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

We had a patient with cancer of the pancreas that was diagnosed by endoscopic retrograde pancreatography where conventional diagnostic methods (including arteriography) were negative. Pancreatic resection was possible and examination of the surgical specimen showed microscopic adenocarcinoma coexistent with an intraductal stone and pancreatitis.
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PMID:Pancreatitis with coexistent pancreatic duct stone and carcinoma. Early diagnosis by endoscopic retrograde pancreatography. 87 35

We undertook to test the recent suggestion that measurement of immunoreactive carcinoembryonic antigen (CEA) in pancreatic secretion may be useful in diagnosis of pancreatic cancer. Using duodenal intubation and a perfusion method in 57 cases, we measured the rate of pancreatic CEA secretion into the duodenum under basal saline perfusion, alone and with continuous intravenous infusion of secretin (2 clinical units per kg per hr) and of cholecystokinin-pancreozymin (CCK, 15 Crick-Harper-Raper units per kg per hr); and we compared the CEA output with secretion of trypsin, lipase, and bicarbonate under the same conditions. Subsequent laparotomy revealed pancreatic carcinoma in 25 patients, pancreatitis in 7, other intraabdominal malignancies in 6, and benign nonpancreatic disorders in 19. CEA output rates did not differentiate all pancreatic-cancer patients from other patients in any test condition. However, pancreatic enzyme outputs were abnormal with almost 90% of cancers of the pancreatic head and with 75% of cancers of the pancreatic body and tail. For detection of pancreatic cancer, enzyme and bicarbonate outputs in response to CCK are more accurate than pancreatic CEA or bicarbonate outputs in response to secretin. Since CCK-stimulated enzyme outputs can be related accurately to malabsorption (not reported here), we prefer them to bicarbonate output for assessment of pancreatic function.
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PMID:Prospective evaluation of the pancreatic secretion of immunoreactive carcinoembryonic antigen, enzyme, and bicarbonate in patients suspected of having pancreatic cancer. 89 42

In a prospective study for the diagnosis of pancreatic cancer, ultrasonography, radionuclide scanning, selective arteriography, and endoscopic retrograde cholangiopancreatography (ERCP) were compared. Eighty-nine consecutive patients were investigated; 58 underwent laparotomy, and 36 were found to have periampullary cancer; seven had other malignant tumors within the abdomen, and nine had pancreatitis on biopsy. Five had other benign disease, and there was one negative laparotomy. Thirty-one patients who did not have laparotomy have shown no evidence of cancer at one year follow-up. Ultrasonography was found to be more reliable than scan or arteriography in the detection and diagnosis of a mass in the pancreas. ERCP achieved the highest rate of correct definitive diagnosis.
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PMID:Comparative value of four methods of investigating the pancreas. 96 35

At least two chemotherapeutic agents, prednisone and L-asparaginase, have been demonstrated to produce pancreatic injury. Early diagnosis of pancreatitis is frequently not possible, as symptoms are vague, physical findings may be minimal, and laboratory studies are frequently inconclusive until the injury is severe. Abdominal echography, as a monitor of pancreatic size, has proven to be helpful in the diagnosis of subclinical and early pancreatic injury of 14 of 19 selected children receiving prednisone and/or L-asparaginase therapy for acute leukemia or non-Hodgkin's lymphoma at the M.D. Anderson Hospital and Tumor Institute. Employment of this new diagnostic method permits prompt withdrawal of the causative agent(s), thus preventing further insult.
Cancer 1976 Oct
PMID:Early detection of chemotherapy-related pancreatic enlargement in children using abdominal sonography: a preliminary report. 99 Oct 74

A patient had subcutaneous and medullary bone fat necrosis associated with chronic, recurrent pancreatitis. In the case, recurrent symptoms of pancreatitis as well as progressive bone destruction were correlated with an increase in serum lipase levels. Total pancreatectomy was followed by relief of all symptoms and healing of destroyed bone. Medullary fat necrosis may be associated with pancreatitis, pancreatic trauma, or cancer of the pancreas. Pancreatectomy may be useful if conservative treatment does not lead to healing of severe medullary fat necrosis associated with recurrent pancreatitis.
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PMID:Total pancreatectomy for recurrent medullary fat necrosis. 99 6

Carcinoembryonic antigen (CEA) activity was assayed in plasma and in pure pancreatic juice from eight patients with carcinoma of the pancreas, 28 patients with pancreatitis, and 13 controls with no demonstrable pancreatic disease. Juice specimens were obtained via direct transduodenal cannulation of the pancreatic duct. The mean pancreatic juice CEA activities in controls, pancreatitis, and pancreatic carcinoma were 8.1 ng/ml, 18.6 ng/ml, and 309 ng/ml, respectively. Pancreatic juice CEA activity in patients with cancer of that organ was significantly higher than in those with pancreatitis or in controls. None of the 32 subjects with both pancreatic juice CEA activity less than 30 ng/ml and plasma CEA less than 2.5 ng/ml had pancreatic cancer. Three of the four patients with CEA elevations in both fluids above these levels harbored this malignancy. These findings suggest that combined measurement of CEA activity in plasma and pancreatic juice may help in diagnosing pancreatic disease.
Cancer 1976 Dec
PMID:Carcinoembryonic antigen (CEA) activity in pancreatic juice of patients with pancreatic carcinoma and pancreatitis. 100 Apr 75

Fine needle aspiration biopsy from the pancreas was carried out peroperatively in 60 patients. A suspicion of malignancy due to a palpaple mass in the pancreas was raised in 45 cases and confirmed by cytology in 27 cases. Of the remaining 18 cases in which malignancy was suspected, the majority were caused by penetrating gastroduodenal ulcers or pancreatitis. There was only one false negative cytological report among the 37 patients with available histological control. There were no complications due to the aspiration biopsy.
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PMID:Fine needle aspiration biopsy of the pancreas. 100 52

The author observed 27 patients with the adducent loop mechanic syndrome (ALMS), which was caused by scarring deformations, ulcerous and cancer process in the region of anastomosis, constructed after one of Billroth-2 technics, impairing evacuation of the adducent loop content. The diagnosis was established on the basis of clinical findings and pinpointed further by roentgenoscopy and fibrogastroscopy. The presence of helminthic invasion of the liver--opisthordiasis resulted in hepatitis, pancreatitis that would not respond to therapy in patients with ALMS. Conservative measures in this syndrome yield but only a provisional effect. Eighteen patients were operated upon.
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PMID:[Causes of mechanical afferent loop syndrome after stomach resection in peptic ulcer]. 101 83

The epidemiological patterns for pancreatic and biliary cancers reveal more differences than similarities. Pancreatic carcinoma is common in western countries, although 2 Polynesian groups (New Zealand Maoris and native Hawaiians) have the highest rates internationally. In the United States the disease is rising in frequency, predominating in males and in blacks. The rates are elevated in urban areas, but geographic analysis uncovered no clustering of contiguous counties except in southern Louisiana. The origin of pancreatic cancer is obsure, but a twofold increased risk has been documented for cigarette smokers and diabetic patients. Alcohol, occupational agents, and dietary fat have been suspected, but not proven to be risk factors. Except for the rare hereditary form of pancreatitis, there are few clues to genetic predisposition. In contrast, the reported incidence of biliary tract cancer is highest in Latin American populations and American Indians. The tumor predominates in females around the world, except for Chinese and Japanese who show a male excess. In the United States the rates are higher in whites than blacks, and clusters of high-risk counties have been found in the north central region, the southwest, and Appalachia. The distribution of biliary tumors parallels that of cholesterol gallstones, the major risk factor for biliary cancer. Insights into biliary carcinogenesis depend upon clarification of lithogenic influences, such as pregnancy, obesity, and hyperlipoproteinemia, exogenous estrogens, familial tendencies, and ethnic-geographic factors that may reflect dietary habits. Noncalculous risk factors for biliary cancer include ulcerative colitis, clonorchiasis, Gardner's syndrome, and probably certain industrial exposures. Within the biliary tract, tumors of the gallbladder and bile duct show epidemiological distinctions. In contrast to gallbladder cancer, bile duct neoplasms predominate in males; they are less often associated with stones and more often with other risk factors. In some respects, bile duct and pancreatic tumors are alike. The male predominance of both tumors, an association between cholecystectomy and pancreatic cancer, and other considerations have prompted the notion that the same biliary carcinogens may affect the bile duct, ampulla of Vater, or, by reflux, the pancreatic duct. Various epidemiological and interdisciplinary approaches are needed to further clarify the origins of biliary tract and pancreatic cancers, but nutritional studies hold special promise in laying the groundwork for prevention of these tumors.
Cancer Res 1975 Nov
PMID:Cancers of the pancreas and biliary tract: epidemiological considerations. 110 53

Gastrointestinal diseases are notoriously protean in their modes of expression. The patient's description of symptoms is particularly important, but psychologic, physiologic, and social factors can cause data-base unreliability. Many of the patients termed crocks have symptoms referable to the gastrointestinal system, and they are at considerable health risk, since they usually alienate health care personnel. Patients with pancreatitis usually have a history of heavy alcohol intake which also needs treatment. Behavioral disturbances are related to toxic psychosis. Pancreatic carcinoma has a higher incidence of associated psychiatric symptoms than other types of cancer. Biologic, psychologic, and environmental factors all interact dynamically to cause peptic ulcer disease. There is a high correlation between the severity of inflammatory bowel disease and degree of emotional disturbances.
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PMID:Psychosomatic aspects of gastrointestinal disease. 110 97


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