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

The clinical and pathological characteristics of Curling ulcer were defined by early and serial endoscopic examination of the duodenum in 37 burned patients. Duodenal disease was present in 27 patients and occurred only in patients with burns involving more than 38 percent of the total body surface. Erosive "duodenitis" could occur within 12 hours after injury and was usually associated with acute gastric disease. Isolated duodenitis occurred only in patients with pancreatitis. Contrast roentgenograms did not reliably show the superficial mucosal disease. Duodenal ulcerations were present in 12 patients and developed on a background of diffuse superficial mucosal injury. Other complications in the patient's postburn course influenced disease progression. Hemorrhage occurred in six patients with duodenal disease, usually originating from a posterior duodenal ulcer. Uncomplicated ulcers invariably healed within five weeks after diagnosis.
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PMID:Acute duodenitis and duodenal ulceration after burns. Clinical and pathological characteristics. 107 60

The authors describe 11 cases of acute abdomen they observed during a two-year period mainly after abdominal operations. The male/female ratio was 6:5, the mean age 59 years with a range from 20 to 75 years. The mean period which had elapsed after the primary operation was 18.5 days. The authors describe four cases with ileus due to adhesions, three cases of volvulus of the small intestine, a stress ulcer, gangrenous appendicitis, acute cholecystitis and adnexitis. In general it is assumed that the most frequent acute abdomen during the post operative period is ileus due to adhesions, postoperative pancreatitis or stress ulcers are less frequent. Extremely rarely the cause of complaints is inflammatory acute abdomen of a different nature which is an unexpected finding during surgical revision. It is dangerous due to the atypical course and the fact that symptoms are masked by manifestations of the receding postoperative state. In the literature the aetiopathogenesis of such rare conditions is most frequently associated with impaired tissue perfusion due to an inadequate blood flow, general tissue hypoxia due to hypovolaemia, protracted postoperative shock, rigid vascular walls which are incapable of adequate reaction to acute deviations of circulatory demands. Despite this these conditions develop more rarely than corresponds to the coincidence of these general relatively frequent adverse factors. Severe immunosuppression is also observed much more frequently in surgical patients than these rare complications. The authors observed the incidence of these cases of acute abdomen at a ratio of 1:2000 which corresponds roughly to data in published work. Seeking the solution in immunity disorders does not explain this problem.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Acute abdomen as a postoperative complication]. 182 40

Whenever the surgeon finds himself face to face with a wound (probably this is the only opportunity for a meeting between physician and pathology which seems to be able to leave the "illness" on one side, almost forgotten, as it were), even when immersed in routine, he can hardly help making a number of considerations of a general nature, to which the sentence above in brackets is not entirely extraneous. In practice, we cannot help asking ourselves an apparently simple, almost banal, question: what exactly is trauma? This triggers off a whole series of secondary queries, such as, for instance, what the relationship is between trauma and classical pathology? In the first place, it should be pointed out that "traumatic" pathology is undoubtedly the only instance of pathology in which, as a rule, at least at the outset, one can justifiably talk about the "isolated" role of what can certainly be regarded as an out-of-body factor. If, then, we consider the specifically morphological and pathophysiological aspects of the period subsequent to the traumatic insult, we find ourselves in an even more embarrassing position: we are faced with irreparably devastated organ and body structures, or with a situation which is already on the way to convalescence. One last alternative is that the traumatic insult is merely a memory, a key finding in the case history, a past reality which to all intent and purposes has ceased to exist, and we are faced with extremely complex clinical pictures which we tend to label as complications. A few examples by way of explanation: shock, adult respiratory distress syndrome (ARDS), stress ulcer, acute post-traumatic cholecystitis, haemorrhagic pancreatitis, and problems caused by resolving the hypovolaemia-ischaemia situation and by implementing reperfusion (oxygen radicals). Trauma favours - and surgeons concerned with organ transplants are well aware of this - the only possibility of death which, perhaps with a grain of excessive optimism, we may even accept as fruitful, in that it occurs without all the destructive deterioration involved in the process of dying. The above consideration probably plays a major role in our attitudes of almost fatalistic resignation towards the youthful victims of trauma.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Biomechanico-clinical study of gunshot wounds (general problems--II)]. 304 29

Thirty-five patients with acute fulminant (hemorrhagic) pancreatitis, verified at laparotomy, were allocated to either pancreatic resection (18 patients) or peritoneal lavation (17 patients) therapy groups. Pancreatic resection was carried out by removing the distal pancreas well cephalad to the portal vein. For peritoneal lavation, two inlet silicone catheters were inserted at laparotomy around the pancreas and an outlet catheter was inserted in the lower abdomen, and the peritoneal cavity was thereafter lavated (1000 ml/hr) with a standard peritoneal dialysis fluid for 7 to 12 days (or until death if met earlier). In other respects, the postoperative care was similar, including intravenous fluids with total parenteral nutrition until oral intake of food was resumed, prophylactic antibiotics (tobramycin and clindamycin) and stress ulcer prophylaxis (cimetidine and antacids). In the resection group, four of the 18 patients (22.2%) died, while in the lavation group eight of the 17 patients (47.1%) died. The most common cause of death was septic complications with multiple organ failure, but one patient in each group died accidentally of airway complications. There was no difference in the incidence of septic complications (sepsis and/or intra-abdominal abscesses), but the incidence and severity of pulmonary and renal complications were greater in the lavation group. However, these complications accumulated to patients who ultimately died. Also, the need for reoperation was greater in the lavation group (20 reoperations/10 patients versus 12 reoperation/eight patients). Yet, the length of overall hospital stay was equal in the two groups. Six of the 14 survivors in the resection group developed diabetes, whereas none of the nine survivors in the lavation group got this complication. The results suggest that pancreatic resection is superior to peritoneal lavation in the management of acute fulminant (hemorrhagic) pancreatitis, decreasing mortality and affording smoother postoperative course. However, these benefits are gained at the expense of higher incidence of postoperative diabetes.
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PMID:Pancreatic resection versus peritoneal lavation for acute fulminant pancreatitis. A randomized prospective study. 671 18