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

Massive ascites is are complication, but not exceptional, in pancreatitis. In a series of ten personal cases and a review of one hundred cases in the world literature, the authors attempt to define the main pathological and clinical characteristics of this disease and the best treatment. Ascites may follow abdominal trauma, involving the pancreas, sometimes it occurs during known chronic pancreatitis, often it is the first sign of pancreatic disease, whether acute or chronic. High levels of pancreatic enzymes in the ascitic fluid are the main factor in diagnosis of pancreatic ascites. The mechanism of formation of the ascites is loss of pancreatic fluid into the peritoneal cavity owing to a breach in the pancreas, the presence of enzyme-rich fluid, causing secondarily "chemical" peritonitis. Paracentesis abdominis or drainage of the fluid during exploratory laparotomy, permits one to obtain in certain cases, a cure of the ascites, but surgical drainage by an anastomosis between the pancreatic cyst and the digestive tract (pancreatico-digestive anastomosis), has the advantage of ensuring treatment of the ascites and of the responsible pancreatic disease.
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PMID:[Massive ascites in pancreatitis. Review apropos of 10 personal cases]. 17 57

Spontaneous hemorrhage without earlier exploration in pseudocysts is a serious complication of chronic relapsing pancreatitis. In the past six years we have seen 6 patients with that disease in 91 cases of pancreatic cyst; 4 patients had distal pancreatectomy and partial excision of the cyst without postoperative complication; 2 patients died without having operative intervention.
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PMID:[Spontaneous erosion hemorrhage in pancreatic cysts]. 45 85

After a short description of the physical principles of ultrasound, the indications and usefulness of the real time B-scan technique in the non-invasive diagnosis of cardiac and abdominal diseases are discussed. A correct diagnosis was made in 90% of the cardiac cases (valve abnormalities, pericardial effusion, cardiac aneurysm, cardiomyopathy), whereas the diagnosis by ultrasound was correct in only 81.1% of the abdominal cases (diffuse and localized liver diseases, pancreatitis, pancreatic cyst, carcinoma of the pancreas, cholelithiasis, renal cyst, renal tumours, aortic aneurysm). The advantages of the real time B-scan technique lie in the two-dimenstional clear representation of intracardiac and intraabdominal structures with the possibility of undertaking quantitative measurements. Furthermore, it is a non-invasive and safe method, which can be repeated as often as necessary and can complete the diagnositic spectrum of radiology, endoscopy and nuclear medicine.
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PMID:[Ultrasonic diagnosis of cardiac and abdominal diseases using real time b-scan technique (author's transl)]. 65 98

Since 13 cases of intrasplenic pancreatic pseudocysts have been previously described in the world literature, an additional case is reported. The mechanisms for the development of this lesion are: 1. direct extension of the pancreatic cyst into the splenic hilum; 2. digestive effects of pancreatic enzymes on splenic vasculature and parenchyma; 3. pancreatitis occurring in ectopic intrasplenic pancreatic tissue and 4. liquefaction of splenic infarcts secondary to thrombosis of the splenic vessels. Criteria for diagnosis and current available diagnostic methods are discussed. Early surgical intervention with splenectomy and possibly caudal pancreatectomy, is advocated.
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PMID:Intrasplenic pancreatic pseudocyst complicating severe acute pancreatitis. 66 40

42 cases of pancreatic cyst in acute (22 cases) pr chronic (20 cases) pancreatitis were seen between 1962 and 1976. Analysis of the case data revealed the following: (1) exact assignment of the cyst to acute or chronic pancreatitis is often possible only by long-term observation; (2) the cysts of chronic pancreatitis are not a uniform group: some (8 cases) apparently occurred in acute pancreatitis through necrotic episodes (pseudocysts), others (12 cases) by a retention mechanism; these "retention cysts" develop later in the course of chronic pancreatitis than the pseudocysts and produce a different clinical picture with better prognosis; (3) barium meal and retrograde cholangiopancreatography proved of diagnostic value' (4) if the cysts persist for more than six weeks operation is indicated because of the high incidence of complications.
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PMID:[Pseudocysts and retention cysts in acute and chronic pancreatitis (author's transl)]. 75 56

A 41-year-old man with chronic pancreatitis and pancreatic stones predominantly composed of fatty acid calcium is reported. He had complained of occasional abdominal pain for 10 years and visited the hospital because of a severe attack of abdominal pain. Laboratory data supported a diagnosis of pancreatitis. Computed tomography (CT) showed a high-density area in the head of the pancreas, and the CT number of this high-density area was lower than usual for pancreatic stones. Ultrasonography and endoscopic retrograde pancreatography showed a cystic lesion with small pancreatic stones in the head of the pancreas and irregular dilatation of the main pancreatic duct. Pancreaticojejunostomy and resection of pancreatic cyst were carried out for repeated episodes of abdominal pain under the diagnosis of chronic pancreatitis. The pancreatic stones obtained at surgery were proved to be mainly composed of fatty acid calcium after analysis of chemical composition of the stones. Fatty acid calcium was sometimes found in the biliary stones but never in the pancreatic stones.
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PMID:Pancreatic stone predominantly composed of fatty acid calcium. 158 38

We report a 4-month-old boy with massive ascites in whom a diagnosis of pancreatitis was made on a raised ascitic amylase level after two inconclusive laparotomies. He developed a pseudocyst which was managed with repeated percutaneous needle aspirations, nutrition being maintained intravenously. Endoscopic retrograde cholangiopancreatography (ERCP) demonstrated a congenital intra-pancreatic cyst. He thrived after operation drainage for recurrent pseudocyst, but repeat ERCP shows that the cyst in the head of the pancreas remains. Pancreatic ascites is rare in children and diagnosis is frequently delayed. A third of reported cases in childhood present in the first year of life. A search for the underlying cause should include an ERCP to demonstrate abnormalities of the pancreaticobiliary ducts.
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PMID:Pancreatic ascites presenting in infancy, with review of the literature. 198 72

During a period of 19 months, 22 organ preserving splenic operations were performed. Eleven of these, were severe third degree traumatic bursting ruptures, which were treated using a resorbable compressive mesh. An intralienal pancreatic cyst, a case of splenomegaly suspicious for lymphoma, one traumatic and two accidental polar lesions were treated by partial splenic resection using stapler. In two patients with traumatic and four with accidental first and second degree lienal lesions, collagen tampon and fibrin adhesive were employed. None of these patients required a second laparotomy. Aside from an edematous tail pancreatitis, no complications arose. Two patients succumbed to their severe cranial injuries. In the same period, four posttraumatic splenectomies were performed. Thus, excluding incidental and technical splenectomies, the application of the described methods resulted in orthotopic splenic preservation in 78% of traumatic splenic ruptures.
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PMID:[Clinical use of new organ-saving technics in splenic surgery]. 231 69

Complement activation has been proposed as a mediator of remote complications of acute pancreatitis. Thirty-seven patients with acute pancreatitis were studied with respect to the formation of anaphylatoxins (C3a/C3adesArg, C5a/C5adesArg) and terminal complement complexes (TCC) in plasma and ascites fluid. The patients were classified according to Ranson's criteria. Eighteen patients with moderate or severe pancreatitis had higher maximum plasma C3a/C3adesArg and TCC concentrations than 19 patients with mild pancreatitis. During convalescence, the concentrations had returned to normal. High concentrations of C5a/C5adesArg and TCC were also found in ascites and pancreatic cyst fluid, drawn from patients with moderate or severe pancreatitis. As the terminal complement pathway activation is involved in reactive lysis and anaphylatoxins increase vascular permeability, anemia and impaired respiration in these patients may be influenced by complement activation.
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PMID:Anaphylatoxins and terminal complement complexes in pancreatitis. Evidence of complement activation in plasma and ascites fluid of patients with acute pancreatitis. 236 18

An autopsy case of chronic pancreatitis associated with unusual chronic thyroiditis in a 54-year-old woman is presented. Microscopically, the pancreas was densely infiltrated by lymphocytes and its exocrine parenchyma was completely replaced by sclerotic tissue. The thyroid gland was also infiltrated by lymphocytes, but no lymphoid follicles were observed. These morphological changes are rare findings with respect to the severity of inflammation and the association of the affected organs. Further findings suggested involvement of an autoimmune mechanism in the pathogenesis of these lesions. Using the avidin-biotin-conjugate technique and antibodies (Abs) against T lymphocyte and HLA-DR antigens (Ags), immunological aspects of the lesions were studied. Most of these infiltrating lymphocytes were revealed to be T lymphocytes, and HLA-DR Ags were observed on the epithelial cells of the pancreatic ducts and thyroid follicles. As a control, 45 surgical specimens of pancreas and thyroid gland were studied for detection of HLA-DR expression on the epithelial cells. One case of chronic pancreatitis was revealed to express HLA-DR Ag on the epithelium. The patient was a 44-year-old woman who had silently developed pancreatic cyst due to chronic inflammation. This finding also suggests a role of autoimmunity in the pathogenesis of chronic idiopathic pancreatitis.
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PMID:Expression of histocompatibility antigen HLA-DR on the epithelial cells of the pancreatic duct and thyroid follicle. An autopsy case. 239 38


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