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

Between 1954 and 1975, 80 pancreaticojejunostomies were performed on 77 patients for intractable pain of chronic pancreatitis. All patients had a history of chronic alcoholism. Drainage operations done primarily for pseudocysts were excluded. Operative procedures included seven caudal pancreaticojejunostomies, 42 longitudinal pancreaticojejunostomies with splenectomy and implantation of the pancreas into the jejunum, and 31 side-to-side pancreaticojejunostomies. Eighty-one percent of the patients noted substantial improvement or complete resolution of their abdominal pain on follow-up that ranged up to 21 years. The operative mortality was 5%. Thirty-two patients died during the period of the follow-up. Continued alcohol abuse, carcinoma, and cardiovascular disease were the leading causes of mortality. Data from this review confirm the effectiveness of pancreaticojejunostomy in relieving the pain of chronic relapsing pancreatitis.
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PMID:Pancreaticojejunostomy for chronic pancreatitis. Two- to 21-year follow-up. 7 68

The efficiency of ultrasound in the diagnosis of pancreatic disease was compared prospectively with that of selenomethionine isotope scanning in 46 patients presenting with abdominal pain or weight-loss or with jaundice. Of 14 patients who later proved to have pancreatic carcinoma, all had an abnormal isotope scan and 13 had an abnormal ultrasound scan. Of 10 patients with chronic pancreatitis, all had an abnormal isotope scan and 9 had an abnormal ultrasound scan. The small advantage of selenomethionine was, however, offset by a higher false-positive rate: of 22 patients who proved not to have pancreatic disease, 13 had abnormal isotope scans compared with only 3 with ultrasound. Review of earlier experience with the two techniques yielded similar results: in pancreatic carcinoma and chronic pancreatitis, isotope scanning gave slightly fewer false-negative results than ultrasound but many more false-positives. Because of its lower false-positive rate, because it avoids ionising radiation, and because it can usually distinguish carcinoma from pancreatitis, ultrasound is the procedure of choice for initial investigation of patients with suspected pancreatic disease.
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PMID:Screening for pancreatic disease: A comparison of grey-scale ultrasonography and isotope scanning. 8 71

Radiologic findings and medical records of 27 patients with angiographic documentation of splenic vein occlusion were reviewed. The most common causes were pancreatic carcinoma, pancreatitis, and malignant lymphoma. Radiographic findings which suggest splenic vein occlusion are gastric varices without esophageal varices and collateral veins in the left upper abdomen during the vascular phase of rapid sequence pyelography. Additional features may be associated with the underlying disease, such as pancreatic calcification and upper abdominal mass lesions. The diagnosis is usually confirmed by high dose celiac or splenic angiography. Examination of the stomach with barium for the detection of gastric varices is more sensitive than has been previusly recognized; features which suggest them are described. Isolated gastric varices may be a clue to isolated splenic vein occlusion and its underlying causes.
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PMID:Recognition of splenic vein occlusion. 9 86

Computed body tomography has become useful in the diagnosis of pancreatic disease. Pancreatitis frequently results in lateral and posterior extension of inflammatory tissue into the pararenal fat planes, which can be visualized by CT. In our series it was associated with clinically diagnosed pancreatitis. Of 100 cases studied for abdominal pathology where pancreatic visualization was optimum, 10 had enlargement of the pancreas with destruction of soft tissue planes extending into the left pararenal space and clinical findings of pancreatitis. Carcinoma of the pancreas was identified in 12; no abnormality was identified in 49; the remaining cases were mixed intraabdominal and retroperitoneal pathology. The value of this sign lies in separating inflammatory processes from neoplastic disease; the sign was not found in normals.
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PMID:A new computed tomographic sign of pancreatitis. 11 7

The accuracy of ERCP in the differentiation between carcinoma of the pancreas and chronic pancreatitis is evaluated in a series of 39 cases with proved final diagnosis. The specificity of 6 different morphological types of duct alterations for carcinoma or for chronic pacreatitis is analyzed. - The accuracy of differentiation was 90% in the present series. Long, irregular stenosis or localized destruction of ductal branches were found in carcinoma only. Short, smooth stenosis or diffuse duct alterations were present in pancreatitis only. Total obstruction was found in both diseases in about the same frequency.
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PMID:[The differentaition between malignant and benign lesions by retrograde pancreaticography]. 13 18

In two cases of typical small-cell bronchial carcinoma (one of them peripheral, small and clinically not diagnosed) destructive parenchylmal metastases in the pancreas, carcinomatous lymphoangiosis and infiltration of the larger excretory ducts by tumour cells were demonstrated. In both the clinical course was dominated by tryptic pancreatitis with treatment-refractory hypokalaemia. Since pancreatic metastases occur in about 10% of bronchial carcinomas, tryptic pancreatitis is, however, only rarely observed. It is, therefore, likely that autodigestion occurs only if in addition to parenchymal destruction by the metastases there are other factors. These may be blockage of lymphatic flow by carcinomatous lymphangiosis and duct stenosis by tumour infiltration of the walls. Hypercorticism due to ectopic ACTH production by the small-cell carcinoma may also be factor, but is without proof.
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PMID:[Tryptic pancreatitis in small-cell bronchial carcinoma (author's transl)]. 19 62

A series of 62 patients referred for endoscopic retrograde cholangiopancreatography is reported. The pancreatic or biliary ductular systems were demonstrated in 42, the success rate of cannulation improving with experience. The technique was diagnostic in 25 of 31 patients referred with hepatobiliary problems and in 3 of 11 with suspected pancreatic pathology. In a further seven patients in this latter group the examination was helpful in management. Duodenoscopy, without duct cannulation, demonstrated carcinoma of the periampullary region in two patients. Pancreatitis occurred in two patients and cholangitis in one. There are few contra-indications to the examination which should be undertaken early in the investigation of patients with cholestasis.
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PMID:Initial experience with endoscopic retrograde cholangiopancreatography: the role in clinical practice. 27 98

Percutaneous fine needle aspiration biopsies were performed on thirty-four patients with clinical suspicion of pancreatic carcinoma. The biopsies were positive in twenty-four of twenty-six patients with proven pancreatic carcinoma and there were no false positive results in this series. The various cytologic appearances of different kinds of cellular components and cytologic features of the pancreatic carcinoma observed in the aspiration biopsy were presented and illustrated. The punctures and aspirations of these thirty-four biopsies did not reveal any immediate complication with one exception of exacerbation of pancreatitis. Percutaneous fine needle aspiration biopsy of the pancreas under the guidance of ERCP or angiography is a reliable diagnostic method for pancreatic carcinoma.
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PMID:Percutaneous fine needle aspiration biopsy of the pancreas. Cytodiagnosis of pancreatic carcinoma. 28 23

Serum RNase (RNase I; ribonuclease 3'-pyrimidino-oligonucleotidohydrolase, EC 3.1.4.22) activity (mean +/- SD) with polycytidine as substrate was determined in normal individuals (24.9 +/- 3.0 units/ml) and in patients with pancreatic cancer (37.3 +/- 14.8), pancreatitis (38.5 +/- 12.6), nonpancreatic diseases (48.7 +/- 14.8), or renal failure (175.8 +/- 92.8). Patients with pancreatic cancer could not be distinguished from those with pancreatitis or with nonpancreatic disease, although the RNase activities in all of these differed from the activity in normal individuals. The serum RNase activities of four patients with resectable "curable") pancreatic carcinoma and two others with advanced pancreatic cancer without obstructive jaundice were normal. After total pancreatectomy, serum RNase activity remained in the high-normal range. The data presented here and data in the literature show that serum RNase cannot be of primarily pancreatic origin. The present study also demonstrates that measurement of its activity is not useful in early detection of pancreatic cancer.
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PMID:Serum RNase in the diagnosis of pancreatic carcinoma. 28 51

Twenty patients with massive abdominal hemorrhage related to chronic pancreatitis, pancreatic neoplasms and arteriovenous malformations were studied angiographically. Abdominal hemorrhage drained most frequently into the gastrointestinal tract, but also flowed through cutaneous drain sites and fistulas, intraperitoneally, into pseudocysts and once into a large pancreatic tumor. The most common angiographic observation in pancreatitis was pseudoaneurysm formation. Both patients with arteriovenous malformation had dilated, racemose feeding arteries and early dense filling of the draining veins. Three patients had pancreatic carcinoma and documented bleeding from gastroesophageal varices related to portal or splenic vein occlusion by the tumor. Five patients were treated by vasopressin infusion, balloon tamponade, or therapeutic embolization.
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PMID:Angiography of massive hemorrhage secondary to pancreatic diseases. 30 42


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