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

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

Visceral artery erosion is an uncommon but disasterous complication of pancreatitis. When gastrointestinal bleeding or severe intra-abdominal hemorrhage is associated with pancreatitis and the usual sources of bleeding are not detected by endoscopy or barium studies, erosion of a visceral vessel should be suspected. We present nine cases and an additional 44 cases from previous reports are reviewed. A palpable abdominal mass was present in 59% of the patients; however, a pseudocyst was present in 78%. Arteriography was performed in 15 patients and the source of bleeding was evident in 14. The splenic artery was the most common site of bleeding, although the other branches of the celiac axis and the middle colic artery have been involved. Successful treatment consisted of ligation of the bleeding vessel and, if present, drainage of the pseudocyst. Depending on the location of the vessel and the pseudocyst, major resections may be necessary. When bleeding and the pancreatic inflammatory process involved the colon, ligation of the bleeding site, drainage of the area, and colostomy was the most successful form of treatment.
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PMID:Visceral vessel erosion associated with pancreatitis. Case reports and a review of the literature. 31 Jun 67

Eighty-five of 186 patients investigated for suspected pancreatic cancer had an unequivocal final diagnosis of either pancreatic cancer (58 patients) or chronic pancreatitis (27 patients). They had been studied prospectively using ultrasonography, computerized tomography, radionuclide scanning, endoscopic retrograde cholangiopancreatography (ERCP), selective celiac and superior mesenteric angiography, duodenal drainage studies, cytologic studies, serum carcinoembryonic antigen assay, and pancreatic oncofetal antigen assay, The results were compared to determine which test would most frequently and reliably differentiate between pancreatic cancer and pancreatitis in a patient believed to have one or other disease. Criteria for interpreting results, first for highest rate of correct diagnoses, and second for highest accuracy were derived. Applying these criteria, ultrasonography achieved the highest rate of correct diagnoses (97% of patients diagnosed with 84% accuracy). ERCP, duodenal drainage studies, and cytology were the most accurate tests ((86% accuracy each test) but, with this accuracy, ERCP most frequently gave a diagnosis (diagnosis rate: ERCP--70%, duodenal drainage--32%, cytology--35%). The results suggest that ultrasonography is the best noninvasive test, and that a combination of ERCP, pancreatic juice assay and cytology in a single procedure may prove to be the best discriminating investigation.
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PMID:Non-operative differentiation between pancreatic cancer and chronic pancreatitis. 44 2

The vascular architecture of the pancreas has been described, but few reports indicate preoperative accuracy. During the last 3 years, selective superior mesenteric and celiac angiography was performed in 471 patients. In 35 of these patients, additional selective angiography of the superior pancreaticoduodenal and inferior pancreaticoduodenal arteries was performed to reveal the detailed vascular pattern of the pancreas and its surrounding structures. Exploratory surgery was performed in all patients except the four control subjects. The angiographic findings reflected a poorly vascularized infiltrating lesion with invasion of the blood vessels and serpiginous encasements. Peripancreatic extension of the tumor indicated nonresectability. In early pancreatitis, the pancreas showed increased vascularity and occasional stretched vessels. In more advanced pancreatitis, the arteries were prominent and irregular with increased parenchymal accumulation of contrast medium in the capillary phase. In pseudocysts of the pancreas, the only finding was stretching of the vessels around the lesion. A well circumscribed lesion with increased contrast medium in the capillary and venous phases diagnostic of pancreatic adenoma. Pancreatic angiography is an important diagnostic tool in evaluating and staging pancreatic neoplasms.
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PMID:Role of angiography in the diagnosis of pancreatic neoplasms. 49 55

The authors' experience with antienzymic treatment of 214 patients having acute pancreatitis is summarized. A method for calculating a dose of antienzymic substances by general activity of trypsin in blood and peritoneal exudate is suggested. By means of radioindication it was found that the maximum accumulation of the inhibitors in the pancreatic gland was dependent on the methods of their injection. It has been shown that the basic therapeutic effect of the inhibitors is to inactivate proteolytic enzymes. The injection of the inhibitors, depending on the form of pancreatitis, intravenously, intraperitoneally and in the celiac artery would eliminate enzymic toxemia in early stages of the disease, prevent the transition of edematous acute pancreatitis into hemorrhagic or necrotic one and avert autolysis of the pancreas.
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PMID:[Modern principles in the inhibitor therapy of acute pancreatitis]. 60 39

A case of congenital duodenal stenosis is reported complicated by recurrent pancreatitis. The diagnosis was not initially entertained because of the pancreatitis. The radiographic appearance on gastrointestinal series was unusual for pancreatitis. The finding of an anomalous celiac axis on arteriography suggested the possibility of other congenital anomalies. The diagnosis of congenital duodenal stenosis was confirmed at laparotomy. The obstruction was relieved with a duodenojejunostomy. Two year follow-up reveals the patient to be asymptomatic without recurrence of pancreatitis. This is the first endoscopic report of this lesion and the presence of the duodenal cervix sign should suggest the diagnosis of congenital duodenal stenosis.
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PMID:Congenital duodenal stenosis. The duodenal cervix sign. 66 52

Report on three clinical examples of the interrelation between chronic recurrent pancreatitits and external compression which cause a stenosis of the celiac artery. If clarification of the etiology of recurrent pancreatitis with the usual examinations is impossible, angiography is very important. A causal therapy is only possible by means of surgical treatment of the stenosis.
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PMID:[Stenosis of the celiac artery as cause of chronic recurrent pancreatitis (author's transl)]. 91 59

Of 21 patients with cirrhosis of the liver 9 had collateral arterial flow to the liver from the superior mesenteric artery. The degree of collateral arterial flow in cirrhosis was related to the presence of centrifugal portal flow, the degree of bilirubinemia and the presence of a markedly enlarged spleen with increased splenic blood flow. Of 27 non-cirrhotic 6 had collateral arterial flow to the liver from the superior mesenteric artery. The greatest degree of collateral arterial flow was associated with celiac stenosis in 4/6 patients. One patient had pancreatitis and an explanation was not evident in one patient.
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PMID:The arterial blood supply to the liver in cirrhosis. 105 62

Five patients with cystadenoma of the pancreas were seen during a period of 22 years at this institute. This rare benign tumor occurred predominantly in middle age women, with the presenting symptoms of pain and an epigastric mass, but without a history suggestive of pancreatitis or abdominal trauma. Selective celiac and superior mesenteric antiography is helpful in establishing the diagnosis. If this cystic tumor is not recognized and adequately treated, the surgeon may miss the opportunity for cure. Cystadenoma should be suspected when a cystic mass arising from the body or tail of the pancreas is encountered without evidence of metastases. Although surgical extirpation is the preferable treatment, undue risks should not be undertaken because of the slow growth rate of this benign tumor. Due to the known association of this tumor with other malignant lesions, diabetes mellitus as well as multicystic tumors of the liver and kidneys, these patients should be thoroughtly investigated.
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PMID:Cystadenoma of the pancreas. 112 84

Percutaneous transhepatic cholangiography (PTC) was performed on a 23-year-old male because of an atypical progression of hepatitis B antigen-negative hepatitis. No bile duct was entered and the procedure was uneventful. However, celiac angiography the day following PTC revealed abnormal liver vessels in the target area and the patient developed hemobilia and clinical pancreatitis, causing common bile duct obstruction. Symptomatology persisted until celiotomy 32 days after PTC. Clots were found obstructing the bile duct. This case is presented both because of the unusual complications of PTC and the unusual angiographic abnormalities. It is suggested that when there is a specific indication for the procedure either to differentiate cholestatic jaundice from extrahepatic jaundice or to localize a site of abstruction before surgical intervention.
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PMID:Hemobilia and pancreatitis as complication of a percutaneous transhepatic cholangiogram. 114 93


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