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

Plasma concentrations of bilirubin, alkaline phosphatase (AP), and glutamic oxaloacetic transaminase (GOT) were measured during 122 attacks of acute pancreatitis in 114 patients, on the day of admission to hospital and 2 days after admission. Concentrations in 74 attacks associated with gallstones were compared with concentrations in 31 attacks in which no stones were found. 24 attacks were severe by clinical criteria. On the day of admission plasma GOT concentrations of more than 60 IU/l were found in 88% of attacks associated with gallstones, but in no attacks without gallstones. Plasma concentrations of more than 25 mumol/l bilirubin and more than 14 King-Armstrong units AP were found in 62% and 66% respectively, of attacks associated with gallstones, and 5% and 10%, respectively, of attacks without stones. In attacks associated with gallstones plasma concentrations of GOT and bilirubin usually fell over the first 48 h of admission. No correlation was observed between these biochemical values and the severity of the attack. In the absence of a history of excessive alcohol consumption, increases in plasma GOT on the day of admission to hospital suggest that gallstones are responsible for the pancreatitis.
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PMID:Biochemical prediction of gallstones early in an attack of acute pancreatitis. 8 54

Acute pancreatitis of biliary tract origin and that of alcoholic origin may be difficult to separate on clinical grounds alone. Such separation is important since operation prevents recurrent attacks in gallstone pancreatitis. We examined the records of 78 patients in the first attack of pancreatitis from gallstones or alcohol. The gallstone group were usually women, older, and had a shorter period of abdominal pain. Pancreatic complications occurred more frequently in the alcoholic group and led to two deaths. Amylase values were diagnostically helpful in that a level greater than 1000 units in patients of the proper age and sex, and a level greater than 2000 units by itself indicated gallstone pancreatitis.
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PMID:The first attack of acute pancreatitis: a clinical study. 9 8

In a prospective study of 70 patients with duodenal diverticula and calculous biliary tract disease, bacteriocholia with typical intestinal bacteria was found in 69%, whereas in cholelithiasis without duodenal diverticula this complication was present in 30% of the cases. With growing distance between duodenal diverticula and the papilla of Vater the rate of bacteriocholia decreases. Rising age of patients results in augmentation of bacteriocholia. Bacteriocholia on the basis of duodenal diverticula seems to present an additional pathogenetic factor for inflammatory biliary tract disease in 69% and for pancreatitis in 20% of the cases. Consequently the pathologic value of diverticulas close to the papilla of Vater is more prominent than reported so far.
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PMID:[Bacteriological findings in patients with cholelithiasis and duodenal diverticuli]. 11 89

A systematic prospective endoscopic study of the incidence of juxtapapillary diverticula in a variety of digestive disorders was undertaken in the Surgical Clinic at the Provincial Hospital, Port Elizabeth. The findings were related to conditions commonly encountered. The following frequency distribution was found: 33 diverticula out of 164 patients associated with gallstones (20.1%); 15 out of 668 patients not associated with gallstones (2.2%); 1 out of 39 patients with pancreatitis (2.6%); and 3 out of 146 patients with gastric ulcer (2.1%). No diverticulum was noted in 111 patients with duodenal ulcer. These findings suggest that juxtapapillary diverticula are nearly 10 times more common in patients with gallstones than in patients without. There is evidence to suggest that these diverticula tend to precede the gallstones. It is conceivable that juxtapapillary diverticula may predispose to gallstones. Alternatively, both conditions may be manifestations of another underlying disorder as yet to be defined.
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PMID:The relationship between juxtapapillary diverticula and biliary calculi. An endoscopic study. 11 84

Activities of organelle specific enzymes (succinate dehydrogenase, glucose-6-phosphatase, acidic DNAase, acidic RNAase, acidic and alkaline phosphatases) were measured in homogenates and subcellular fractions of liver tissue of patients with cholelithic disease. Liver tissue samples analyzed were investigated also by light and electron microscopy. The data obtained were considered in connection with localization of cholelith in biliary system, type of inflammation, presence of subhepatic cholestasis and of accompanying syndrome of pancreatitis. Typical alterations were observed in the activity of organelle specific enzymes and in the ultrastructure of mitochindria, lysosomes and endoplasmic reticulum in cholelithic disease. The most distinct alterations in the enzymatic activities were found in choledocholithiasis as well as in subhepatic jaundice.
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PMID:[Changes in organelle-specific enzyme activity and the ultrastructure of liver cells in cholelithiasis]. 19 99

The authors report a series of 30 cases of acute pancreatitis associated with cholelithiasis. There were 9 cases of necrotizing pancreatitis and the latter group included the 4 deaths observed in this series. Clinical, radiological and laboratory data were in favor of this association in 24 out of the 30 cases. Cholelithiasis appeared to be directly responsible for initiating the pancreatitis in 1/3 of cases. In another 1/3 of cases the mecanism was thought to be related to scarring of the sphincter of Oddi. In the remaining 1/3 of cases no direct relationship could be found. On the basis of these findings, the authors recommend that emergency surgery be reserved for these cases in which cholelithiasis appears to be the etiology. (The biliary syndrome overshadowing the pancreatic syndrome) and to postpone treatment of pancreatic lesions. In all other cases, the authors suggest to keep elective surgery, for after a period of initial conservative treatment with the hope of then treating together biliary and pancreatic lesions.
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PMID:[Acute pancreatitis and cholelithiasis. A study of thirty cases (author's transl)]. 23 83

Fine-needle cholangiography (FNC) in the jaundiced patient is well established, but its role in the diagnostic work-up of nonjaundiced patients has not been emphasized. We present 44 consecutive nonjaundiced patients with a serum bilirubin level of 2.4 mg% of less who underwent FNC. The indications were recurrent RUQ pain (77%), painless cholestasis (16%), and relapsing pancreatitis (7%). In all but two patients, one or more inconclusive techniques [oral cholecystography, ultrasonography, intravenous cholangiography, or endoscopic retrograde cholangiography (ERC)] had been employed prior to FNC. Biliary tract opacification was successful in 35 of 44 (80%). In nine of 35 (26%) choledocholithiasis and/or cholelithiasis was present. In four (11%) a significant extrahepatic biliary stricture was noted. More than five needle insertions were often required for successful entry. No complications occurred. Indications for FNC should be extended to include nonjaundiced patients with RUQ pain or painless cholestasis in whom oral cholecystography, ultrasonography, and intravenous cholangiography have been of no diagnostic help. The relative ease and low cost of FNC make it preferable to ERC in these patients.
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PMID:Fine-needle cholangiography (FNC) in the nonjaundiced patient. 26 37

Pancreatitis is a rare disease under the age of 15 years, and expecially so when associated with gallstones. A case is reported here of a young girl who had acute pancreatitis and was subsequently found to have gallstones. She made an uneventful recovery and remains symptom-free after cholecystectomy.
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PMID:Acute pancreatitis associated with gallstones in a twelve-year-old girl. 26 21

The group of conditions variously termed biliary dyskinesia, acalculous cholecystitis, biliary pain without stones, or functional disorders of the biliary tract, is poorly defined clinically, and no consistent pathological abnormalities have been previously described in patients with this diagnosis. In this paper we report histological abnormalities encountered in operative live biopsies in such patients. The criteria for the diagnosis of a functional biliary tract disorders were: pain typical of biliary pain, negative results of investigations for organic biliary tract or other gastrointestinal disease, and reproduction of the patient's symptoms by cholecystokinin, or morphine, or both. Twenty of 45 patients with a presumptive diagnosis satisfied these criteria, and had a wedge liver biopsy at the time of operation. The 20 liver biopsy specimens were compared in a blind fashion with similar ones taken from patients having diagnostic laparotomies; patients with stones confined to the gallbladder; patients with gallstone pancreatitis; and patients with proven common bile duct stones. The biopsy findings were found to be similar to those in the latter two groups. Thus the abnormalities were similar to those found in partial or intermittent biliary obstruction, and it is suggested that they may be due to intermittent increases in biliary pressure.
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PMID:Operative liver biopsy abnormalities in patients with functional disorders of the biliary tract. 28 96

Within the last years 70 transduodenal sphincterotomies at stringent indication have been carried out at the Department of Surgery of the RWTH Aachen. This means 9.2% of all operations caused by cholelithiasis. The lethality was 4.2%. The following postoperative complications where stated: a) the bleeding from the divided duct of sphincter with or without haemobile (1.4%), b) the post-sphincterotomy pancreatitis (9.5%) owing to lesion of the pancreatic duct, c) the retroperitoneal abscess with biliary peritonitis (1.8%), d) insufficiency of the duodenal wall or duodenal fistula (1.9%), e) postoperative disturbances of passage of the transsected sphincter Oddi. The haemorrhagic necrosing pancreatitis, the insufficiency of the duodenal wall, the retroperitoneal abscess and the bleeding postsphincterotomy force us to immediate re-operation, while functional disturbances like a spasm or an oedema are controllable pharmacologically and functionally for a short time.
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PMID:Lesions after sphincterotomy. 30 46


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