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

Patients with chronic renal failure and total diversion of the lower urinary tract have been considered poor transplant candidates, and post-transplant urinary diversion, i.e., Bricker loop, has been thought to be necessary. Our experience with nine patients clearly indicates that these patients are actually excellent transplant candidates and that post-transplant urinary diversion rarely is necessary. Ureteroneocystostomy of the allografted ureter was performed in seven patients with pretransplant total urinary diversion and all have completely normal bladder and renal function 10 to 66 months after transplantation; the two patients with Bricker loop procedures performed at transplantation died 7 months after transplantation of rejection and pancreatitis. The excellent results achieved with ureteroneocystostomy are attributed to (1) errors in diagnosis resulting in inappropriate bladder or ureteric surgery early in the course of the patient's disease; (2) confusion of immunologic of functional disorders with anatomic problems; (3) growth and development of the bladder, and (4) complete control of chronic bladder infection by pretransplant nephrectomy, ureterectomy, and antibiotics.
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PMID:Renal transplantation in patients with urinary tract abnormalities. 76 10

A total of 25 patients with metastatic renal cancer were treated on a phase II protocol with 5 days of continuous-infusion fluorodeoxyuridine (FUDR), (0.1 mg/kg daily) together with high-dose oral leucovorin (100 mg 4 h) and daily x6 high-dose interferon-alpha 2b (30 x 10(6) IU/m2). Despite the good performance status of the patients and the inclusion of 14 previously untreated patients in the cohort, no response was observed among the 20 evaluable patients. Toxicities included high fever, moderate anemia, transient leukopenia, transient and mild elevations of transaminases, and moderate to severe nausea, vomiting, diarrhea, and mucositis. There were also two episodes each of confusion, fluid retention, and pancreatitis and one episode of increased creatinine levels. During the study three deaths occurred, two of which were possibly therapy-related. Despite previous reports of activity of FUDR in metastatic renal cancer, the present regimen cannot be recommended.
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PMID:Continuous-infusion fluorodeoxyuridine with leucovorin and high-dose interferon: a phase II study in metastatic renal-cell cancer. 146 58

During studying the literature a big confusion around the item abscess can be recognized. Especially in the English publications it is used for sterile tissue necrosis, infected necrosis, infected pseudocyst or suppuration. Pancreas phlegmon means there a sterile mass of pancreas and peripancreatic oedema. With us an abscess still is a located plus collection surrounded by a more or less tight capsule and a phlegmon is a diffuse purulent infection in the tissue. This definition is important because the frequency and prognosis of a true abscess is far below an infected necrosis (with us 4 abscess in 48 necrotising pancreatitis but 54% infected necrosis). Abscess formation needs two to four weeks whereas pseudocyst develops rather fast in one to two weeks. Although spontaneous resorption of pseudocyst is possible, we recognized ten and operated on all of them either by internal drainage or by resection of the tail of the pancreas. Mortality of one series of 124 patients with acute pancreatitis was at 30 days 4% and 27%, respectively, when necrosis was present and overall mortality having treated all patients to final discharge was 5% and 44%, respectively. Mortality rate was constant in the last years but Ranson score was continuously increasing.
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PMID:[Abscesses and pseudocysts as a sequela of acute pancreatitis]. 152 48

Laparoscopic laser cholecystectomy is becoming increasingly popular in the surgical community for the treatment of gallbladder disease. Physicians will need to familiarize themselves with the imaging consequences of this new therapy. Described below is a case report of a woman in whom calculi were incidentally found within the pelvis on a plain radiograph of the abdomen after she presented to the hospital with pancreatitis. Initial confusion regarding the etiology of these calculi was solved after it was discovered that the patient had proven gallstones and a recent laparoscopic procedure. In the appropriate clinical setting, gallstones should be added to the differential consideration of intrapelvic calcifications.
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PMID:Intrapelvic calculi demonstrated in a patient after laparoscopic laser cholecystectomy: a case report. 153 50

Subcutaneous fat necrosis is a well described, rare sequela of acute pancreatitis. Uncommonly, arthritis is seen in association with these 2 disease processes. We report a case of fulminant pancreatitis presenting as an acute arthritis. Birefringent crystal-like structures led to initial diagnostic confusion with gout.
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PMID:Subcutaneous pancreatic fat necrosis associated with acute arthritis. 159 88

The laboratory determination of serum and urine amylase activity is commonly requested by the Emergency physician. While depressed levels are occasionally seen, they are almost always secondary to chronic pancreatitis and pancreatic destruction. The typical abnormality is an elevation that may represent a normal physiologic process, a benign inflammation, the concomitance of ongoing disease, or an emergent problem. The differential diagnosis of hyperamylasemia is difficult, but most high levels are caused by pancreatitis and biliary tract disease. Serial determinations of amylase levels, as well as simultaneous assessments of urine and serum amylase, may be useful in determining the source of the problem. The laboratory methods for measurement are many and varied, reflecting the lack of a perfect test. Because of the different procedures, confusion has ensued over the units of description and the normal or reference ranges. Any standard equipped medical laboratory should be able to determine amylase activity in both serum and urine in a timely fashion. The average cost per amylase determination is $17.75. The actual time to perform the test in the laboratory is approximately 7.5 minutes, though turnaround times usually exceed 1 hour. The fractionation of amylase into isoenzymes is a sophisticated procedure requiring equipment not routinely found in a typical hospital laboratory.
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PMID:Amylase. 242 11

Macroamylasemia is a condition characterized by a serum amylase activity increase due to complex macromolecules whose large size prevents its urinary excretion. It cannot be consistently correlated with any particular disease state, and should be regarded as a benign chemical derangement. The major clinical importance of macroamylasemia is the confusion of this condition with other causes of hyperamylasemia and its prevalence in the population, comprised between 1 and 2%. Macroamylasemia should be considered in any patient with elevated levels of serum amylase activity whose serum lipase and urine amylase levels are normal, in the face of unimpaired renal function. Confirmation rests on the demonstration of a macromolecular amylase component in the serum by means of chromatography, ultracentrifugation and electrophoresis. In this report, we, describe a patient with chronic liver disease caused by alcohol, occasional abdominal pain and persistent hyperamylasemia, though to be due to pancreatitis, but subsequently shown to be due to a macroamylase.
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PMID:[Macroamylasemia or pancreatitis? A diagnostic problem]. 244 75

There are many controversies regarding the surgical management of calculous gallbladder disease. Newer data in the surgical literature and competing medical treatments compound this confusion. In this guest lecture the author reviews current data and provides an update in seven controversial areas: the timing of operation in acute cholecystitis, the management of the diabetic patient with gallstones, the treatment of the patient with asymptomatic gallstones, the medical treatment of gallstones, the use and abuse of operative cholangiography, the management of the patient with gallstone pancreatitis and management of the patient with acalculous cholecystopathy.
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PMID:Controversies in biliary tract surgery. 353 49

Some surgeons drain the gallbladder bed routinely, some selectively and some not at all. We aimed to clarify this confusion by entering 155 consecutive patients undergoing emergency and elective cholecystectomy without exploration of the common bile duct into a random control clinical trial. In 78 patients a 3 mm suction drain was left in the gallbladder bed and in 77 the abdomen was closed without drainage. There were no withdrawals, one death (in the drainage group) from myocardial infarction and one intraperitoneal abscess complicating postoperative pancreatitis (in the no-drainage group). Other events studied were postoperative pyrexia, wound infection, respiratory tract infection and duration of hospital stay. In none of these did the two groups differ either clinically or statistically. We conclude that drainage or non-drainage of the gallbladder bed must remain a matter of individual preference.
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PMID:Suction drainage of the gallbladder bed does not prevent complications after cholecystectomy: a random control clinical trial. 388 68

The safety of AmBisome was evaluated in 187 transplant recipients treated for 197 episodes. Patients included 89 bone marrow transplant recipients, 64 liver transplant recipients, 20 renal transplant recipients and 14 recipients of combined organs. AmBisome was instituted for verified invasive fungal infection in 34 cases, suspected invasive fungal infections in 80 cases and as prophylaxis in 83 cases. AmBisome was given for a median of 11 days (range 1-112 days) with a maximum daily dose of 1.49 +/- 0.70 mg/kg/day (mean +/- SD). The total cumulative dose of AmBisome was 1.11 +/- 1.78 g (mean +/- SD). Side-effects definitely attributed to AmBisome therapy included low potassium (n = 3), low back pain (n = 3), dyspnoea (n = 2), allergic rash (n = 1), nausea and vomiting (n = 1), confusion (n = 1), rise in alkaline phosphatase (n = 1) and cholecystitis (n = 1) with an overall incidence of 13 of 197 (7%). AmBisome was discontinued due to side-effects in 6 (3%) of the cases. During AmBisome treatment the mean cyclosporin dose was 9.6 +/- 28.8 mg/kg/day. Compared to pre- and post-AmBisome therapy there was a significantly increased cyclosporin concentration in blood during AmBisome therapy. Side-effects with possible association to AmBisome therapy included low serum potassium (36%), increase in serum creatinine (31%), rise in alkaline phosphatases (26%) and fever (3%). The overall mean increase in serum creatinine was 20%. Other possible side-effects like headache, abdominal pain, rash, rise in bilirubin, cramps and pancreatitis was seen in single patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Safety of liposomal amphotericin B (AmBisome) in 187 transplant recipients treated with cyclosporin. 770 25


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