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

In this paper we present our experience with computerized tomographic imaging of the pancreas, both in normal and abnormal conditions. Eighty patients were studied for evaluation of pancreatic disease. A further 50 patients, all with a normal pancreas, were studied for abnormalities of other abdominal organs and served as the control group. Helpful signs in establishing the diagnosis of carcinoma of the pancreas were mass effect within the pancreas, alteration of organ contour and obliteration of retroperitoneal fat planes. We found that differentiation from pancreatitis or retroperitoneal lymphadenopathy may at times be difficult. Our results showed that in 22 out of 23 patients with proven normal pancreas, the pancreas size on the CT display was within the adopted normal range. In 30 patients with proven carcinoma of the pancreas, a pancreatic mass was seen in 24 (83%). Computerized tomography is clearly a valuable method for viewing both normal pancreatic anatomy and anatomical variations and pathologies.
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PMID:Imaging of the pancreas with computed tomography. 42 41

One hundred thirty-four children referred to the pediatric surgical service with the diagnosis of possible acute appendicitis underwent abdominal ultrasonography within 24 hours of admission. A final diagnosis of appendicitis was made in 45, and of gynecological disease in 11 children. One child had pancreatitis, another jejunal perforation, and a third gross mesenteric lymphadenopathy. In 75 children the clinical picture completely resolved without a definitive diagnosis being made. Clinical diagnosis of gynecological disease showed two false-negatives, and three false-positives, whereas the ultrasonographic diagnosis was accurate in all patients. The sensitivity of the pediatric surgical diagnosis at the time of admission for acute appendicitis was 49% (23 false-negatives) and the specificity was 95% (three false-positives). Ultrasonographic diagnosis of appendicitis had a sensitivity of 89% (five false-negatives) and a specificity of 92% (five false-positives). There was a negative laparotomy rate of 0.7% (one patient) using both clinical evaluation and ultrasonography. These data suggest that abdominal ultrasonography in the child with possible appendicitis is an important diagnostic adjunct.
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PMID:Ultrasonography in the management of possible appendicitis in childhood. 219 59

A previously well 27-year-old Caucasian woman presented with five episodes of alcohol-induced abdominal pain over two years culminating in severe acute pancreatitis. Chest x-ray showed bilateral hilar lymphadenopathy and nodular pulmonary infiltrates. In hospital she developed a unilateral facial nerve palsy and other features of sarcoidosis, which was confirmed by biopsy of a pretracheal lymph node. No previous case is reported of sarcoidosis presenting with recurrent pancreatitis apparently induced on each occasion by moderate alcohol consumption and in the absence of other risk factors. Pancreatic involvement as part of sarcoidosis is uncommon but is treatable if recognized and has a good prognosis.
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PMID:Sarcoidosis presenting as recurrent alcohol-induced pancreatitis. 236 88

Infectious mononucleosis, a systemic illness caused by the Epstein-Barr virus, is seen frequently by primary care physicians. Mononucleosis affects several organ systems, and, within the abdomen, there can be splenic involvement, hepatitis, mesenteric lymphadenopathy, hyperplasia of gut-associated lymphoid tissue, pancreatitis, and transient malabsorption. Life-threatening abdominal complications require prompt recognition and intervention. Other abdominal complications, though worrisome, are usually short-lived and resolve without sequelae.
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PMID:Abdominal complications of infectious mononucleosis. 305 95

Obliteration of the fat plane surrounding the superior mesenteric artery has been described as characteristic of pancreatic carcinoma. To determine the specificity of this and other computed tomography findings in the pancreas and peripancreatic region, scans of 86 patients were reviewed without clinical history. Diagnoses included pancreatitis (26 patients); pancreatic adenocarcinoma (14 patients); lymphoma (17 patients); metastatic nonpancreatic carcinoma (14 patients); and normal findings (15 patients). Confluent adenopathy could not be reliably differentiated from a pancreatic mass except when adenopathy separated the common bile duct from the duodenum. Retrocrural adenopathy was unusual with pancreatic carcinoma. The fat plane surrounding the superior mesenteric artery was obliterated with pancreatic carcinoma (36%), nonpancreatic carcinoma (29%), and lymphoma (24%), but not with pancreatitis, although perivascular edema was seen in 19%. Evaluation of the celiac axis was less rewarding. Obliteration of the superior mesenteric artery fat plane is a sign of malignancy, but it is not specific for pancreatic carcinoma. We propose that the superior mesenteric artery origin be considered within a paraaortic space, separate from the anterior pararenal space. This explains its characteristic lack of involvement by pancreatitis.
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PMID:The superior mesenteric artery fat plane: is obliteration pathognomonic of pancreatic carcinoma? 360 49

Graft-versus-host disease developed in two dogs injected with lymphocytes from BCG immunized donors. The disease was characterized by bone marrow depression, ulcerative enteritis, necrotizing cholangiohepatitis, thymic atrophy, pancreatitis, lymphadenopathy, inflammation of mucous membranes and weight loss. In one of the two dogs repopulation of bone marrow and lymphoid tissue by donor cells was demonstrated by cytogenetics. The development of GVHD was considered unusual because both animals received on immunosuppressive treatment and both responded well to PHA in lymphocyte transformation assays indicating they were immunocompetent. It was hypothesized that stimulation of donor lymphocytes by BCG enhanced their ability to induce a graft-versus-host reaction.
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PMID:Graft-versus-host disease in two immunocompetent dogs. 746 Oct 47

A 55 year old man presented with clinical signs and symptoms of subacute pancreatitis of unknown aetiology. Two weeks later, inguinal lymphadenopathy developed and a lymph node biopsy revealed a B cell immunoblastic lymphoma. Computerized tomography showed enlargement of the pancreas and imaging features consistent with pancreatitis. Administration of VACOP-B combination chemotherapy achieved complete resolution of the pancreatic mass and the enlarged lymph nodes. We consider this patient to have had lymphoma associated pancreatitis. This case represents a rare clinical presentation of lymphoma suggesting an alternative aetiology of subacute pancreatitis in some cases.
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PMID:Lymphoma-associated pancreatitis as a presenting manifestation of immunoblastic lymphoma. 751 21

A 22-year-old Pakistani man presented with a 1-year history of recurrent attacks of pancreatitis of unknown etiology that had required hospitalization and extensive investigation in Pakistan. He was admitted with abdominal pain, fever, and weight loss. An ultrasound and computed tomographic scan of the abdomen revealed abdominal lymphadenopathy, bulky and inhomogeneous pancreas, and a large fluid collection anterior to the right lobe of the liver. The collection was aspirated but Gram-stain, Ziehl-Neelsen stain for acid-fast bacilli, and DNA analysis by a highly specific polymerase chain reaction-based assay were negative. Because of a strong clinical suspicion of tuberculosis, the patient was started on antituberculous chemotherapy; 4 weeks later the aspirate grew Mycobacterium tuberculosis (hominis). The patient improved rapidly and has remained well after 18 months follow-up. A high index of clinical suspicion and appropriate microbiological investigation is required for the diagnosis of this rare, but potentially curable cause of pancreatitis.
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PMID:Tuberculous pancreatitis: a diagnostic problem. Case report and review of literature. 779 34

A 51-yr-old man, who presented with diabetes mellitus, abdominal pain, inguinal lymphadenopathy, and diffuse enlargement of the whole pancreas on ultrasonography, was at first thought to have pancreatic lymphoma. Chemotherapy including steroid was carried out successfully, although the definitive diagnosis of lymphoma was not made. However, on follow-up, we realized that both laboratory findings, such as hyperglobulinemia and autoantibody-positive results, and radiographic features in this case were very similar to those of a case of autoimmune pancreatitis recently reported by Yoshida et al. (Dig Dis Sci 1995;40:1561-8). When the disease recurred, therefore, treatment with steroid alone was performed with an excellent result. We report a case of autoimmune pancreatitis simulating primary pancreatic lymphoma.
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PMID:Autoimmune chronic pancreatitis simulating pancreatic lymphoma. 894 97

A 56-year-old previously healthy man had two episodes of unexplained pancreatitis in the setting of constitutional symptoms, recurrent palsy of the right seventh cranial nerve, and bilateral parotitis. Chest radiography revealed marked bilateral hilar lymphadenopathy, and sarcoidosis was diagnosed by bronchoscopy with transbronchial biopsy showing noncaseating granulomas. The pancreatitis and sarcoidosis responded to corticosteroid therapy but recurred after corticosteroid dosage was reduced. Retreatment with a higher dosage of corticosteroids led to resolution of pancreatitis; 3 months later, the patient remained well and without further recurrence of pancreatitis while taking the higher dose of corticosteroids. Clinically significant pancreatitis should be included as an unusual manifestation of sarcoidosis, and corticosteroid therapy should be considered in the management of pancreatitis associated with sarcoidosis.
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PMID:Sarcoidosis associated with recurrent pancreatitis. 911 38


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