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)

From January to May 1989, 50 patients with symptomatic gallstones were treated by means of extracorporeal piezoelectric lithotripsy combined with oral bile acid therapy. In 98% of all patients stone fragmentation was achieved. The mean number of treatment sessions per patients was 3.24. We observed as complications one gallbladder- and one liver hematoma each besides colicy pain and asymptomatic laboratory changes. Two patients developed mild pancreatitis and two a cholecystitis; three patients had symptomatic common bile duct stones during the follow-up. ERCP with endoscopic papillotomy was performed four times, one female patient had to undergo surgery due to an acute gallbladder. Three months after the first treatment, 18 patients (36%) were stonefree, six months later 54% (21/39). Patients with solitary stones up to 2 cm in size were in 71.5% stonefree respectively after three months. Thus, piezoelectric lithotripsy represents in our opinion a possible therapeutic modality for the treatment of symptomatic gall stones in selected patients.
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PMID:[Piezoelectric lithotripsy in the treatment of symptomatic gallstone patients]. 219 Dec 8

The management of 25 pregnant patients (gestational age 4-40 weeks) treated at Henry Ford Hospital from 1980-86 was reviewed. Eleven women were treated for a variety of nontraumatic general surgical emergencies including cholecystitis, appendicitis, pancreatitis, and gastrointestinal obstruction. Fourteen women were treated after sustaining traumatic injuries. Ten patients were managed without operation and 15 required surgical intervention as part of their treatment. Diagnostic studies that proved helpful included diagnostic peritoneal lavage, ultrasonography, intravenous pyelography, and roentgenograms of the chest and abdomen. There were no maternal deaths, but two fetal deaths occurred as a result of traumatic injuries. Five women and one neonate developed major complications requiring prolonged hospitalization. Early aggressive resuscitation and thorough diagnostic evaluation are required to achieve a favorable outcome in the management of the pregnant patient who presents with an emergent general surgical problem.
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PMID:Management of general surgical emergencies in pregnancy. 219 16

The increasing application of ultrasonography in biliary tract disease had led to more frequent recognition of an old disorder--"biliary sludge." Sludge is detected on ultrasound as low-amplitude echoes without acoustic shadowing. It layers in the most dependent part of the gallbladder and shifts with positioning. Particulate matter in bile, such as cholesterol monohydrate crystals, has been shown to be echogenic. Agglomeration of these crystals in biles with high mucus content accounts for the layering and the characteristic appearance of the movement of sludge with alteration in patient position. Within the gallbladder, the stability of the vesicular form of cholesterol and protein-lipid interactions are important determinants of cholesterol precipitation. In mixed and pigment gallstones, the equilibrium between ionized and unionized calcium and the hydrolysis of conjugated bilirubin are also important factors. Although the risk factors contributing to the formation of gallbladder sludge have not been critically examined, it is now known that in some instances sludge can produce biliary pain and can be associated with acalculous cholecystitis, recurrent pancreatitis and, ultimately, the formation of gallstones. A better appreciation of the pathogenesis of sludge formation can help in the understanding of the genesis of gallstones and also perhaps in understanding other documented but poorly understood biliary and pancreatic disorders.
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PMID:Pathogenesis of biliary sludge. 221 Jun 50

Findings of dynamic cholangiomanometry with the analysis of the tension curves are overviewed. This technique helped reveal different functional ailments of the bile papilla in major variants of the cholelithiasis course (acute obstructive++ cholecystitis, recurrent pancreatitis, and choledocholythiasis with obstructive jaundice). Parallel radioimmunoassay-based studies of a series of gastrointestinal polypeptides (insulin, glucagon, gastrin, vasoactive peptide, bombesin , and somatostatin) were conducted to determine the importance of these polypeptides in the pathogenesis of cholelithiasis complications. The levels of certain polypeptides were found to be related to the clinical manifestations of the disease. The complex assessment of the bile papilla function and gastrointestinal polypeptide concentrations offers a possibility for elaborating the pathogenetically relevant methods of therapy for this group of diseases.
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PMID:[Plasma levels of various gastrointestinal polypeptides in patients with cholelithiasis and different degree of functional disorders of the major duodenal papilla]. 227 84

43 patients with symptomatic gallbladder stones were treated by extracorporeal shockwave lithotripsy and oral bile acids. In all patients the stones were successfully fragmented during the first lithotripsy session. 33 patients underwent 2-4 treatment sessions. In 16 out of 43 patients the stones disappeared within 7.9 months. The rate of stone dissolution was dependent on the number and size of stones. 3 patients required surgery because of frequent colic in one case, cholecystitis in one case and lack of cooperation in one case. No important side effects were noted except mild pancreatitis 3 weeks after lithotripsy in one patient. Results at this center of extracorporeal shockwave lithotripsy combined with oral bile acids indicate that this treatment may become an alternative to cholecystectomy in patients with a small number (less than 3) of stones not exceeding 30 mm in diameter.
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PMID:[A year experience with extracorporeal shockwave lithotripsy of gallstones]. 233 88

Cholecystostomy for decompression and drainage of the biliary tree is indicated when the elderly, poor risk patient with destructive inflammatory process in the gallbladder is unable to tolerate a more extensive operation. Cholecystostomy is often criticized as an inferior operation, because it provides some palliation but leaves the patient with most problems unattended. To re-evaluate the role of cholecystostomy in the management of acute disease of the gallbladder, we reviewed our experience with it. During the years 1974 to 1987, 37 patients underwent a cholecystostomy. Patients ranged in age from 58 to 90 years, with an average age of 69 years. Twenty-eight patients had acute destructive cholecystitis, usually complicated by perforation, peritonitis or ascending cholangitis. Five had severe pancreatitis; three, cholelithiasis, and one patient, carcinoma of the bladder. Twenty-seven of the 37 patients had severe systemic disease and were critically ill. At the operation, calculi were extracted and the gallbladder and abscess were drained. Two patients died, yielding a mortality rate of 5.4 per cent. Tube cholangiography was done in 33 patients. Although residual stones were demonstrated in seven patients, the stones were removed electively at a later date under much more favorable conditions. None of the 35 survivors had symptoms of disease of the gallbladder during the follow-up period, which ranged from one to 12 years. Cholecystostomy is a curative operation indicated in critically ill and elderly patients for whom extensive operation is a prohibitive risk.
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PMID:Cholecystostomy as a definitive operation. 234 69

Primary bacterial peritonitis and catheter-associated infections compose the large majority of abdominal events in continuous ambulatory peritoneal dialysis (CAPD) patients. Yet occasionally primary pathology involving the abdominal viscera develops, and surgery is frequently considered. The early manifestations of intraabdominal inflammation or bleeding in patients undergoing CAPD depend on the pathological process, its access to the peritoneal cavity, and whether generalized bacterial peritonitis supervenes to obscure helpful physical findings. Clear dialysate is not a reliable sign that major pathology is absent, nor does initial stabilization of the clinical course with antibiotic therapy uniformly indicate that surgery will not be necessary. Polymicrobial peritonitis may develop in cholecystitis, pancreatitis, or from a colonic source, the latter featuring more bacterial species and more gram-negative and anaerobic organisms. A history directed at progression of symptoms and sites of abdominal discomfort and an examination for deep local tenderness and bowel incarcerated in an abdominal wall hernia are essential. Measurement of dialysate amylase and Gram stain of dialysate for food fibers may be helpful. Imaging techniques such as abdominal radiographs for dilated bowel or free subdiaphragmatic air, ultrasonography of the gallbladder or pancreas, computed tomographic (CT) scanning of the lower abdomen, and water-soluble contrast colonic studies may help identify the pathologic process. Special studies such as these should be considered early in the course of suspected unusual abdominal events in patients on CAPD.
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PMID:Abdominal catastrophes and other unusual events in continuous ambulatory peritoneal dialysis patients. 236 12

The mean serum amylase of 42 asymptomatic CAPD patients was elevated but was not significantly different from that of a group of chronic hemodialysis patients. Serum amylase levels in CAPD patients with peritonitis were not elevated with respect to asymptomatic patients. Amylase activity was not detectable in the peritoneal fluid of 38/42 asymptomatic patients and 6/13 peritonitis patients and was present at low levels in the other 11 patients. Patients with other abdominal conditions (pancreatitis, cholecystitis and small bowel perforation) had very marked elevations of serum and/or peritoneal fluid amylase which differentiated them from the asymptomatic and peritonitis patients. Although hyperamylasemia is common in asymptomatic CAPD patients and in those with peritonitis, measurement of serum and peritoneal fluid amylase levels is useful in the evaluation of CAPD patients presenting with abdominal symptoms.
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PMID:Serum and peritoneal fluid amylase levels in CAPD. Normal values and clinical usefulness. 244 7

A method to prepare cisplatin suspended in an oily lymphographic agent, Lipiodol (LPS), has been established to deliver cisplatin to hepatocellular carcinoma (HCC) by the hepatic artery. Seventy-one patients, one Stage I, 16 Stage II, 16 Stage III, and 38 Stage IV, were treated with LPS therapy. A partial response was obtained in 33 cases (46.5%), a minor response in 20 cases (28.2%), and no change in 18 cases (25.3%). In 34 patients whose serum alpha-fetoprotein (AFP) levels were greater than 400 ng/ml, the serum AFP levels decreased in 31 patients (91.2%). The AFP decreased by more than 50% in 25 cases (73.5%) and more than 75% in 19 cases (55.9%). The plasma des-gamma-carboxy prothrombin (DCP) levels decreased in all of the 26 DCP-positive patients. The survival rate was 77% at 6 months and the 1-year survival rate was estimated to be 55%. The patients treated with LPS therapy survived longer compared with patients given Lipiodol containing neocarzinostatin by the hepatic artery. Complications such as acute gastroduodenal mucosal lesions (24%), cholecystitis (2.8%), pancreatitis (7%), delayed jaundice (7%), and hepatic encephalopathy (4.2%) were observed after therapy. The peak plasma platinum (Pt) concentrations determined as ultrafilterable Pt occurred 5 to 20 minutes, and 5 to 60 minutes as total Pt after the end of LPS injection. The Pt concentrations in the tumor tissues were 42 times higher in four operated cases and 7.1 times higher in six autopsy cases than those in the nontumorous tissue. These results suggest that LPS selectively accumulates in the HCC, is long-lasting and gradually releases the drug. In addition it is effective as a new anti-cancer therapy for hepatocellular carcinoma.
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PMID:Hepatic arterial injection chemotherapy with cisplatin suspended in an oily lymphographic agent for hepatocellular carcinoma. 247 31

An increased incidence of gallbladder disease is seen in patients receiving long-term parenteral nutrition (PN). Stasis is thought to play a key role in the development of gallbladder sludge and gallstone formation. The highest incidence of gallbladder disease, by previous reports, is seen in patients with terminal ileal disease or resection. Since PN-dependent patients with severe short bowel syndrome secondary to mesenteric vascular accident have both gallbladder stasis and massive small bowel resection, a retrospective study was undertaken to evaluate the incidence of symptomatic gallbladder disease in this group. Of 11 patients followed over 9 years, five met the inclusion criteria of less than 60 cm of bowel remaining, receiving PN for longer than 6 months and the initial presence of a gallbladder. All five patients developed symptomatic gallbladder disease manifested by cholecystitis or pancreatitis. Factors contributing to gallbladder stasis included poor oral intake and use of anticholinergic and analgesic drugs. Gastric hypersecretion indirectly contributed to decreased oral intake as a means to minimize stool output. As these patients often require several laparotomies during the initial hospitalization, consideration should be given to performing prophylactic cholecystectomy, especially when the potential mortality and morbidity of emergent cholecystectomy done for symptomatic gallbladder disease is taken into account.
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PMID:Gallstone disease in patients with severe short bowel syndrome dependent on parenteral nutrition. 251 85


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