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

This study characterizes a syndrome of partial common bile duct obstruction and marked elevation in serum alkaline phosphatase in 6 male alcoholic patients with calcific pancreatitis. In each patient, a marked elevation in serum alkaline phosphatase was associated with minimal, if any, elevation in serum bilirubin. In all cases, the alkaline phosphatase was hepatic in origin, and intravenous or operative cholangiography showed a dilated common bile duct. Liver biopsy showed canalicular bile stasis in 4 patients and bile duct proliferation in 2 patients. This study demonstrates that calcific pancreatitis may cause partial bile duct obstruction which differentially increases serum alkaline phosphatase without altering bilirubin or bromsulphthalein excretion.
 ...
PMID:Marked alkaline phosphatase elevation with partial common bile duct obstruction due to calcific pancreatitis. 124 86

In patients suspected of having functional disorders of the papilla it is often difficult to establish the indications whether or not to perform endoscopic papillotomy (EP). We report on thirty-two consecutive patients referred for endoscopic retrograde cholangiopancreatography who all had longstanding biliary tract pain and episodes of liver enzyme elevation indicating cholestasis. Further features were: 1) a dilated common bile duct (CBD) after cholecystectomy (n = 11) or 2) a dilated CBD without or with larger (greater than cystic duct diameter) gallbladder stones (n = 6) or 3) multiple small gallbladder stones, with a normal or dilated CBD, in patients with signs of acute gallstone pancreatitis or in whom elective cholecystectomy was not indicated (n = 15). No CBD stones, organic obstruction or other disorders were found in these patients. Without further diagnostic procedures, EP was routinely performed. The laboratory (up to 3 months) and clinical findings (2 to 4 years follow up) showed improvement in all patients undergoing EP. We conclude that immediate EP appears justified in these selected patients.
 ...
PMID:Endoscopic papillotomy in biliary tract pain and fluctuating cholestasis with common bile duct dilatation and small gallbladder stones. 137 52

The purpose of this prospective study was to investigate the complication rate of endoscopic retrograde cholangiopancreatography (ERCP) in the management of jaundiced and unjaundiced patients with laboratory findings suggesting cholestasis. ERCP was performed in 144 jaundiced patients and in 27 patients with unjaundiced cholestasis (age range 18-89 years, mean 66 years). Endoscopic papillotomy was performed in 45 patients, three for spasm of the sphincter of Oddi and the rest for choledochal stones. Seven bile duct prostheses were inserted endoscopically, all for treatment of malignant obstruction. The complications of ERCP were as follows: four cases of pancreatitis (2.3%), five cases of cholangitis (2.9%), two cases of bleeding (1.2%) and two perforations (1.2%). The overall complication rate was thus 7.6% (13/171) and there was no primary mortality. ERCP seems to be a safe and effective method in the diagnostic study and management of bile duct obstruction even in the elderly patients with jaundice or unjaundiced cholestasis.
 ...
PMID:Complications of endoscopic retrograde cholangiopancreatography in jaundiced and cholestatic patients. 162 48

It is well known that Crohn's disease can involve the duodenum, but isolated secondary complications such as pancreatitis or common bile duct obstruction have only rarely been reported, and never in the same patient. Herein, we describe a patient with duodenal Crohn's disease and both pancreatitis and calculous common bile obstruction. This unusual constellation of findings was managed with percutaneous techniques in which transhepatic catheterization of the bile duct permitted balloon dilatation of the ampulla of Vater, as well as a duodenal stricture. These maneuvers resulted in passage of the biliary stone and relief of the patient's symptoms. The management of this patient may serve as a guide possibly to delay or even prevent surgical intervention in similar cases of benign enteric strictures.
 ...
PMID:Crohn's disease of the duodenum complicated by pancreatitis and common bile duct obstruction. 164 5

The clinical, biochemical and radiological data of 25 patients with carcinoma of the head of the pancreas were compared with the same parameters of 25 patients with chronic pancreatitis producing cholestasis. History of alcohol abuse, pruritus and palpable gallbladder were the only clinical findings useful for the differential diagnosis. Plasma bilirubin levels were significantly higher in patients with malignancy (20.0 +/- 14.3 vs 2.5 +/- 2.4) but the course of the bilirubinemia was similar in the two groups after hospital admission. Preoperative ultrasound and cholangiography were usefull in differentiating both groups of patients. Sensibility of a point score based on significant differences was 100% for pancreatitis and 96% for malignancy.
 ...
PMID:[Differential diagnosis of cholestasis in pancreatic cancer and chronic pancreatitis]. 166 25

Shock-wave-induced soft-tissue damage after biliary extracorporeal shock-wave lithotripsy (BESWL) has been reported. Every patient treated in Vancouver has, therefore, had liver function tests and serum amylase levels measured before and within 6 days after BESWL. All patients had symptomatic cholecystolithiasis with normal pre-BESWL biochemistry. Analysis of 311 patients after treatment with the Siemens Lithostar unit showed elevation of one or more laboratory value in 19% (60/311). Serum aspartate transaminase level was most frequently abnormal (38 cases). The majority of abnormalities were mild, less than two times normal levels. Clinically significant complications occurred in five patients (three pancreatitis, one cholecystitis, one common bile duct obstruction); four of these occurred 1 week or more after treatment. The results of routine laboratory tests could not be used to predict complications. No correlation was seen between abnormal values and number of shock waves administered or peak shock-wave pressure. Of 112 patients surveyed at the time of post-BESWL enzyme measurement, 49 (44%) reported a degree of pain, which was severe in eight cases. Presence of severe pain correlated strongly (p less than .001) with abnormal laboratory findings, however not with the degree of abnormality. As results of these laboratory tests are nonspecific, have not been shown to correlate with the degree of severity of BESWL-induced tissue damage, and do not predict complications, the tests are of little value in the absence of clinical signs and symptoms. These conclusions, however, apply only to the Siemens Lithostar Plus with patients treated in the steep left posterior oblique position. Cost savings can be expected if routine post-BESWL biochemical tests are abandoned.
 ...
PMID:Routine liver function tests and serum amylase determinations after biliary lithotripsy: are they necessary? 169 18

Groove pancreatitis is a rare form of chronic pancreatitis. Distinction between pancreatitis and pancreatic carcinoma is often difficult. Two cases of groove pancreatitis diagnosed by endosonography are described. A hypoechoic pattern between the duodenal wall and pancreas was clearly imaged in both patients. Narrowing of the second part of the duodenum and evidence of bile duct obstruction were also found. The endosonographic diagnosis was confirmed either by surgery or follow-up examination.
 ...
PMID:Endosonography of groove pancreatitis. 174 34

The pathologic changes associated with human cryptosporidiosis have not been well characterized. In this report, 15 cases of cryptosporidiosis in acquired immunodeficiency syndrome patients are described. Organisms were found in autopsy tissue specimens in 13 cases, and only in antemortem stool samples in two. Gastrointestinal/hepatobiliary distribution of organisms was as follows: small intestine (13 cases), extrahepatic bile ducts (eight), intrahepatic bile ducts (seven), large intestine (six), pancreas (five), stomach (three), and esophagus (one). At all sites, infection was usually associated with nonspecific reactive epithelial changes, architectural abnormalities such as villous flattening in the small intestine, and interstitial edema with mixed inflammatory cell infiltrates. Presence of organisms and associated mucosal injury were patchy and of variable severity in the intestine. In the biliary tract, injury was commonly diffuse and severe. Pancreatic duct injury was generally mild and often limited to hyperplastic squamous metaplasia. In late-stage acquired immunodeficiency syndrome patients with cryptosporidiosis, widespread infection in the gastrointestinal and biliary systems by this coccidian was more common and severe than previously suggested. Although the mechanisms have yet to be determined, infection usually is accompanied by pathologic changes that may be causally related to pathophysiologic abnormalities, such as diarrhea and malabsorption, and may account for other clinical manifestations of pancreatitis, cholangitis, and obstructive cholestasis.
 ...
PMID:Cryptosporidiosis in the acquired immunodeficiency syndrome: a study of 15 autopsy cases. 174 28

Over the period of two weeks a 19-year-old man developed gradually increasing painless jaundice with dark urine and light-coloured soft stools (6-7 times daily), as well as loss of appetite, nausea and nagging itch. Biochemical tests indicated marked cholestasis (alkaline phosphatase 800 U/l, gamma-GT 206 U/l). Abdominal ultrasound examination revealed high-grade stenosis of the distal choledochal duct caused by an enlargement of the head of the pancreas and computed tomography confirmed a tumour in this location. Endoscopic retrograde cholangiopancreatography demonstrated filiform stenosis of the major pancreatic duct and prepapillary stenosis of the choledochal duct. Several needle biopsies failed to establish a definitive diagnosis. A Whipple operation was performed: the stomach was preserved but about 40% of pancreatic tissue resected. Histologically there was chronic suppurative pancreatitis of the head of the pancreas. The patient was symptom-free 6 months after the operation. The case illustrates that it is not always possible in a painless pancreatic tumour to distinguish between pancreatitis and malignant tumour.
 ...
PMID:[Chronic purulent, draining, indolent pancreatic head pancreatitis with extrahepatic cholestasis]. 193 34

Extracorporeal shock wave lithotripsy (ESWL) has been reported to be a safe and relatively effective non-invasive treatment for radiolucent gallbladder calculi in selected patients. Ideally, the goal of successful treatment is the passage of all fragments from the gallbladder into the intestinal tract. Biliary colic has been reported in up to 35% of treated patients, although complications such as cholecystitis, cholangitis, common bile duct obstruction, and pancreatitis are surprisingly infrequent. Cholescintigraphy is the procedure of choice in patients with biliary colic and suspected acute cholecystitis. It has proven to be more sensitive than ultrasound in detecting acute common bile duct (CBD) obstruction, since functional obstruction precedes morphologic dilatation of the CBD. This report reviews two cases of post-lithotripsy cystic and common duct obstruction and discusses the role of Tc-DISIDA scintigraphy following gallstone ESWL.
 ...
PMID:Biliary complications of gallstone lithotripsy detected by Tc-99m DISIDA scintigraphy. 203 26


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>