients presenting with malignancy had more severe hyperbilirubinemia (18.5 +/- 2.1 vs 5.6 +/- 1.6 p to ten days of hospital admission was the single most accurate test distinguishing carcinoma from pancreatitis. The mean bilirubin rose in carcinoma but fell in pancreatitis (mean net change 15.1 +/- 2.9 vs 3.9 +/- 0.6, p less than 0.001). Calcification in the pancreatic region was identified on a flat plate of the abdomen in 8/13 with pancreatitis but 0/16 with malignancy. Preoperative percutaneous transhepatic cholangiography was helpful in defining the site of biliary obstruction but the radiologist was unable to clearly predict the definitive diagnosis in five of the 29 patients. A point score based upon the major significant differences noted, predicted the presence or absence of malignancy in all patients (16/16 vs 0/13, p less than 0.01).
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PMID:Mass in the head of the pancreas in cholestatic jaundice: carcinoma or pancreatitis? 50 68

The changes in serum trypsin concentration have been measured in 47 subjects for up to 2 hours after a Lundh meal. In 18 healthy controls, mean fasting trypsin concentration was 285 +/- 125 ng/ml (mean +/- 2 SD). The maximum increase after the Lundh meal (the trypsin response ratio) was 6.7 +/- 7.5%. Six patients with chronic renal failure had elevated fasting serum trypsin concentrations (range 460-1100 ng/ml) but trypsin response ratios fell within the control range. Of five patients with relapsing pancreatitis, two had raised and three normal or low fasting trypsins. After stimulation two had elevated trypsin response ratios; one of the two had evidence of main duct obstruction. Eleven out of 12 patients with chronic pancreatitis (with or without insufficiency) had low fasting trypsin concentrations (range 0-120 ng/ml) Seven of the 12 also had raised trypsin response ratios. In six patients with cancer of the pancreas, fasting trypsin was low in three, normal in two, and raised in one. Both patients with a normal fasting level had a raised trypsin response ratio. The combination of a single estimation of fasting serum trypsin concentration followed by serial measurements after a Lundh meal provides a useful screening test for chronic pancreatic disease.
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PMID:Serum immunoreactive trypsin concentration after a Lundh meal. Its value in the diagnosis of pancreatic disease. 52 92

Polyacrylamide gel electrophoresis of pure pancreatic juice from 14 healthy normal subjects, 11 chronic alcoholics without detectable pancreatic disease, 15 patients with pancreatitis, and two with cancer of the pancreas consistently demonstrated the presence of two variants of trypsinogen with different electrophoretic mobilities. In healthy normal subjects the proportion of cationic to anionic trypsinogen was invariably greater than 1 and averaged about 2. In chronic alcoholics, patients with pancreatitis or cancer of the pancreas, this ratio, with a single exception, was below one and averaged about 0.45. The extraordinary consistency of these findings suggests that the quantitative relationship between cationic and anionic trypsinogen in human pancreatic juice may be a very sensitive indicator of incipient or existing pancreatic pathology. The most acceptable explanation for the reversal of the normal zymogen ratio in pancreatic disease is a selective increase in the synthesis of the anionic variant relative to that of the cationic species. Total trypsinogen concentrations differed widely from one another in the three patient groups, but the ratio of cationic to anionic trypsinogen exhibited little change and remained below 1. Our results also demonstrate for the first time a specific effect of chronic alcohol abuse on the secretory profile of a pancreatic enzyme in human subjects. A newly discovered minor, trypsinogen-like component of human pancreatic juice was found to be significantly increased in pancreatic juice of chronic alcoholics, decreased in pancreatic secretions of patients with pancreatitis, and barely detectable in those of two patients with cancer of the pancreas.
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PMID:Trypsinogen variants in pancreatic juice of healthy volunteers, chronic alcoholics, and patients with pancreatitis and cancer of the pancreas. 53

Arterioportography has superseded splenoportography which has given inadequate and at times misleading information. Eighty-two arterioportograms have been done in 78 patients with portal hypertension. The arterial phase may disclose malignancy, pancreatitis, diminished liver perfusion and the venous phase flow reduction, occlusion and the presence of thrombus. Arterioportography should provide evidence of suitability for specific shunts and features relevant to the performance of of a mesocaval or distal spleno-renal shunt are given in detail. An attempt is made to relate arterioportography and transhepatic portal catherisation into a combined function in the management of patients with portal hypertension.
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PMID:Arterioportography. 56 89

The authors report 5 cases of subcutaneous cytosteatonecrosis (Weber-Christian syndrome of pancreatic origin) and review 68 cases in the world literature. The skin, bone joint and general manifestations may appear without any clinical or radiological sign of pancreatitis. The rise in blood and urinary amylase and lipase, the skin lesions, the joint pleural and peritoneal effusions, orient the diagnosis towards the pancreas and suggest a full radiological arteriographic and echotomographic investigation. The pancreatic disease was pancreatitis in 50 cases, cancer in 18 cases. Too long a delay between the initial signs and the diagnosis may lead to early operation even in the absence of pancreatic signs. The cancer may still be limited and removable. The pancreatitis was in 18 cases a false cyst of the head in 2/3rds, whether obvious clinically or not. Operation led to its discovery usually but may miss the lesion which is then only discovered on autopsy. Removal or early by pass operations transform the prognosis which is otherwise fatal. Analysis of these cases illustrates well the problems of indication operative management and efficacy of surgery in a disease still relatively unfamiliar both to physicians and surgeons.
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PMID:[Subacute cytosteatonecrosis of pancreatic origin. Surgical problem in 5 cases (author's transl)]. 60 49

We report on eight cases of parathyroid carcinoma seen at the Bowman Gray School of Medicine, Winston-Salem, NC, since 1969. Diagnosis of a parathyroid disorder was made on the basis of elevated serum calcium levels and associated disorders such as renal calculi, peptic ulcer disease, pancreatitis, and demineralization of bone. Six of the involved glands were on the left side. In seven patients, the disease was localized to the gland or adjacent structures; one patient had cervical lymph node invasion. Except for the last patient, in whom radical neck dissection and wide excision was done, local excision with adequate margins was the only procedure done. The patient with metastases died of his disease four years later. One patient died of myocardial infarction two years later, but had been normocalcemic in the interval between operation and death, and one patient is hypercalcemic and has had two local recurrences within a 3 1/2 year period. The other five patients are alive and well. The routine use of automated serum level determinations of all hospitalized patients has led to early detection of this malignancy, while it is still a stage I lesion in many instances. On the basis of this material, we conclude that radical neck dissection can no longer be advocated as a routine measure in the treatment of parathyroid carcinoma.
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PMID:Carcinoma of the parathyroid. 62 71


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