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

Ascaris lumbroicoides is the most prevalent human parasite worldwide. Although usually asymptomatic, ascaris is responsible for a variety of severe complications such as intestinal obstruction, cholangitis, or hepatitis, which are caused by worm migration. This article is the second known case report of pancreatitis caused by biliary ascaris during pregnancy. We also review the pathophysiology of this disease and review the various treatment modalities available for pregnant patients. We believe that because of the growing influx of immigrants from endemic areas into the United States, the clinician needs a basic understanding of the etiology, diagnosis, and treatment of biliary ascarasis.
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PMID:Acute pancreatitis caused by biliary ascaris in pregnancy. 855 44

A case of "wandering spleen" associated with recurrent pancreatitis and diagnosed with computed tomography (CT), is reported. The entity was also associated with a rotated, distended stomach, gastric outlet obstruction secondary to extrinsic compression of the duodenum, and partial small bowel obstruction secondary to extrinsic compression of a mobile, distended cecum that lay under the right diaphragm.
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PMID:Recurrent acute pancreatitis: an additional manifestation of the "wandering spleen" syndrome". 863 47

Cystic fibrosis (CF), the most common lethal autosomal recessive disease in white populations, is characterized by dysfunctional chloride ion transport across epithelial surfaces. Although recurrent pulmonary infections and pulmonary insufficiency are the principal causes of morbidity and death, gastrointestinal symptoms commonly precede the pulmonary findings and may suggest the diagnosis in infants and young children. The protean gastrointestinal manifestations of CF result primarily from abnormally viscous luminal secretions within hollow viscera and the ducts of solid organs. Bowel obstruction may be present at birth due to meconium ileus or meconium plug syndrome. Complications of meconium ileus include volvulus, small bowel atresia, perforation, and meconium peritonitis with abdominal calcifications. Older children with CF may present with bowel obstruction due to distal intestinal obstruction syndrome or colonic stricture, and tenacious intestinal residue may serve as a lead point for intussusception or cause recurrent rectal prolapse. Radiologic studies often demonstrate thickened intestinal mucosal folds in older children and uncommonly show colonic pneumatosis, peptic esophageal stricture due to gastroesophageal reflux, and duodenal ulcer. Appendicitis due to inspissated secretions is uncommon. Obstruction of ducts and ductules produces exocrine pancreatic insufficiency, pancreatitis, cholestasis, cholelithiasis, and cirrhosis with portal hypertension. On imaging studies, the pancreas is commonly small and largely replaced by fat, sometimes displays calcifications, and is rarely replaced by macrocysts. Radiologic features of hepatobiliary disease include an enlarged radiolucent liver from steatosis, gallstones, a shrunken nodular liver, splenomegaly, and portosystemic collateral vessels. With the improved survival of CF patients, an increased risk for developing gastrointestinal carcinomas has been established, many occurring as early as the 3rd decade.
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PMID:Gastrointestinal manifestations of cystic fibrosis: radiologic-pathologic correlation. 883 77

Thirty-eight children (2 months to 26 years of age) underwent esophageal replacement at our institution between 1962 and 1993. Twenty-four patients had esophageal atresia, with the replacement performed at a mean age of 17 months. The remaining patients (37%) had strictures and were older (mean, 7.4 years). Replacement procedures involved the right colon in 61% of cases and the transverse left colon in the others (39%). Sixty-three percent were placed substernally and 37% were done in transthoracic fashion. The average length of stay in the hospital was 34 days (range, 11 to 256 days.) Early complications (within 30 days) included cervical anastomotic leaks (11 patients; 29%) pneumonia (4), would infection (2), pneumothorax/hemothorax (3), wound dehiscence (1), prolonged ventilation (2), vocal cord paralysis (1), Horner's syndrome (1), pancreatitis (1), and perforated graft (1). Despite the incidence of early leaks, only two persisted long-term (more than 3 months). Other late complications included significant proximal strictures (5), and cologastric strictures developed in five patients. Seven cases were considered graft failures (18%), and all of these eventually require graft replacement. Additional problems included redundant graft requiring revision (4) and dumping syndrome (2). There were six cases of intestinal obstruction caused by adhesions. Four of these involved intrathoracic obstruction of the graft and two involved small bowel obstruction. There was only one death, which occurred late and was not related to the primary disease or procedure. Long-term follow-up data were available for 20 patients (53%). The follow-up period ranged from 1 to 33 years (mean, 12 years). Fourteen had excellent results after the initial interposition, being able to eat and function well without any further intervention. Seven patients (18%) have had poor results and 17 (45%) required additional procedures to obtain good functional results. In our experience, the colon continues to be a good option for esophageal replacement, but additional procedures frequently are necessary to optimize the functional outcome. Good results can be expected in the majority of cases, but late problems (ie, redundant colon and poor emptying) are not unusual, and careful follow-up is essential in the management of such patients.
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PMID:Esophageal replacement using the colon: is it a good choice? 886 25

We report two patients who had non-surgical management of Pancreatic Pseudocyst. The first patient presented with acute pancreatitis and intestinal obstruction, had laparatomy and found to have hemorrhagic pancreatitis and impacted gallstone in terminal item which was removed. Two weeks after laparatomy U/S and CT showed a dilated CBD and two Pancreatic Pseudocysts. ERCP showed dilated CBD. Endoscopic sphincterotomy and stent insertion in CBD and Cystoduodenostomy was done. A percutaneous drainage was done for the pseudocyst involving the body of the pancreas. The second patient presented abdominal pain and clinically had an abdominal mass which was shown by CT as Pseudopancreatic cyst. This was drained percutaneously and given treatment with somatostatin with good outcome.
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PMID:Non surgical management of pancreatic pseudocyst: two case reports and review of the literature. 890 70

The round worm, Ascaris lumbricoides, is one of the largest of the parasites that infest the human bowel. The worms usually develop in the jejunum and can reach several thousand in number, causing bowel obstruction, volvulus, intussusception, appendicitis and even bowel perforation with penetration into the peritoneal cavity. They tend to invade the bile and pancreatic ducts and may cause acute cholecystitis and pancreatitis. Ascaris lumbricoides can be detected by sonography. This imaging modality can be helpful in diagnosing the presence of the worms and in evaluating response to treatment. We present an 18-month-old girl in whom bowel worms were detected by sonography.
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PMID:[Sonographic imaging of Ascaris lumbricoides]. 894 May 20

The aim of this study was to review the cases 200 children and 40 adults who had cyst excision combined with hepaticoenterostomy (CEHE) for choledochal cyst, with particular emphasis on post-CEHE complications and their surgical management. Patients who had CEHE at the age of 15 years or less were defined as children, and those aged 16 years or older were defined as adults. The mean age when patients became initially symptomatic was 3 years in children and 26 years in adults. Eleven adults became symptomatic as children (< or = 15 years of age). The mean age of CEHE in children and adults was 4.2 years and 35 years, respectively. The time interval between the onset of initial symptoms and CEHE was significantly less in children than in adults (P < .0001). Of the 200 children, 176 had primary CEHE, and 24 had secondary CEHE converted from cystoenterostomy or other biliary surgery. Seventy children had intraoperative cyst endoscopy, which enabled us to examine the proximal intrahepatic bile ducts for stenosis and debris, and to wash out debris, protein plugs, and stones from the intrapancreatic ducts. Of the 40 adults, 22 had primary CEHE, 18 had secondary CEHE. The mean follow-up period was 10.9 years in children and 10.7 years in adults. The number of patients with post-CEHE complications in children and adults was 18 (9.0%) and 17 (42.5%), respectively. The post-CEHE complication rate in children was significantly lower than in adults (P < .0001). The 18 children had 25 post-CEHE complications such as cholangitis, intrahepatic bile duct stones, pancreatitis, stone formation in the intrapancreatic terminal choledochus or pancreatic duct, and bowel obstruction. Twenty-seven post-CEHE complications developed in the 17 adults including 2 cases of cholangiocarcinoma. There were no post-CEHE complications in the 70 children who had intraoperative cyst endoscopy. No stone formation was seen in the 145 children who had CEHE at the age of 5 years or less. Eight stone formations were seen in seven (12.7%) of the remaining 55 children aged over 5 years. Stones developed in seven (17.5%) adults. The incidence of post-CEHE stone formation in children aged 5 years or less was significantly lower than in other children and adults (P < .0001). Reoperation was required in 15 children: revision of hepaticoenterostomy in 4, percutaneous transhepatic cholangioscopic lithotomy (PTCSL) in 1, excision of intrapancreatic terminal choledochus in 2, endoscopic sphincterotomy of the papilla of Vater in 1, pancreaticojejunostomy in 1, and laparotomy for bowel obstruction in 6. Ten adults required reoperations: revision of hepaticoenterostomy in 2, PTCSL in 2, left hepatic lobectomy in 1, endoscopic sphincterotomy in 2, exploratory laparotomy in 2, and adhesiolysis in 1. The authors conclude that early diagnosis followed by CEHE is the treatment of choice for choledochal cyst, and intraoperative cyst endoscopy is recommended as a valuable adjunct to CEHE.
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PMID:Complications after cyst excision with hepaticoenterostomy for choledochal cysts and their surgical management in children versus adults. 924 42

Nonobstetric surgical emergencies may be difficult to recognize in pregnant patients whose normal physiologic state is altered by pregnancy. Early suspicion and serial examination in pregnancy may result in appropriate interventions for appendicitis, cholecystitis, pancreatitis, and bowel obstruction. Treatment in pregnant patients who experience trauma must be systematic so that situations at risk for maternal and fetal loss can be recognized.
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PMID:Nonobstetric emergencies in pregnancy: trauma and surgical conditions. 932 13

A 28-year-old woman was hospitalized because of the third episode of acute pancreatitis. No hint for an extrinsic cause was evident. Under conservative treatment pancreatitis and signs of intestinal obstruction were persisting. Imaging procedures showed an undefinite mass in the neighbourhood of the pancreatic caput. Endoscopy revealed a phytobezoar in a wind sock web, a special form of congenital duodenal atresia. Obstructing the papilla of Vater the bezoar had caused acute pancreatitis. After endoscopical removal the symptoms of pancreatitis disappeared immediately. Web excision and duodenoduodenostomy were performed. At operation further anomalies of the gastrointestinal tract frequently associated with duodenenal atresia were found.
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PMID:[Rare cause of acute pancreatitis: phytobezoar in an intraluminal diverticulum in type I duodenal atresia, intestinal malrotation and rudimentary pancreas anulare]. 961 27

The Valtrac ring is a biofragmentable ring used for gastrointestinal anastomoses. Over a two-year period, 15 anastomoses in 16 patients (mean age: 60 years) were performed with the Valtrac ring: 10 ileal, 4 ileocolonic, and 1 jejunojejunal anastomoses. One anastomosis could not be performed because of an excessively narrow ileal lumen. The mean stay in the intensive care unit was 3 days: gastric aspiration was maintained for an average of 1 week, as return of gastrointestinal motility was long, with first flatus on the 6th day and the first stools on the 7th day. Complications consisted of 2 cases of gastrointestinal fistula (11th and 13th days) one of which was fatal, evisceration on the 7th day, a transient partial bowel obstruction and one bowel obstruction treated medically on the 27th day, due to pancreatitis. Our results are not identical to those reported in the literature. It is often difficult to insert the current form of the Valtrac ring into a healthy ileum, as the smallest ring is often too large. In contrast with gastrointestinal surgery, the anastomoses performed in urology involve a non-thickened, non-distended small intestine.
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PMID:[Use of the Valtrac ring for digestive anastomoses in urology: apropos of 16 cases]. 961 30


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