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

A case of spontaneous oesophageal rupture or Boerhaave syndrome is described. The absence of the typical initial vomiting together with a clinical picture that successively indicated repeated myocardial infarction, pancreatitis and pulmonary abscess delayed diagnosis by 4 days, after which emergency thoracotomy, performed on the identification of extravisceral overflow by contrast radiography using a water-soluble medium, revealed necrotic inflammation of the oesophagus, mediastinum and left lung that was so severe that only thoracic drainage was possible. After an initial improvement the patient died of septic shock on the 16th postoperative day.
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PMID:[Spontaneous esophageal rupture or Boerhaave's syndrome. Presentation of a case]. 233 50

Ten patients with the syndrome of non-ketotic hyperosmolar coma are described. The mean age of the patients was 62.3 +/- 17.12 years. One patient was 16 years old. In 9 cases the patients had type II diabetes, one had type I diabetes. In 7 cases the coma was the first sign of diabetes. The factor predisposing in most cases was infection. In the treatment-acting insulin and hypotonic solutions were given. In 2 cases clinical signs of the DIS syndrome were observed manifesting themselves with local changes, including mental disturbances. Heparin was given with good effect. Three patients (30%) died in hospital. The cause of death was serious disease associated with this coma: pancreatitis and myocarditis, purulent bronchopneumonia, myocardial infarction.
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PMID:[Hyperglycemic hyperosmolar nonketotic coma]. 240 21

To evaluate the prognosis and prognostic factors of chronic pancreatitis, 84 patients with alcoholic chronic pancreatitis and 51 with nonalcoholic chronic pancreatitis have been followed for 1-21 years (average of 7.1 years). The follow-up period was defined as the period from diagnosis to death in those who died and to the present in those still alive. The following conclusions were obtained. (1) Patients with alcoholic chronic pancreatitis showed a significantly higher mortality rate (26.2%) and cancer death rate (8.3%) than the age- and sex-matched population. In patients with nonalcoholic chronic pancreatitis, however, the difference did not reach the level of statistical significance, although both rates tended to be higher. (2) Patients with alcoholic chronic pancreatitis showed a significantly poorer prognosis than those with nonalcoholic chronic pancreatitis. (3) Frequent causes of death in chronic pancreatitis were cancer (11 cases) and diabetes-associated conditions (renal failure in three cases, intractable pneumonia in one, hypoglycemic shock in two, and myocardial infarction in two). Death directly from pancreatitis was observed in four. (4) Unfavorable prognostic factors in alcoholic chronic pancreatitis included heavy drinking, continuance of drinking after diagnosis, smoking, insulin-dependent diabetes, and an advanced age. In nonalcoholic chronic pancreatitis, however, patients' age was the only significant prognostic factor; smoking did not reach the level of statistical significance, although it tended to lead to a poorer prognosis.
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PMID:Prognosis and prognostic factors in chronic pancreatitis. 292 Jun 51

Heart failure with myocardial infarction occurred in the course of a neonatal infection with aseptic meningitis. Coxsackie B4 infection was found in the child and its mother. The unusual myocardial action of the virus, coronary embolus, intermediate role of a pancreatitis. By age 8 months, under digitalis glycosides treatment, growth and psychomotor development were normal.
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PMID:[Neonatal myocardial infarct associated with maternal-fetal infection due to Coxsackie B4 virus]. 302 76

Circulating phospholipase A2 (PLA2) has been recognized as a mediator of circulatory collapse in experimental endotoxic shock. To assess the role of serum PLA2 in septic shock in man, we determined serum PLA2 profiles in a prospective study in 12 patients with septic shock. During the hypotensive phase of sepsis, serum PLA2 levels were consistently elevated as high as 33,428 U/ml (normal range 115 +/- 12 [SE]; n = 101). In all 12 patients, PLA2 levels correlated directly with the magnitude and duration of circulatory collapse (p less than .001), with a progressive fall of serum PLA2 levels during convalescence. In contrast, serum PLA2 levels in patients with cardiogenic shock secondary to myocardial infarction remained low. In pancreatitis, PLA2 levels paralleled fluctuations of serum amylase and lipase, whereas in septic shock without pancreatic involvement, PLA2 changes were discordant with changes in pancreatic enzymes. As well, septic shock serum PLA2 failed to crossreact by radioimmunoassay with antiserum against human pancreatic PLA2. These data are consistent with an extrapancreatic source of intravascular PLA2 release during sepsis. Since endogenous serum PLA2 levels correlate directly with the magnitude of hypotension in both experimental endotoxic shock and clinical septic shock, and since parenteral administration of purified exogenous PLA2 reproduces hypotension in experimental models, we conclude that high levels of intravascular PLA2 may contribute similarly to the circulatory collapse in septic shock in man.
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PMID:Pathogenesis of hypotension in septic shock: correlation of circulating phospholipase A2 levels with circulatory collapse. 333 73

Ninety consecutive patients underwent surgery for coronary artery disease. Eighty-one (90%) did not require blood transfusion in the immediate postoperative period; nine patients received 16 units of blood, 6 of whom bled excessively; 2 were re-explored. Twelve had post-operative haemoglobins below 8.5 G/dl during their stay. They were transfused a total of 28 units of blood before discharge. Post-operative blood loss in the 9 transfused early averaged 894 +/- 176 ml (SEM). Loss from the not transfused patients averaged 481 +/- 18 ml (p less than 0.001). Patients transfused later had a mean loss of 510 +/- 36 ml (P NS). Sixty-nine patients were not transfused. Haemoglobin on the first post-operative day was 11.3 +/- 1.3 G/dl (SD). This declined to 10.2 +/- 1.2 G/dl on the fifth day. Discharge haemoglobin was 10.5 +/- 1.2 G/dl. Two patients died, one of myocardial infarction on the third day and the other of pancreatitis on the fourth. Both had had early blood transfusion. Haemoglobins were above 10 G/dl. Of the 69 untransfused patients 17% had supraventricular arrhythmias. Ten percent had serous wound discharges; 3 were infected. There were no sternal dehiscences. It is concluded that bank blood transfusion with its attendant hazards and expense is easily avoidable in most patients. This saving of resources will increase the availability of blood and rare groups for surgery.
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PMID:Reduction of blood use in surgery for coronary artery disease. 378 68

Some surgeons drain the gallbladder bed routinely, some selectively and some not at all. We aimed to clarify this confusion by entering 155 consecutive patients undergoing emergency and elective cholecystectomy without exploration of the common bile duct into a random control clinical trial. In 78 patients a 3 mm suction drain was left in the gallbladder bed and in 77 the abdomen was closed without drainage. There were no withdrawals, one death (in the drainage group) from myocardial infarction and one intraperitoneal abscess complicating postoperative pancreatitis (in the no-drainage group). Other events studied were postoperative pyrexia, wound infection, respiratory tract infection and duration of hospital stay. In none of these did the two groups differ either clinically or statistically. We conclude that drainage or non-drainage of the gallbladder bed must remain a matter of individual preference.
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PMID:Suction drainage of the gallbladder bed does not prevent complications after cholecystectomy: a random control clinical trial. 388 68

Thirty-one patients with radiolucent common bile duct stones received medical treatment. Nineteen had Rowachol, a terpene preparation, eight (42%) achieving complete stone disappearance within 3 to 48 months. Fifteen (including 3 of the above) took Rowachol with bile acid (chenodeoxycholic in 11, ursodeoxycholic in 4) for 3 to 60 months: 11 (73%) achieved complete dissolution within 18 months. Persistent symptoms and complications settled on conservative management: 8 (25%) patients required admission (2 biliary colic, 1 obstructive jaundice, 4 cholangitis, 1 pancreatitis). One patient died of a myocardial infarction during recovery from pancreatitis; the other continued treatment, 2 achieving complete dissolution/disappearance. Oral dissolution therapy with Rowachol and bile acids should be considered when endoscopic sphincterotomy or surgery is not feasible, but careful attention to potential complications is required while stones persist.
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PMID:Stones in the common bile duct: experience with medical dissolution therapy. 402 60

The effects of three types of stress-electroplexy, surgery, and myocardial infarction-on blood fibrinolytic activity and plasma fibrinogen levels were studied in 10, eight, and six patients respectively. The fibrinolytic response to electroplexy consisted of an initial short increase followed in half the patients by reduced fibrinolytic activity lasting two to four days. After surgery and myocardial infarction normal fibrinolytic activity was followed by a period of reduced activity; the timing of the measurements on these patients may have precluded recognition of an initial increase in fibrinolysis similar to that following electroplexy. The fibrinolytic ;shutdown' which lasted for about 10 days in the coronary patients was evidently due to reduction of plasminogen activator, as judged by prolongation of the euglobulin lysis times as well as of the blood clot lysis times. Plasma fibrinogen levels rose in the surgical and coronary patients but not in the patients given electroplexy which indicates that fibrinolytic activity changes independently of plasma fibrinogen level. The results suggest that the fibrinolytic system exhibits a common reaction pattern to stress, irrespective of its nature and of tissue damage. They call for caution in assuming a specific causal association in acute diseases such as pancreatitis and haematemesis where similar fibrinolytic changes may be encountered.
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PMID:Reaction pattern to three stresses--electroplexy, surgery, and myocardial infarction--of fibrinolysis and plasma fibrinogen. 536 37

The entire middle-aged male urban population of a Swedish city, as defined by a census in November 1969, was assessed for any mental hospital hospitalization during a 3-year period (1978-1980), as well as for any general hospital hospitalization during a 10-year period (1970-1979) within the catchment area. Inpatients of the mental hospital population belonging to the cohort and put in the categories 'Psychiatric alcoholic spectrum' and 'Severe depression' were studied for diagnoses of physical illness during any general hospital hospitalization. The psychiatric alcoholic spectrum was associated positively with infections, injuries, alcohol intoxication, pancreatitis, liver cirrhosis, arthritis/rheumatic diseases and duodenal peptic ulcer; and negatively with malignant neoplasms, myocardial infarction, gallstone disease and urolithiasis. Severe depression was associated positively with infections, myocardial infarction, asthma and alcohol intoxication. A nosologic taxonomy, aimed at explaining the epidemiological associations recorded, is suggested.
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PMID:Physical illness in severe depressives and psychiatric alcoholics in Gothenburg, Sweden. 621 51


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