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

The epidemiological patterns for pancreatic and biliary cancers reveal more differences than similarities. Pancreatic carcinoma is common in western countries, although 2 Polynesian groups (New Zealand Maoris and native Hawaiians) have the highest rates internationally. In the United States the disease is rising in frequency, predominating in males and in blacks. The rates are elevated in urban areas, but geographic analysis uncovered no clustering of contiguous counties except in southern Louisiana. The origin of pancreatic cancer is obsure, but a twofold increased risk has been documented for cigarette smokers and diabetic patients. Alcohol, occupational agents, and dietary fat have been suspected, but not proven to be risk factors. Except for the rare hereditary form of pancreatitis, there are few clues to genetic predisposition. In contrast, the reported incidence of biliary tract cancer is highest in Latin American populations and American Indians. The tumor predominates in females around the world, except for Chinese and Japanese who show a male excess. In the United States the rates are higher in whites than blacks, and clusters of high-risk counties have been found in the north central region, the southwest, and Appalachia. The distribution of biliary tumors parallels that of cholesterol gallstones, the major risk factor for biliary cancer. Insights into biliary carcinogenesis depend upon clarification of lithogenic influences, such as pregnancy, obesity, and hyperlipoproteinemia, exogenous estrogens, familial tendencies, and ethnic-geographic factors that may reflect dietary habits. Noncalculous risk factors for biliary cancer include ulcerative colitis, clonorchiasis, Gardner's syndrome, and probably certain industrial exposures. Within the biliary tract, tumors of the gallbladder and bile duct show epidemiological distinctions. In contrast to gallbladder cancer, bile duct neoplasms predominate in males; they are less often associated with stones and more often with other risk factors. In some respects, bile duct and pancreatic tumors are alike. The male predominance of both tumors, an association between cholecystectomy and pancreatic cancer, and other considerations have prompted the notion that the same biliary carcinogens may affect the bile duct, ampulla of Vater, or, by reflux, the pancreatic duct. Various epidemiological and interdisciplinary approaches are needed to further clarify the origins of biliary tract and pancreatic cancers, but nutritional studies hold special promise in laying the groundwork for prevention of these tumors.
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PMID:Cancers of the pancreas and biliary tract: epidemiological considerations. 110 53

Three patients with pancreatic clonorchiasis were examined with endoscopic retrograde pancreatography. On each of the three cases there was diffuse irregular dilatation of tributaries of the pancreatic duct in the pancreatic tail. The main pancreatic duct and tributaries draining into the body and head portion were not dilated. A sonogram from one patient showed diffuse enlargement of the pancreas, especially the tail. All three patients showed typical cholangiographic findings of hepatic clonorchiasis, namely diffuse peripheral intrahepatic bile duct dilatation with no or minimal dilatation of the extrahepatic duct. When the tributaries of the pancreatic duct in the tail of the pancreas are diffusely dilated, in the appropriate clinical setting, pancreatitis caused by Clonorchis sinensis should be considered.
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PMID:Clonorchiasis of the pancreas. 218 70

To assess the usefulness of endoscopic retrograde cholangiography (ERCP) in the study of acute pancreatitis, 101 of a possible 114 patients (89 per cent) with acute pancreatitis underwent ERCP after recovery from acute illness. In 81 per cent, ERCP was performed within two weeks of recovery. The biliary tract was successfully demonstrated in 87 per cent of the patients and the pancreatic duct in 73 per cent. Roentgenograms of the biliary tract showed stones in the gallbladder in 40 per cent of the patients and in 36 per cent in the biliary ducts. In addition, the gallbladder was not visualized in nine patients. In eight of those patients, the gallbladder was subsequently shown to be abnormal. Other findings of the biliary system included one patient each with clonorchiasis, ascariasis and malignant disease. Changes in the pancreatic duct were detected in 11 per cent of the patients. Most of the changes were consistent with acute or chronic pancreatitis. Minimal morbidity was encountered. ERCP is very accurate in identifying the biliary causes of pancreatitis. In areas where a significant proportion of acute pancreatitis has biliary causes, it should be performed upon all patients soon after resolution of the acute illness to identify those patients who will benefit from early operation upon the biliary tract.
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PMID:Endoscopic retrograde cholangiopancreatography after acute pancreatitis. 376 40

The existence of clonorchiasis cases among the Asian immigrants and the major clinical and pathologic features encountered in those patients is emphasized. Owing to the longevity of the parasite, clinical symptoms may occur long after endemic exposure. The common manifestations among the immigrants are recurrent pyogenic cholangitis and pancreatitis. The relationship between clonorchiasis and cholangiocarcinoma and the possible pathogenesis of this tumor are discussed. The specific immunologic phenomenon in clonorchiasis is described.
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PMID:Pathology and immunology of Clonorchis sinensis infection of the liver. 632 70

Family physicians in the United States are increasingly called on to manage the complex clinical problems of newly arrived immigrants and refugees. Case studies and discussions are provided in this article to update physicians on the diagnosis and management of potentially unfamiliar ailments, including strongyloidiasis, hookworm infection, cysticercosis, clonorchiasis and tropical pancreatitis. Albendazole and ivermectin, two important drugs in the treatment of some worm infections, are now available in the United States.
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PMID:Case studies in international medicine. 1059 16

Endoscopic retrograde cholangiopancreatography (ERCP) has evolved from a largely diagnostic to a largely therapeutic modality. Cross-sectional imaging, such as computed tomography (CT) and magnetic resonance imaging (MRI), and less invasive endoscopy, especially endoscopic ultrasound (EUS), have largely taken over from ERCP for diagnosis. However, ERCP remains the "first line" therapeutic tool in the management of mechanical causes of acute recurrent pancreatitis, including bile duct stones (choledocholithiasis), ampullary masses (benign and malignant), congenital variants of biliary and pancreatic anatomy (e.g. pancreas divisum, choledochoceles), sphincter of Oddi dysfunction (SOD), pancreatic stones and strictures, and parasitic disorders involving the biliary tree and/or pancreatic duct (e.g Ascariasis, Clonorchiasis).
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PMID:Endoscopic therapy in acute recurrent pancreatitis. 1828 84