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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 severe pancreatitis and deep shock are reviewed. In the first case measures to relieve the shock state were unsuccessful. Laparatomy was, therefore, performed and revealed acute haemorrhagic pancreatitis with diffuse purulent peritonitis. After insertion of a drain and irrigation of the abdominal cavity the incision was closed. Twice-daily lavage of the pancreatic fistula via a drain was continued until, after 5 months, the fistula healed spontaneously. In the second case intensive therapy succeeded after 9 days in controlling the acute stage of the disease. Conservative treatment was continued for 6 weeks and the patient was then discharged from hospital. He was re-admitted 3 weeks later because of suspicious clinical and biochemical signs of obstructive jaundice. Laparatomy disclosed inflammatory stenosis of the distal portion of the common bile duct and Vater's papilla and also a pancreatic pseudocyst the size of a child's head. The latter was removed and a drain was inserted. There were no postoperative complications.
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PMID:[Severe acute pancreatitis; course and response to intensive therapy (author's transl)]. 7 34

Endoscopic retrograde pancreaticocholangiography (ERPC) has been performed in 140 patients, mainly Blacks and Indians. The first 100 patients have been analysed. The greatest diagnostic yield in this series is in (suspected) obstructive jaundice, where 26 diagnoses were made in 35 patients. In 40 patients with pancreatitis, the widest ducts were seen in 12 patients with calcific pancreatitis, but the procedure was of less help than expected. This was because no patients with continual pain after cessation of alcohol intake were found with operable strictures of the main pancreatic duct. The pancreatic function test with secretin and cholecystokinin-pancreozymin correctly diagnosed 4 patients with non-calcific pancreatitis in whom the ERPC was normal. There was a useful diagnostic yield in patients with unexplained upper gastrointestinal symptoms (15 diagnoses were made in 23 patients).
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PMID:Technique and results of endoscopic retrograde pancreaticocholangiography. A preliminary report on 140 patients. 16 2

Serum RNase (RNase I; ribonuclease 3'-pyrimidino-oligonucleotidohydrolase, EC 3.1.4.22) activity (mean +/- SD) with polycytidine as substrate was determined in normal individuals (24.9 +/- 3.0 units/ml) and in patients with pancreatic cancer (37.3 +/- 14.8), pancreatitis (38.5 +/- 12.6), nonpancreatic diseases (48.7 +/- 14.8), or renal failure (175.8 +/- 92.8). Patients with pancreatic cancer could not be distinguished from those with pancreatitis or with nonpancreatic disease, although the RNase activities in all of these differed from the activity in normal individuals. The serum RNase activities of four patients with resectable "curable") pancreatic carcinoma and two others with advanced pancreatic cancer without obstructive jaundice were normal. After total pancreatectomy, serum RNase activity remained in the high-normal range. The data presented here and data in the literature show that serum RNase cannot be of primarily pancreatic origin. The present study also demonstrates that measurement of its activity is not useful in early detection of pancreatic cancer.
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PMID:Serum RNase in the diagnosis of pancreatic carcinoma. 28 51

Intrapancreatic cysts were demonstrated by endoscopic retrograde pancreatography (E.R.P.) in nine patients with a clinical diagnosis of relapsing pancreatitis. The cysts ranged in diameter from 0.6 cm to 5 cm and were frequently associated with a prolonged elevation of the serum amylase level. The complication of intracystic haemorrhage with obstructive jaundice developed in one patient requiring early surgical decompression and drainage. In four patients laparotomy was performed because of continuing abdominal pain. One patient was treated by cystogastrostomy and another by cyst aspiration, but in two patients the cyst could not be visualized or palpated. Four patients were observed without operation for periods of four to 24 months, and all showed improvement or resolution of symptoms. E.R.P. was repeated in one patient and the cyst could not be outlined, while in another an abnormal barium meal X-ray examination result reverted to normal. Intrapancreatic cysts can be managed non-operatively, since complications appear infrequent and spontaneous resolution may occur.
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PMID:Intrapancreatic cysts associated with relapsing pancreatitis. 28 28

The prevalence of carcinoma of the pancreas is increasing in North America. Primary prevention of this disorder is not yet possible and secondary prevention is difficult because most investigative procedures are either highly invasive or not universally available. The authors tested the efficacy of a simple immunologic assay, the leukocyte adherence inhibition (LAI) assay, in the detection of carcinoma of the pancreas. They investigated 55 patients who were divided into six groups--normal (control) patients (16) and those with carcinoma of the pancreas (9 patients), pancreatitis (15), other intra-abdominal carcinomas (9), obstructive jaundice (4) and pancreatic pseudocysts (2). The LAI assay proved highly effective in selecting patients who, at surgery, were shown to have carcinoma of the pancreas, but was not as effective in the groups. This assay may therefore prove valuable in the early evaluation of patients with a suspected pancreatic malignant condition.
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PMID:Immunologic detection of primary carcinoma of the pancreas. 35 62

The physiology and pathophysiology of the sphincter of Oddi are poorly understood. The relationships of functional disorders of the sphincter to biliary and pancreatic disease and of organic lesions of the papilla to pancreatic inflammatory disease are subjudice to say the least. The efficacy of sphincter section in the treatment of chronic pancreatitis is unproved. Section of the sphincter may be necessary to treat biliary tract pathology but its use should not be routine or indiscriminative since, there is morbidity as well as mortality. Finally, the price of sphincterotomy is: 1. hemorrhage; 2. duodenal perforation; 3. pancreatic duct damage--a. acute pancreatitis; b. chronic pancreatitis; 4. sphincter incompetence--a. common duct regurgitation--cholangitis; b. pancreatic duct regurgitation--pancreatitis; 5. sphincter stenosis--obstructive jaundice; 6. stasis cholecystitis; 7. diarrhea; 8. morbidity 10%; 9. mortality 1.9%.
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PMID:The sphincter of Oddi, sphincterotomy and biliopancreatic disease. 39 44

The first case of obstructive jaundice secondary to a chronic afferent loop obstruction has been reported. The cause of the obstructed afferent loop was found to be a carcinoma of the gastric pouch occurring 25 years after surgery for peptic ulcer disease. The failure to develop any evidence of pancreatitis despite marked dilatation of the biliary tree and gall bladder suggests the existence of an independent functioning pancreatic sphincter, perhaps the sphincter of Boyden.
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PMID:Afferent loop obstruction presenting as obstructive jaundice. 42 93

To evaluate diagnostic usefulness for pancreatic cancer, serum ribonuclease (RNase) level was determined in three groups of subjects; 1) normal volunteers as control, 2) patients with histologically determined pancreatic cancer, and 3) patients with miscellaneous diseases other than pancreatic cancer. A small increase of RNase values was recognized with age in the normal subjects and in the patients with nonpancreatic diseases, if renal function was normal. The mean RNase level in the control subjects was 97 +/- 41.2 units. A marked elevation of serum RNase level was demonstrated in the patients with pancreatic cancer (p less than 0.001) and in the patients with renal dysfuction, but no significant rise was noticed in the patients with pancreatitis. Mean values of RNase in the patients with pancreatic cancer and renal dysfuncton were 368 +/- 146 units and 342 +/- 78.1 units respectively. RNase values above 300 units were recognized in 15(71%) out of 21 patients with pancreatic cancer. Seven cases with elevated RNase over 300 units other than non-pancreatic malignancy and renal dysfunction were noticed in 6 instances of obstructive jaundice and in one instance of early gastric cancer (an 84-year-old male). The above-stated findings indicate that serum RNase determinations can be utilized as a diagnostic indicator for pancreatic cancer.
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PMID:Assessment of the clinical usefulness of serum ribonuclease assays: an indicator for the detection of pancreatic cancer. 44 87

From one obstructive jaundice case examined, the Authors describe, radiologically, the result of a chronicle pancreatitis: pseudocyst with internal cysto-duodenal fistula and visualisation by radiographic examination; stenosis of second duodenum; aerobilia.
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PMID:[Pancreas pseudocyst examined by gastro-duodenal transit. From one observation (author's transl)]. 50 5

ERCP is a useful method in adults for diagnosing bilio-pancreatic disorders. The application of this technique in children is limited until now according to the rare case reports in the literature. Our experience with this procedure, based on the examination of six children and 12 youths, shows that ERCP can be employed with great benefit, when taking into account the correct indication. ERCP is mainly applied to clarify obstructive jaundice, especially when anomalies of the bile duct system are suspected, and to discover a reason for relapsing pancreatitis where other procedures fail. Blunt abdominal traumata with upper GI bleeding may well be another reason. In general our first reported data are encouraging.
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PMID:Endoscopy of the biliary tract and the pancreas in children. 69 82


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