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

Two cases of acute pancreatitis in pregnancy occurred among Vietnamese evacuees in Arkansas. In both cases, Ascaris lumbricoides seemed the likely cause. In endemic areas including the rural southeastern United States, a high index of suspicion for ascariasis is needed because these worms may cause a variety of abdominal disorders including pancreatitis, cholecystitis, and bowel obstruction. In appropriate settings, a therapeutic trial with antihelminthics is indicated.
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PMID:Acute pancreatitis in pregnancy with Ascaris infestation. 83 Nov 88

A case of biliary ascaridiasis is presented in which biliary obstruction and pancreatitis were diagnosed. Recovery followed surgical removal of the worms. The literature is reviewed.
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PMID:[Biliary ascaridiasis]. 141 30

The incidence, clinical disease and outcome of acute pancreatitis caused by ascariasis in an endemic area of Kashmir, India, was studied prospectively. Ascariasis was an aetiological factor in 59 of 256 patients (23.0 per cent) with acute pancreatitis. Worms had invaded the bile duct in 51 patients, the pancreatic duct in four and both ducts in four. Pancreatitis was mild in 46 patients and severe in 13. Associated pyogenic cholangitis was present in eight. Acute complications occurred in 11 patients. Endoscopic retrograde cholangiopancreatography (ERCP) was performed in all cases within 72 h of admission and delineated ascarides in the duodenum invading the ampullary orifice (44 patients), in the bile duct (55) and in the pancreatic duct (eight). At ERCP, worms were extracted from the ampullary orifice and removed via the mouth of 33 patients with intractable epigastric pain, leading to rapid relief of symptoms. The eight patients with pyogenic cholangitis underwent endoscopic nasobiliary drainage to decompress the bile ducts; worms were extracted from the bile duct of three of these patients using a Dormia basket. A total of 56 patients recovered from acute illness with a combination of conservative and endoscopic treatment; the other three required emergency surgery. At a mean(s.d.) follow-up of 19(7) months, ten patients showed symptomatic worm reinvasion of the biliary tree. The overall mortality rate was 3 per cent.
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PMID:Ascaris-induced acute pancreatitis. 148 33

Biliary ascariasis is as frequent a cause of adult biliary disease as gallstones in Kashmir Valley, India. In the present study, we prospectively evaluated the role of sonography in the diagnosis of biliary ascariasis and its utility in monitoring the exit of worms from the bile duct. Sonography was performed on 28 patients with biliary ascariasis proven by endoscopic retrograde cholangiopancreatography. The bile ducts were dilated on sonography in 26 patients. The characteristic sonographic features of worms in the bile duct were as follows: (a) a single, long, linear or curved echogenic structure without acoustic shadowing (2 patients); (b) multiple, long, linear, parallel echogenic strips, usually without acoustic shadowing (15 patients); (c) a thick, long, linear or curved, nonshadowing echogenic strip containing a central, longitudinal anechoic tube, probably representing the digestive tract of the worm (7 patients); and (d) characteristic movement of these long echogenic structures within the bile duct (8 patients). One patient with pancreatic ascariasis exhibited long, linear, nonshadowing echogenic strips in a dilated pancreatic duct. Other sonographic changes observed in these patients were (a) gallbladder distention (10 patients), edema of the gallbladder wall (8 patients), sludge within the gallbladder (11 patients), a coiled echogenic structure within the gallbladder (1 patient); (b) multiple liver abscesses (1 patient); and (c) edematous pancreatitis (4 patients). Sonography detected worms in the biliary tree in 24 of 28 patients (85.7%). Serial sonograms accurately demonstrated the spontaneous exit of worms in 18 patients and the persistence of worms in 3 patients. Sonography is a simple, rapid, and noninvasive method for diagnosis and follow-up of patients with biliary ascariasis.
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PMID:Sonographic appearances in biliary ascariasis. 329 10

Cholangitis and pancreatitis have resulted from migration of Ascaris lumbricoides up the biliary tree. We report our experience with the endoscopic management of 11 patients who presented with cholangitis and pancreatitis. Successful endoscopic worm extraction with or without sphincterotomy was achieved for worms located in the biliary tree but endoscopic worm extraction from the pancreas was technically difficult. Anthelminthic therapy is indicated to eradicate the gut infestation and prevent recurrent disease.
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PMID:Endoscopic management of biliary ascariasis. 341 Feb 42

We have described a case of biliary ascariasis with the uncommon complication of pancreatitis. Ideally, the diagnosis is made preoperatively by cholangiography. If conservative therapy fails, surgery is recommended. Proper therapy includes complete clearance of worms from the hepatobiliary tract and the intestine. Results are good with early diagnosis and treatment.
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PMID:Biliary ascariasis. 648 98

Nine cases of acute pancreatitis due to parasites in the common bile duct (Ascaris lumbricoides 4, Clonorchis sinensis 5) are reported. Eight cases were discovered at laparotomy and one at postmortem. The indications for operation were worsening pancreatitis, sepsis or cholangitis. Decompression of the biliary system and removal of parasites resulted in the recovery of the eight cases operated upon. In endemic areas, all patients with acute pancreatitis should be screened for parasites. Antibiotics and/or antihelminthics should be given if they are found. Surgery is necessary for those with worms causing biliary or pancreatic obstruction who do not respond.
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PMID:Severe acute pancreatitis caused by parasites in the common bile duct. 653 Jul 10

Biliary tract histopathologic responses of the Mongolian jird, Meriones unguiculatus, were monitored during infection with Brachylaime microti. At 15 days postinoculation (PI), an inflammatory cell (polymorphonuclear and band neutrophil) response occurred in periductal tissue of the common bile duct at the site of oral sucker attachment; basophils and eosinophils were not observed. Capillary prominence and fibroblasts also were noted in this region. Histologic evidence suggested an immunologic response had begun by 15 days PI; massive periductal lymphocytic infiltration occurred and enlarged mesenteric lymph nodes adjacent to the pancreas contained proliferating lymphocytes. Hepatocyte vacuolation was noted at this time. By 30 days PI, the bile duct epithelium had invaginated and lymph nodes were enlarged further. At 65 days PI, worms were encapsulated in small intrahepatic ducts by fibrous tissue of host origin. Gastric peritoneal mesothelial cysts containing ova were seen in one host. Pancreatitis was not observed in response to infection with B. microti.
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PMID:Histopathologic responses of the jird, Meriones unguiculatus, to the bile duct and pancreatic trematode, Brachylaime microti. 724 Dec 83

A six-year-old aboriginal girl living in northeast Taiwan, was admitted via Emergency Service with the chief complaint of epigastralgia for one day. Fever, leucocytosis, hyponatremia, acidosis and unilateral pleural effusion were noted. The serum amylase was 2976 U/L. Image studies including abdominal sonography and computerized tomography revealed a swollen and edematous pancreas. There was no evidence of previous trauma, drug using, hereditary problems, nor biliary tract stone; the patient was noted to have adult worms and eggs of Ascaris lumbricoides in stool and vomitus. Ascariasis associated with pancreatitis was suspected. She recovered completely after antihelmintic therapy (mebendazole) and supportive treatment. Fourteen ascarides and 20 trichurides were expelled during nine days of admission.
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PMID:Ascariasis associated with acute pancreatitis in a child. 779 78

Acute pancreatitis caused by Ascaris lumbricoides is more common in certain areas than is generally appreciated. We report a series of 42 patients, mostly young adult women, admitted to our hospital in Hunan Province, China, during the period January, 1983 to December, 1992. The diagnosis was based on the detection of worms by ultrasonography, and on the presence of severe upper abdominal pain and tenderness and raised serum amylase level without other apparent causes. Only 2 patients had necrotizing pancreatitis (4.8%). With our conservative policy, 40 patients recovered and 2 patients were operated. The mortality has remained at zero and we therefore believe that early surgical intervention is unwise. However, laparotomy should be performed if the patient fails to respond to conservative therapy, there is evidence of infection around the pancreas, bloody peritoneal fluid on aspiration, and dead worms remain within the biliary tree. We compare acute ascaris pancreatitis with acute pancreatitis caused by lithiasis.
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PMID:Forty-two patients with acute ascaris pancreatitis in China. 800 May 21


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