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

A simple method of percutaneous fine needle aspiration biopsy of malignant lesions in and around the pancreas following radiological localization is described. Biopsy was performed in 28 patients. Twenty-three were eventually considered to have malignant disease and biopsy was positive in 19 of these (83%), including 16 of 18 patients with carcinoma of the pancreas (89%). One patient developed an exacerbation of pancreatitis following the procedure. Surgery became unnecessary in 5 of the 18 patients with positive biopsies. From these results and from a review of the literature on percutaneous fine needle aspiration biopsy, we believe that this is a simple, relatively painless, reasonably safe and reliable method of obtaining a preoperative diagnosis and advocate the procedure as desirable in all patients in whom malignant disease is suspected and can be localized radiologically.
Cancer 1978 Jun
PMID:Fine needle aspiration biopsy of malignant lesions in and around the pancreas. 65 5

Endoscopic retrograde cholangiopancreatography (ERCP) is essential in the diagnosis of pancreatic disease, jaundice and in post-cholecystectomy syndromes, as well as in cases where cholecystography and i.v. cholangiography fail to explain disturbances that strongly suggest bile duct involvement. Its confirmation of clinically established pancreatic disease is much more positive than that given by scintiscanning and multiple superselective arteriography. Unlike the latter, it also permits the differential diagnosis of chronic pancreatitis, cancer of the pancreas, pseudocysts, etc. and distinguishes medical and surgical pancreatitis (stenosis, proteinaceous calculi, and obstructing pseudocysts). Differential diagnosis of progressive jaundice on clinical grounds or with the aid of ordinary means of examination is sometimes unsatisfactory. ERCP clearly distinguishes medical and surgical forms, so that exploratory laparotomy is not needed in subjects with liver-cell forms. It also shows the nature, site and extent of extrahepatic obstruction, and points to the organic cause in 79% of cases of postcholecystectomy syndrome. Right hypochondrial pain or intermittent jaundice and negative cholecystography and i.v. cholangiography is a further indication, since ERCP will reveal disease of the pancreas or bile ducts (cholelithiasis, choledocholithiasis, sclerosing cholangitis, etc). It is also useful in the diagnosis of cirrhosis, abscess, echinococcus cyst and primary or secondary cancer in cases where needle biopsy and-or arteriography are either contra-indicated or inconclusive.
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PMID:[Diagnostic value of retrograde cholangiopancreatography by transendoscopic route]. 66 74

Duodenal lesions are being reported in cases with familial polyposis of the colon. A case is described presenting with duodenal obstruction and pancreatitis complicating a peri-ampullary carcinoma in a patient with familial polyposis (adenomatosis of the colon and rectum). Upper gastrointestinal lesions notably in the duodenum include duodenal polyps and carcinoma and peri-ampullary malignancy. It is suggested that endoscopy and hypotonic duodenography be considered in patients with adenomatosis of the colon and rectum presenting with non-colonic alimentary symptoms.
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PMID:Pancreatitis and duodenal obstruction due to periampullary carcinoma associated with familial polyposis coli. 68 14

A highly specific pancreatitis primarily affecting the intralobular and intrainsular ductules has been demonstrated in Syrian golden hamsters bearing homologous, non-syngeneic, transplantable pancreatic adenocarcinomas induced by N-nitrosobis(2-oxopropyl)amine (BOP). The ductulitis provides further evidence that induced pancreatic neoplasms originate from ductules.
Cancer Lett 1978 Oct
PMID:Pancreatic ductulitis in Syrian golden hamsters bearing homologous transplantable pancreatic adenocarcinomas. 68 4

In 260 cytologic examinations of pancreatic juice and gall we were able to make a reliable diagnosis in 75%. 90% of the samples were taken before an ERCP. In the cytogram the cells of the gall passages, of the duodenum, and of the pancreas are easily distinguishable. Degenerative pancreas epithelia appear not only in pancreatitis but also in pancreatic carcinoma. 78% of the cases of pancreatic cancer were cytologically positive. By combining cytological examination with ERCP we can attain a large degree of reliability in the detection of cancer.
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PMID:[Cytodiagnosis of pancreatic juice and gall (author's transl)]. 70 69

We have analysed retrospectively the pancreatic ultrasound scans (using a bistable machine) in 138 consecutive patients, and have related the results to the clinical status and the final diagnosis in each case. The scans were read without knowledge of the patient's clinical state. When technically unsatisfactory scans were excluded from consideration, the overall diagnostic accuracy of ultrasonography proved to be 82%, with a false positive rate of 8%. The scan was abnormal in all 10 patients with cancer of the pancreas: a positive diagnosis of cancer was made in six. All patients with chronic pancreatitis in relapse had abnormal scans, but in 53% the scans were normal in patients in whom the disease was in clinical remission. In seven patients with chronic pancreatitis who suffered relentless pain, the head of the pancreas was swollen and contained cystic areas or emitted abnormal echoes. In acute pancreatitis ultrasonic scanning proved useful in following the progression of the disease to final resolution, or to development of complicating pseudocyst, abscess, or ascites. Random echoes in the early stages of acute pancreatitis are features of haemorrhagic necrosis. In alcoholic relapsing pancreatitis the persistence of abnormal echoes, disposed linearly along the axis of major ducts, suggests the presence of chronic pancreatitis.
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PMID:Ultrasonic scanning in pancreatic disease. 73 69

Observer variation in the interpretation of endoscopic pancreatograms has been examined by asking four experienced observers to assess 40 sets of well-documented radiographs (from 20 patients with cancer and 20 with pancreatitis), both without ("blind") and with clinical details, each on three occasions. Individual consistency for "blind" diagnoses ranged from 61% to 78%, increasing significantly with clinical information. Overall diagnostic accuracy with clinical information varied from 52% to 83% for cancer, and from 87% to 95% for pancreatitis. However, unanimous and correct opinions were given by the four observers for only 53% of all cases, even when clinical details were provided. Clinical information changed the radiographic diagnosis in 43% of assessments, 83% of these changes leading to improved accuracy. ERCP gives direct information about the major pancreatic and biliary duct systems and often provides an accurate diagnosis. Caution must be exercised in relying upon radiological appearances alone.
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PMID:Is pancreatogram interpretation reliable?--a study of observer variation and error. 73 8

A critical "blind" evaluation of 129 randomly selected angiographic examinations was carried out including 37 control patients, 58 patients affected by proven chronic relapsing pancreatitis and 34 patients with cancer of the pancreas. In 48.5% of the control patients a completely normal angiographic picture was found. The false positives were found in 10.8% of chronic pancreatitis and in pancreatic carcinoma in 5.5% of the cases. Equivocal signs were found in 35.2%. The percentage of the false negative results in chronic pancreatitis was 34.4% (of which 8.6% were suggestive of pancreatic cancer). In pancreatic cancer positive results were seen in 70.6% of the cases. The percentage of the false negatives was 26.5% (suggestive of chronic pancreatitis); equivocal signs were found in 2.9% of these patients. Notwithstanding the not-negligible percentage of errors, angiography can be usefully employed in diagnosis of pancreatic disorders.
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PMID:Angiography in chronic pancreatitis and pancreatic cancer. A critical evaluation. 74 14

Pancreatic isoamylases were determined in serum and in duodenal aspirate in 7 patients with pancreatitis. The serum activities were abnormally low in 3 cases with cancer and in 7 cases with pancreatitis. In 2 cases with normal pancreatic isoamylase activities in serum, pancreatic disease was reflected by an abnormal isoamylast pattern. Thus the serum amylast determination was abnormal in 12 of the 20 patients.
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PMID:Isoamylases in pancreatic carcinoma and chronic relapsing pancreatitis. 83 69

The continuing controversy between proponents of open and closed commissurotomy might be clarified by analysis of late follow-up with modern actuarial techniques that provide a true perspective of patient risk. We have used open mitral commissurotomy exclusively for 15 years in 100 patients. There was one operative death from pancreatitis and one late death from cancer; the actuarially projected survival rate (+/- the standard error) at 10 years is 97 per cent (+/- 2). Thirteen patients had preoperative emboli, 6 of whom were in sinus rhythm and 7 in atrial fibrillation. Two patients had postoperative emboli, both in sinus rhythm. The actuarial chance of remaining free of embolism at 10 years is 97 per cent (+/- 2). Sixteen patients required reoperation on the mitral valve for functional deterioration. The remaining survivors were in Class I or II when last seen. The actuarial chance of not requiring a reoperation after 5 years is 91 per cent (+/- 4) and at 10 years, 38 per cent(+/- 16). Results in different centers are difficult to compare for many reasons, but imprecise statistical methods further obscure such comparisons. The use of actuarial techniques may help to define the role of open mitral commissurotomy.
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PMID:Prognosis of patients after open mitral commissurotomy. Actuarial analysis of late results in 100 patients. 85 Apr 33


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