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

Surgical experience with 9 patients with chronic pancreatitis is reviewed. Vague, atypical abdominal pain and obstructive jaundice were the most common form of presentation. Serum amylase was elevated in less than half the patients. Ultrasound, ERCP, and operative cholangiopancreatography were the most helpful studies. Ampullary or intrapancreatic obstruction were the main indications for operation, and, when relieved, resulted in resolution of symptoms for an average followup of 4.4 yr. Patients with familial and recurrent bouts of pancreatitis should be studied with ERCP to determine if an anatomic lesion is present.
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PMID:Surgical implications of chronic pancreatitis. 716 80

Twelve patients with obstructive jaundice as a direct result of pancreatitis or its complications are described. The value of ultrasonography in the diagnosis of this condition is stressed. The criteria for surgical intervention and the operation of choice are discussed.
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PMID:Obstructive jaundice in pancreatitis. 722 81

We report a 3-year-old asymptomatic patient who had obstructive jaundice. Percutaneous transhepatic cholangiogram showed total obstruction of the distal common bile duct. At laparotomy, fibrosing pancreatitis was found. Sphincteroplasty and choledochoduodenostomy relieved his symptoms. A review of the literature disclosed ten patients, nine of whom had abdominal pain. Fibrosing pancreatitis should be considered in the differential diagnosis of obstructive jaundice in children, even in the absence of abdominal pain.
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PMID:Fibrosing pancreatitis--an obscure causes of painless obstructive jaundice: a case report and review of the literature. 724 23

Although obstructive jaundice in pancreatic inflammatory disease is being recognized with increased frequency, duodenal obstruction is thought to be unusual. The occurrence of both duodenal and biliary obstruction suggests pancreatic cancer, and has seldom been described in pancreatitis. We report three patients with combined duodenal and biliary obstruction occurring as a complication of chronic pancreatitis. Distinction from carcinoma by barium study or laboratory results alone was not possible; instead, it depended on studies of the common bile duct, exploratory laparotomy in two patients, and follow-up in all three.
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PMID:Duodenal and common bile duct obstruction in pancreatitis simulating carcinoma. 727 92

Common bile duct stricture secondary to chronic pancreatitis is difficult to detect clinically. Surgical bypass is necessary if complications from biliary obstruction develop. In 21 patients operated on between 1968 and 1979, the earliest typical biochemical finding was a persistently elevated serum alkaline phosphatase level. The SGOT level was minimally elevated in seven patients, but did not correlate with changes in the stricture. An increased bilirubin level was noted either during an acute exacerbation of pancreatitis or late in the course of the stricture development, when obstruction was almost complete. Operative cholangiograms taken in 12 of these patients and transhepatic cholangiograms taken in nine demonstrated a stricture of the intrapancreatic bile duct more than 2 cm long. Operations were performed for treatment of obstructive jaundice (11), ascending cholangitis (three), suspected pancreatic cancer (three), and progressive biliary cirrhosis (two). Sphincteroplasty, initially attempted in four patients, uniformly failed to relieve the obstruction due to the length of strictured duct. Satisfactory drainage was obtained for up to ten years with choledochoduodenostomy (12), choledochojejunostomy (three), and cholecystojejunostomy (six).
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PMID:Common duct stricture from chronic pancreatitis. 737 60

Pancreatitis and pancreatic insufficiency have not previously been associated with mucinous cystadenoma of the pancreas. This report describes a patient with a long history of chronic pancreatitis whose course was complicated by obstructive jaundice and cholangitis and pancreatic insufficiency. Endoscopy with retrograde cholangiopancreatography provided the correct diagnosis, and the findings are described.
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PMID:Mucinous cystadenoma of the pancreas. Endoscopy as an aid to diagnosis. 741 18

Serum and pancreatic juice carcinoembryonic antigen (CEA) concentrations were studied in a group of 144 patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) with a variety of benign and malignant pancreatic and biliary diseases. Serum CEA was found to be a poor diagnostic and discriminating marker for pancreatic disorders and was raised in obstructive jaundice from various causes correlating with serum alkaline phosphatase. A pancreatic juice CEA concentration of greater than 106 mcg/l was associated with pancreatic disease but did not distinguish benign from malignant lesions. Criteria derived from pancreatic juice volumes and bicarbonate responses provided additional diagnostic differentiation of normal from pancreatic disease but not cancer from pancreatitis. Pancreatic juice CEA may have a limited application where imaging techniques have failed or are not available and additional study of pancreatic juice biochemistry is required before adequate diagnostic criteria can be established.
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PMID:Serum and pancreatic juice carcinoembryonic antigen in pancreatic and biliary disease. 742 29

During a 48 month period to December 1990, 367 patients, median age 75 years, with obstructive jaundice caused by common bile duct stones (201), malignant biliary obstruction (148), and benign biliary strictures (18), underwent therapeutic endoscopic retrograde cholangiopancreatography. Endoscopic biliary stenting and drainage was achieved in 343 of 367 patients attempted (93%), seven patients requiring a combined percutaneous endoscopic approach. Endoscopic stenting failed in 24 patients because of malignant duodenal infiltration (10), Billroth 2 gastrectomy (6), tight and extensive biliary strictures (6), peripapillary diverticulum (1), and technical failure (1). Prolonged follow up was available in 91% (311 of 343). The 30 day mortality was 5% (17 of 343), which included two procedure related deaths (0.6%) from fulminant pancreatitis and major sphincterotomy site bleeding. Early complications occurred in 14% (48 of 343) and late complications occurred in 11.9% (35 of 294) patients, as of the original 343, 17 had died within 30 days and another 32 were lost to follow up. Eighty patients with incomplete bile duct clearance and eight patients with benign biliary strictures had biliary stents inserted for 12-48 months (median 30). Endoscopic biliary stenting services are necessary in a district general hospital with technical success, death and morbidity rates comparable to other studies.
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PMID:Endoscopic biliary stenting in a district general hospital. 755 82

We report 16 patients of focalized pancreatitis. All patients presented mass in the head of pancreas and obstructive jaundice (13 patients), characterized by spontaneous mass shrinkage and jaundice subsidence within two weeks after admission without any surgical intervention. Sonography, ERCP, exploration and intraoperative biopsy are of value in differentiating FP from carcinoma. Six patients received conservative therapy. Operations aimed to drain the commonbile duct and pancreatic duct (T tube drainage of commonbile duct, choledochojejunostomy, pancretojejunostomy) were performed in 7 patients. Pancretoduodenectomy were performed in 3 patients on tentative diagnosis of carcinoma in the head of the pancreas. Follow-up in 12 patients showed satisfactory results.
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PMID:[The diagnosis and treatment of focalized pancreatitis: report of 16 cases]. 758 71

The "groove pancreatitis" is a special form of segmental chronic pancreatitis affecting the "groove" between pancreatic head, duodenum and common bile duct. This type of chronic pancreatitis was first described in 1973 and only few cases have been reported in literature. Unlike other forms of chronic pancreatitis, this is often preceded by peptic ulcers, gastric resections or biliary tract diseases; it could be associated with cysts of the duodenal wall and pancreatic cysts. Abdominal pain, vomiting due to duodenal stenosis, obstructive jaundice and weight loss are the most common presenting symptoms. The radiological features show a pancreatic mass similar to a pancreatic head carcinoma and the discrimination of groove pancreatitis from pancreatic carcinoma is often difficult or even impossible in some patients. We describe a case of groove pancreatitis treated with pancreatoduodenectomy, reviewing the clinical and radiological features. We remark that the groove pancreatitis is a disease that must be known and should be considered in the differential diagnosis of pancreatic carcinoma.
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PMID:[Groove pancreatitis. A case report of chronic focal pancreatitis]. 764 41


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