Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030305 (pancreatitis)
 16,014 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To determine whether the increasing use of percutaneous fine-needle biopsy of abdominal lesions is associated with an increase in serious complications, the author updated a literature search and evaluated a questionnaire (distributed among selected hospitals in the United States in 1986 and 1987) that followed up a questionnaire distributed in 1983. The updated literature review revealed a total of 24 deaths and 20 needle tract seedings. The updated questionnaire revealed five deaths after 16,381 biopsies (0.031%), whereas the previous questionnaire had shown four deaths after 63,108 biopsies (0.006%). Two similar European questionnaires revealed mortality rates of 0.008% and 0.018%, respectively. Of the total of 33 deaths, 21 involved biopsies of liver lesions; six involved pancreatic biopsies. Seventeen of the 21 deaths after liver biopsies were secondary to hemorrhage; five of the six deaths after pancreatic biopsies were due to pancreatitis. Of the 23 instances of needle tract seeding, 10 occurred after biopsies of pancreatic malignancies. The frequencies of needle tract seeding in the four questionnaires were 0.005%, 0.006%, 0.003%, and 0.009%, respectively. Although infrequent, serious complications may be associated with this procedure. The author makes suggestions that may help minimize them.
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PMID:Complications of percutaneous abdominal fine-needle biopsy. Review. 198 14

One hundred twenty-six effusion samples from 102 patients were examined by cytology and flow cytometry (FCM). Overall, there was an 84% correlation between cytologic and FCM results. Of the 36 malignant cases determined by cytologic examination, FCM revealed an aneuploid peak in 20 (56%). Image analysis (IA) performed on the malignant cytologic cases with a diploid flow pattern detected two additional aneuploid peaks. In addition, FCM indicated three aneuploid cases in which cytologic characteristics were initially interpreted as benign (false negative). Aneuploidy was therefore detected in 64% of the malignant effusion specimens by FCM and IA. Twenty-three of the total of 24 aneuploid cases detected by FCM were associated with malignancy (predictive value = 96%). The one nonmalignant case was that of hemorrhagic pancreatitis with infected pseudocyst. FCM is an excellent tool when moderate to large numbers of tumor cells are present, whereas use of IA is advantageous for specimens containing smaller numbers of malignant cells because these can be directly analyzed. When an aneuploid peak is present, a diagnosis of malignancy must be suspected, and, if the initial cytologic screen is negative, a critical review of the cytology slides is justified. In those cases with an equivocal atypical cytology report and an abnormal cytometric histogram, additional investigation is warranted. In some malignancies the tumor cells will be diploid (in this study 36%) and neither FCM nor IA will add to tumor detection, leaving cytologic examination as the definitive technique.
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PMID:Diagnostic value of DNA analysis in effusions by flow cytometry and image analysis. A prospective study on 102 patients as compared with cytologic examination. 198 48

CEA, CA19-9 and CA50 are tumour-associated antigens defined by monoclonal antibodies that have been raised against adenocarcinoma cell lines, but no single antibody is specific for the detection of pancreatic malignancy. The aim of this study was to determine whether the combined use of CEA, CA19-9 and CA50 would improve diagnostic accuracy. An immunoradiometric assay was used for the detection of CEA and CA19-9 and the Delfia system for CA50. Serum was collected from 65 normal subjects, 16 with pancreatitis and 28 with pancreatic carcinoma. Of the 28 cancer patients, 24 (85%) had a CA19-9 level above 46 mu/ml, 26 (92%) had a CA50 level above 21 mu/ml and 10 (37%) had a CEA level above 7 ng/ml. Multivariant discriminant analysis on the combined antibodies showed that 96% of the malignant group, 13% of the pancreatitis group and 11% of the normal group were positive, with an overall correct classification of 91% into the three groups (multivariant discriminant analysis P less than 0.05). Thus the combined use of CEA, CA19-9 and CA50 improves diagnostic accuracy in differentiating benign from malignant disease of the pancreas.
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PMID:Clinical evaluation of combined use of CEA, CA19-9 and CA50 in the serum of patients with pancreatic carcinoma. 199 58

We review CT of 24 cases of intraabdominal abscess with fistulous communication to the GI tract confirmed by GI contrast study or fistulogram. Underlying causes of fistulization included recent GI tract surgery (13), diverticulitis (four), unknown etiology (three), malignant neoplasm (two), trauma (one), and pancreatitis (one). Thirteen (54%) abscesses showed air-fluid levels, 14 (58%) showed air bubbles, and seven (29%) showed both. Bowel contrast material was administered in 21 cases, and optimal bowel opacification was effected in 16. However, contrast extravasation into the abscess was noted in only six cases. We conclude that an air-fluid level may indicate the presence of a fistulous communication to the GI tract, but its absence does not necessarily mean there is no communication. Also, recognition of contrast within the abscess is uncommon even with optimal bowel opacification. In cases of clinical suspicion of internal fistula, a fistulogram or GI contrast study should be performed.
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PMID:CT of abdominal abscess with fistulous communication to the gastrointestinal tract. 202 7

For evaluating the diagnostic rate of serum CA19-9 and carcinoembryonic antigen (CEA) in pancreatic malignancies and pancreatitis, 22 patients with pancreatic malignancy, 27 patients with acute pancreatitis and 7 patients with chronic pancreatitis were included in this prospective study. The normal values of CEA and CA19-9 were 2.0 ng/ml and 36 U/ml respectively in 10 healthy males and 11 healthy females. The positive rates of CEA (greater than 2.5 ng/ml) in pancreatic malignancy, acute pancreatitis and chronic pancreatitis were 50%, 47% and 38%, respectively. On the other hand, the positive rates of CA19-9 (greater than 37U/ml) in pancreatic malignancy, acute pancreatitis and chronic pancreatitis were 82%, 26% and 23%, respectively. In diagnosis of pancreatic malignancy, the positive rate of CA19-9 is higher than that of CEA (82% vs 50%), and CA19-9 has a sensitivity significantly higher in differentiating from pancreatitis than CEA. In 7 cases of pancreatic malignancy with metastasis (liver or peritoneum), all had abnormally high serum CA19-9 (greater than 195 U/ml), 6 of 7 had CA19-9 levels over 1000 U/ml. In the view of CEA, 6 of 7 had serum CEA over 5 ng/ml, one patient with peritoneal metastasis had normal CEA level. In this study, we conclude that the diagnostic rate of CA19-9 in pancreatic malignancies is better than that of CEA.
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PMID:[Serum carcinoembryonic antigen (CEA) and carbohydrate antigen (CA 19-9) values in patients with pancreatic cancer or pancreatitis]. 203 68

We examined a case of choledochal cyst in an adult having congenital dilatation of the bile duct classified, according to Todani's, as type I and treated by excision with hepatic-jejunostomy Roux-en Y. This procedure is recommended as the best treatment for eliminating pancreatitis by pancreaticobiliary disconnection and thus for reducing the risk of malignancy.
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PMID:Choledochal cysts in adults: a case report. 208 43

The indications and results of 316 endoscopic sphincterotomies (ES) performed during 13 years are described. The most common indications were choledocolithisis 83% and stenosis 17% including: papillary stenosis, Oddi's disfunction, cancer of the ampulla and terminal choledochus, biliary pancreatitis and benign strictures. Stones were retrieved from in 95% of cases. We had complications in 7%, hemorrhage was the most frequent. Three cases were operated because of perforation and bleeding with no mortality. We placed 11 papillary stents, 8 naso-biliary drainages and 2 balloon dilatations. Comments are made on ES and recent advances in therapeutic endoscopy, dissolution and fragmentation of stones. Therefore, ES is a non-aggressive method, that diminishes hospital expenses and solves most of the cases in high-risk surgical patients. ES will play a very important role in the treatment of gallbladder and bile duct stones.
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PMID:[Endoscopic sphincterotomy: long-term results]. 210 12

Monoclonal antibody defined antigen (CA19-9), carcinoembryonic antigen (CEA), ultrasonography (US) and computerized tomography (CT) were carried out as the tests in 113 patients suspected to have pancreatic cancer. Of 98 patients who underwent operation, 55 were found to have pancreatic cancer, 25 benign pancreatic disease, and 18 cancer of the biliary tract. Follow-up study was carried out for more than 1 year in 15 other patients suffering from pancreatitis without surgical intervention. The accuracy of CA19-9, US, CEA and CT was 87%, 69%, 61% and 56% respectively. The sensitivity of each test was CA19-9, 98%; US, 89%; CT, 80%; and CEA, 38%. The sensitivity of parallel test combined with CA19-9 and CEA was 100%. It may be regarded as the first step to detect pancreatic cancer in suspected population. The specificity of each test was CEA, 82%; CA19-9, 76%; US, 50% and CT, 40%. And the specificity of serial tests combined with CA19-9 and US was 90%. When these two tests were both positive, pancreatic cancer was highly suspected.
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PMID:Evaluation of non-invasive diagnostic tests in detecting cancer of the pancreas. 212 54

Of 570 ERHP performed in patients with biliary tract and pancreas diseases, duodenal diverticuli were found in 67 (11.8 per cent). Diverticuli were more frequently diagnosed in patients beyond 60 years of age (67.2 per cent). In 83.6 per cent the diverticuli were single, mostly measuring 15-30 mm and localized in the peripapillary area (70 per cent). ERHP was successful in 85 per cent. Diverticuli were most frequently accompanied by stenosing papillo-odditis (82 per cent), cholecystitis (67 per cent), common bile duct calculosis (58 per cent), followed by pancreatitis (37 per cent) and cancer of the bile ducts (4.5 per cent). Endoscopic treatment was conducted in 46 cases: endoscopic sphincterotomy, hydrostatic balloon dilation of narrowed segments, hydrostatic balloon extraction of calculi, mechanical lithotripsy, nasolabial drainage and endoprosthesis. Significantly lower was the technical success of endoscopic sphincterotomy (78 per cent) when compared with its performance in patients without diverticuli (99 per cent). In spite of this, complex endoscopic treatment resulted in significant fall of bilirubin level (t = 6.58; p less than 0.0001), of AP (t = 8.15; p less than 0.001), of GGJP (t = 6.99; p less than 0.0001), of AcAT (t = 7.14; p less than 0.01). The incidence of complications (6.5 per cent) was not higher than the one observed in patients without diverticuli. In conclusion, endoscopic treatment of bile duct diseases is recommended to be performed also in patients with diverticuli, especially in adult patients and in those exposed to increased operative risk.
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PMID:[The relationship between duodenal diverticula, biliary tract and pancreatic diseases and their endoscopic treatment]. 212 48

Over a period of 14 years a total of 1,996 surgical procedures have been performed on extrahepatic biliary pathways. In 182 cases (9.11%) biliodigestive anastomoses have been done for a therapeutical solution of mechanical jaundice. Biliodigestive anastomoses have been mandatory in 76 cases (41.76%) because of mechanical jaundice induced by biliary stones. In 106 cases the anastomosis was carried out in an attempt to solve mechanical jaundice that was not induced by biliary stones but by other causes. In 45 cases the lesions that had determined the jaundice were benign, and in 61 of the cases malignancy was at the origin of the jaundice. The following types of anastomosis were employed: choledochoduodenal anastomoses were done in 120 cases (65.93%); hepatic duct-duodenal anastomoses in 15 cases (19.23%); hepatojejunal anastomoses in 7 cases (3.84%); recalibration of previous anastomoses in 5 cases (2.74%). These surgical methods, applied in cases of various etiologies, most of them quite severe, in debilitated patients, with iterative surgery, were associated with early postoperative mortality of 8% (13 cases), and a general morbidity of 35% (65 cases), which included: fistulae, anastomotic stenoses, acute postoperative pancreatitis, angiocholitis and suppuration. The late results were good, depending on the etiology of the mechanical jaundice. The authors preferred choledochoduodenal anastomosis for benign lesions, and anastomoses with the diverticular apparatus, or the main biliary pathway in palliative surgery.
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PMID:[Biliodigestive anastomoses; a modality for resolving mechanical jaundice]. 215 38


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