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

A variety of neoplasms and nonneoplastic hepatic lesions have been noted in winter flounder, Pseudopleuronectes americanus, from Boston Harbor, Massachusetts. Inflammatory lesions include cholangiitis, pericholangiitis, pericholangial fibrosis, hepatitis, and pancreatitis. Necrotic lesions consist essentially of focal coagulative necrosis and a distinctive vacuolated cell lesion of the hepatic parenchyma. The most conspicuous and numerous proliferative lesion is macrophage aggregate hyperplasia and hypertrophy. Preneoplastic lesions include principally basophilic foci of cellular alteration and hepatocellular adenoma. Carcinomas consist of several morphologic varieties: hepatocarcinoma, cholangiocarcinoma, and anaplastic adenocarcinoma. The pathogenesis of the lesions observed is discussed with respect to anthropogenically introduced chemical contaminants and the resistant hepatocyte model of hepatocarcinogenesis. This study, and others of bottom-living food fish with enzootic neoplastic disease, warrants further evaluation, particularly with respect to possible bioaccumulation of chemical contaminants in edible tissues.
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PMID:Neoplasms and nonneoplastic liver lesions in winter flounder, Pseudopleuronectes americanus, from Boston Harbor, Massachusetts. 164 9

Intraductal mucin-hypersecreting neoplasms of the pancreas with extreme dilatation of the main duct were studied in eight patients. They included five men and three women, aged 47-85 years. Five patients had a history of symptoms mimicking pancreatitis; four developed steatorrhea and/or diabetes. At endoscopic retrograde pancreatography, five patients showed an open ampulla filled with mucin, and six patients showed patchy filling defects in the ectatic main duct. Morphological examination showed extreme dilatation of the entire pancreatic duct in six patients and its tail segment in two patients. The duct segments filled with viscous mucin were lined by well-differentiated mucin-secreting cells, forming papillary foldings and occasionally showing cellular atypia. None of the patients had invasive tumor or metastasis. Six patients whose lesions were resected are alive and doing well (mean follow-up, 5.5 years). It is concluded that intraductal mucin-hypersecreting neoplasm is a pancreatic tumor with favorable prognosis. Because it shares many features with intraductal papillary neoplasm, a common pathogenesis of these pancreatic tumors is suggested.
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PMID:Intraductal mucin-hypersecreting neoplasms of the pancreas. A clinicopathologic study of eight patients. 153 10

We report our experience with nine patients with "mucin-producing tumor of the pancreas," in which abundant mucin secreted by the tumor cells played a major role in the characteristic alterations of the pancreatic duct system. Four of nine patients presented with pancreatitis. Ultrasound and computed tomography demonstrated a well-defined cystic mass and dilated main pancreatic duct. Endoscopic retrograde pancreatography showed ductectatic character, i.e., diffuse dilatation of main duct and/or cystic dilatation of the branch ducts with filling defects of mucin. Ultrasound proved to be a good screening test. However, the diagnosis was confirmed on endoscopic retrograde pancreatography. Nine of our cases had no peripancreatic invasion or metastasis, resulting in a good prognosis after pancreatectomy. Mucin-producing tumor of the pancreas is a unique clinical entity that should be distinguished from "common" pancreatic carcinomas, and a favorable prognosis can be expected after surgical operation.
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PMID:Mucin-producing tumor of the pancreas: a unique clinical entity. 165 83

Celiac plexus block is usually performed under fluoroscopic or tomodensitometric guidance. We report on a new procedure using sonographic guidance. the patient lies in supine position. We use a real-time sonograph with a 3.5 MHz probe. On a transverse plane, the celiac axis is localized emerging from the aorta. Under local anesthesia, the tip of the spinal needle (177 mm, 22 g) is placed close to the aorta (about 5 mm) on both sides. 5 to 10 ml of 1% lidocaine, then 10 to 20 ml of absolute alcohol, are injected on each side. 21 patients (10 males, 11 females, mean age: 61.4) underwent the procedure. They presented with cancer of the pancreas in 14 cases, metastatic nodes from an extra-pancreatic tumor in 5 cases and chronic calcifying pancreatitis (CCP) in 2 cases. No pain relief was secured in 3 patients (14%). One of these presented with CCP, but endoscopic cystic diversion of a small cyst was successful in eradicating pain. Partial pain relief was secured in 5 cases (24%) and total pain relief in 13 cases (62%). No treatment-related complication was observed. We conclude that sonography is a simple and safe method of guidance in performing alcohol block of the celiac plexus. The anterior approach may prevent neurologic complications occurring with other methods of guidance using a posterior approach.
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PMID:[Percutaneous echography-guided alcohol block of the celiac plexus as treatment of painful syndromes of the upper abdomen: study of 21 cases]. 170 57

The authors studied the data concerning 101 patients who had undergone erroneous laparotomy for suspected acute surgical disease; these accounted for 0.4% of all the patients who were operated on for emergency indications in the same period. Eleven patients died. The operation was undertaken for an erroneous diagnosis of acute appendicitis (32 patients), acute cholecystitis (18), perforating gastric ulcer (15), peritonitis of unknown etiology (14), acute intestinal obstruction (5), strangulated hernia (3), destructive pancreatitis (3), tumor of the large intestine complicated by obstruction (3), abdominal abscess (2), thrombosis of the mesenteric vessels (1), ovarian apoplexy (1), closed abdominal trauma with injury to the viscera (4 patients). Diseases simulating the clinical picture of "acute abdomen" but not requiring an emergency operation were as follows: female reproductive (20 patients), pancreatic (11), renal diseases (11), hepatitis, cirrhosis of the liver (10), cardiovascular (9), pulmonary diseases (5), mesoadenitis (5), Crohn's disease (3), chronic colitis (3), carcinomatosis of the peritoneum (3), herpes zoster (3), and other diseases and injuries (20 patients). The main causes of the diagnostic and tactical errors were objective difficulties in the differential diagnosis due to similar symptomatology, as well as errors in the examination of the patient and haste in making a decision to make an operation.
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PMID:[Erroneous laparotomy in emergency surgery]. 177 33

Tumor-associated trypsin inhibitor (TATI) is a 6,000 Daltons peptide, which is synthesized by several tumors and cell lines. TATI is identical to pancreatic secretory trypsin inhibitor (PSTI). This peptide is also produced by the mucosa of the gastrointestinal tract, where it is thought to protect the mucosal cells from proteolytic breakdown. Elevated serum and urine levels of TATI occur in connection with many types of cancer, especially mucinous ovarian cancer. Elevated levels may also occur in nonmalignant diseases, e.g. in pancreatitis, severe infections and tissue destruction. Thus TATI may behave as an acute phase reactant. Tumors producing TATI often express tumor-associated trypsinogen. Elevation of TATI in cancer and pancreatic disease is therefore associated with expression of trypsin, but such a connection has not been demonstrated in inflammatory disease. TATI can inhibit trypsin-mediated degradation of extracellular matrix by tumor cells. Therefore its role may be to control the activation of tumor-associated trypsinogen. TATI has also been shown to possess growth factor activity in vitro, but it is not known whether this is a physiological function.
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PMID:Biology and function of tumor-associated trypsin inhibitor, TATI. 178 Jun 91

Dynamic positron emission tomography (PET) was performed following an intravenous bolus injection of 15O-water for the assessment of regional pancreatic blood flow in 4 normal volunteers and 11 patients with pancreatic cancer. The regional pancreatic blood flow index (PFI) was calculated by the autoradiographic method assuming the time-activity curves of the aorta as an input function. The mean PFI value was 0.514 +/- 0.098 in the normal pancreas but it was decreased in pancreatic cancer (0.249 +/- 0.076) (p less than 0.01), with a concomitant decrease in the pancreatic region distal to the tumor. On the other hand, in cases with body or tail cancer, the part proximal to the tumor (nontumorous head region) had a similar PFI value (0.554 +/- 0.211) to that of normal cases. Thus, a PET study with 15O-water permits quantitative assessment of pancreatic blood flow which decreased in both pancreatic cancer and concomitant obstructive pancreatitis distal to the tumor.
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PMID:Assessment of pancreatic blood flow with positron emission tomography and oxygen-15 water. 179 67

Disorders of the pancreas occur frequently, but they are difficult to diagnose because of anatomic inaccessibility of the pancreas, vague clinical signs and examination findings, and inconsistent laboratory results. Ultrasonography is the imaging modality of choice to evaluate the pancreas. Ultrasonographic examination of the pancreas is difficult due to ultrasound wave propagation interference by adjacent bowel gas, abdominal pain accompanying pancreatitis, and inability to image the normal pancreas consistently. These three problems can be overcome by adhering to a systematic scanning method, proper transducer selection, and proper patient preparation. Scanning techniques used to image the pancreas, and ultrasonographic findings of canine and feline pancreatitis and canine pancreatic neoplasia, are explained.
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PMID:Ultrasonography of the pancreas. 180 71

Diagnostic ability of Magnetic Resonance Imaging (MRI) was evaluated in 41 patients with pancreatic cancer who underwent surgery 1 to 43 days following MRI. MRI of surgical specimens revealed that pancreatic cancer and caudal pancreatitis showed similar intensities when compared with the normal pancreas. The usefulness of the contrast medium, Gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA), was confirmed in the differentiation between cancer and caudal pancreatitis. In the diagnosis of tumor extension, portal vein invasion was better diagnosed by MRI than by angiography. (Spearman's rank correlation test showed higher correlation in MRI than in angiography, p = 0.501, 0.464, respectively.) In the diagnosis of the invasion to the anterior pancreatic capsule its sensitivity was 43%, specificity 81% and efficiency 59%. Retropancreatic invasion was diagnosed with a sensitivity of 48%, a specificity of 90% and an efficiency of 59%. Lymph-node metastasis was well demonstrated especially near the pancreas but beyond them it was difficult. The liver metastasis was correctly diagnosed in 7 of 9 cases and was confirmed by laparotomy.
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PMID:[Studies on magnetic resonance imaging of pancreatic cancer]. 182 3

To determine if changes involving the root of the superior mesenteric artery are specific for neoplasm, the authors retrospectively reviewed 173 computed tomographic (CT) examinations of patients with proved pancreatitis (103 examinations) and pancreatic ductal adenocarcinoma (70 examinations). Streaky infiltration of the fat surrounding the root was seen in 27 of 56 examinations of acute pancreatitis, in four of 24 examinations of chronic pancreatitis, in 12 of 23 examinations of pancreatitis complicated by abscess, and in 25 of 70 examinations of pancreatic carcinoma. Periarterial lymph nodes were visible in 14 with acute pancreatitis, in three with chronic pancreatitis, in six with pancreatic abscess, and in 11 with pancreatic carcinoma. A focal mass extended to within 1 cm of the root in 10 with acute pancreatitis, in two with chronic pancreatitis, in four with pancreatic abscess, and in 24 with pancreatic carcinoma; the mass obliterated the periarterial fat in seven with acute pancreatitis, in one with pancreatic abscess, and in 18 with pancreatic carcinoma. Circumferential encasement occurred in one with chronic pancreatitis, in four with pancreatic abscess, in 14 with pancreatic carcinoma, and in none with acute pancreatitis; nearly all cases of encasement revealed loss of periarterial fat. Thus, these indicators are not specific for neoplasm.
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PMID:Root of the superior mesenteric artery in pancreatitis and pancreatic carcinoma: evaluation with CT. 187 Dec 69


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