Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030305 (pancreatitis)
 16,014 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The levels of carcinoembryonic antigen (CEA), elastase 1, and carbohydrate antigen determinant (CA 19-9) in the pancreatic cystic fluid and the serum from five patients with cystadenocarcinoma of the pancreas, one patient with retention cyst due to pancreatic carcinoma, three patients with cystadenoma, and eight patients with benign pseudocyst accompanying or following pancreatitis, were determined by immunoassay technique. Fluid from pancreatic cysts was obtained by ultrasonically-guided percutaneous fine-needle aspiration biopsy. The specimens were centrifuged and the supernatant was used for the measurement of CEA, elastase 1, and CA 19-9, while the cell pellet was examined cytologically. The levels of CEA in the aspirated fluid were significantly higher in patients with malignant cysts of the pancreas than in those with benign cystadenomas and pseudocysts. In contrast, the levels of elastase 1 were significantly lower in patients with malignant cysts than in those with benign pancreatic cysts. Although the levels of CA 19-9 were significantly higher in patients with malignant cysts than in those with pseudocysts, the overlap between the values of patients with malignant and benign pancreatic cysts is too great. The serum CA 19-9 was most useful, however, to distinguish an individual patient with malignant cysts of the pancreas from those with benign pancreatic cyst, since there were no significant differences between the levels of serum CEA and elastase 1 in patients with malignant and benign pancreatic cysts. Correct diagnoses were made cytologically in 4 (66.7%) of 6 patients with malignant cysts. In two patients with malignant cyst, in whom no cancer cells were detectable in the aspirated materials, levels of CEA were abnormally high, but high levels of elastase 1 did not occur. Therefore, the combined measurement of CEA and elastase 1 in the aspirated cystic fluid of the pancreas could be used as an aid in diagnosis of malignant cysts of the pancreas.
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PMID:Values of carcinoembryonic antigen, elastase 1, and carbohydrate antigen determinant in aspirated pancreatic cystic fluid in the diagnosis of cysts of the pancreas. 242 Apr 41

The purpose of this study is to clarify the clinicopathophysiology of splenic vein occlusion due to pancreatic disease from hemodynamic points of view. We reviewed the angiographic findings and medical records of 82 patients who had pancreatitis, pancreatic cyst or pancreatic cancer in the pancreatic body and tail. According to the site of occlusion in 16 patients with complete splenic vein occlusion, this entity may be divided into two categories: Type A, an occlusion close to the spleen in which short-gastric system seems to be major collateral, and Type B, an occlusion distant from splenic hilum in which gastroepiploic system becomes prominent as collateral. As compared to 7 patients with incomplete splenic vein occlusion, gastric varices and splenomegaly were frequently observed with the patients having complete occlusion. Among these 16 patients, splenic arterial occlusion was superimposed in 3 patients with pancreatic cancer in whom gastric varices were not detected. Thus, clinical features of this entity must be carefully assessed according to the nature of the underlying disease. Based on these observations, three consecutive phases: Phase 1 Insiduous or latent phase, Phase 2 Collateral developing phase, Phase 3 Vanishing phase may be distinguished for splenic vein occlusion secondary to pancreatic disease.
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PMID:[Splenic vein occlusion due to pancreatic disease: regional portal hypertension from hemodynamic points of view]. 277 Jun 83

A total of 32 histologically documented cases of heterotopic pancreas was found in a review of the records of the department of pathology at the Chang Gung Memorial Hospital between 1977 and 1987. This review was done to ascertain the clinical significance of this uncommon entity. In 14 patients (44%), the aberrant pancreatic tissue was symptomatic; in the other 18 (56%), it was found incidentally. In the symptomatic group, the heterotopic pancreatic tissue was found in a duplication cyst of the ileum in one patient, in the common bile duct in one, in a Meckel's diverticulum in four, in the stomach in three, in a congenital duodenal diaphragm in one, in the duodenum in three, and in the ileum in one. The majority of heterotopic pancreatic tissue in the asymptomatic group was encountered in the jejunum (15 patients). Symptoms were related to complications, including obstruction of the common bile duct, mucosal ulcer with hemorrhage, intussusception, and intestinal obstruction, but not to pathologic conditions of the pancreas itself, such as pancreatitis or pancreatic cyst or neoplasm. In all of the clinically significant cases, the clinical symptoms disappeared completely after surgical removal of the aberrant tissue. In 28 cases (87%), diagnosis was made by frozen section during operation. Preoperative diagnosis of aberrant pancreas was not made in any of the cases. Histologically, all cases showed pancreatic excretory ducts; in 31 cases (97%), exocrine glands were present, and in 27 cases (84%), islets of Langerhans were discernible. There was no relationship between symptoms and the presence of islets, acini, or ducts. Mallory's phosphotungstic acid-hematoxylin stain was used to demonstrate zymogen granules in the acinar cells, and insulin, glucagon, and somatostatin were demonstrated with the horseradish peroxidase-antihorseradish peroxidase immunocytochemical staining technique; islets of Langerhans were also identified. Technetium Tc 99m scintigraphy was used to detect the bleeding source in a Meckel's diverticulum and an enteric duplication associated with ectopic gastric mucosa.
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PMID:Pancreatic heterotopia: a reappraisal and clinicopathologic analysis of 32 cases. 305 29

Over a 6-year period at the University Hospital in London, Ont., 101 patients underwent heart transplantation and 5 heart-lung transplantation. The authors review the general surgical problems identified from the charts of 13 of these patients. In the early postoperative period (within 30 days), laparotomy was required for pancreatitis (one), perforated peptic ulcer (two), cholecystectomy (one), pancreatic cyst (one) and appendicitis (one). In addition, a spontaneous colocutaneous fistula and spontaneous pneumoperitoneum occurred; both were managed conservatively. Later, three patients required cholecystectomy; one underwent a below-knee and a Symes amputation for dry gangrene and one surgical correction of a lymphocele. The incidence of surgical problems (13%) indicates an increased susceptibility in this group of patients. Four of the 13 patients died. Pancreatitis is a well-recognized complication of cardiac surgery; it is frequently associated with a normal or only slightly elevated serum amylase level, making a definitive diagnosis without laparotomy almost impossible. Persistence of abdominal signs should signal the need for exploratory surgery. During the early postoperative period and in the absence of multiorgan failure, immediate operation for an acute abdomen is usually successful. Despite the additional risk, cardiac transplantation does not preclude later surgery, but immunosuppression must be continued and carefully monitored.
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PMID:Management of general surgical problems after cardiac transplantation. 329 32

Four cases of annular pancreas diagnosed by endoscopic retrograde cholangiopancreatography (ERCP) are described and 105 cases of this anomaly in adults in Japan were reviewed. Among 105 cases, abdominal pain was the most frequent symptom. Concerning associated diseases, peptic ulcer was present in 24.8% and pancreatitis in 13.3%. In case 1, duodenal ulcer and pancreatic cyst were noted. Pancreatolithiasis was found in two cases (case 1 and 2). Case 4 presented the clinical features of acute pancreatitis. Out of 105 cases, well-described 26 were divided into six types. The following results were obtained. 1) The most frequent type was that in which the annular duct arose from the duct of Wirsung. 2) The next most frequent type was that in which the main pancreatic duct encircled the duodenum. 3) The other types corresponded to those in which the annular duct arose from the duct of Santorini and the common bile duct. We emphasized that ERCP is the most important procedure to find the characteristic features and to establish the therapeutic strategy in cases of annular pancreas.
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PMID:Annular pancreas detected in adults, diagnosed by endoscopic retrograde cholangiopancreatography: report of four cases. 356 55

The annular pancreas which is responsible for one third of the cases of duodenal obstruction plays a central role in pancreatic malformations. Therapy of choice is a duodeno-duodenostomy. Prognosis is deteriorated by frequent premature delivery, Down's syndrome and associated malformations. Among pancreatic tumors the congenital pancreatic cyst, the cysto-papillary adenoma and the insulinoma are particularly considered the latter in connection with the discussion of hyperinsulinism which also nesidioblastosis is associated. Pancreatic tumors to require surgical therapy and a subtotal excision of the pancreas is frequently necessary in nesidioblastosis. Besides pancreatitis which is diagnosed in Germany also pancreatic rupture with subsequent posttraumatic pancreatitis leading to pancreatic pseudocysts is discussed. There are no deaths after isolated pancreatic trauma or surgery of pancreatic pseudocysts.
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PMID:[Pediatric problems arising from surgery of the pancreas in childhood (author's transl)]. 610 38

The clinical usefulness of serum pancreatic secretory trypsin inhibitor (PSTI) in pancreatic diseases was evaluated. The mean serum PSTI level of 41 healthy normal persons was 9.4 ng/ml (ranging from 5.2 to 16.7 ng/ml). Serum PSTI levels were abnormally raised in all patients with acute pancreatitis ranging from 35.0 to 4500 ng/ml, but were almost within normal range in patients with chronic pancreatitis, pancreatic cyst, acute abdominal emergencies such as perforated ulcer and intestinal obstruction, and macroamylasemia. There was no correlation between serum PSTI levels and total or pancreatic-type isoamylase activity. Patients with acute pancreatitis in whom the elevation of serum PSTI was transient and occurred after that of serum amylase activity had relatively mild symptoms and recovered along with normalization of serum PSTI levels. On the other hand, patients whose serum PSTI values became increased coincidentally with serum amylase activity and remained elevated, had severe clinical symptoms and unfavorable clinical outcome. Of 2 patients who underwent partial pancreatectomy, the serum PSTI level increased markedly in one who developed postoperative pancreatitis but not in the other without pancreatitis. In contrast to patients with acute pancreatitis, the serum response to the secretin stimulation in patients with chronic pancreatitis, was only small and transient, reaching the maximum at 10 min after administration of secretin. These results suggest that measurement of serum PSTI concentration may be useful in the diagnosis of acute pancreatitis and that the degree of rise and the duration of the elevated levels of serum PSTI are closely related to the severity of acute pancreatitis.
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PMID:Serum pancreatic secretory trypsin inhibitor in pancreatic disease. 620 36

Pancreatic cysts were diagnosed on computed tomography (CT) in 6 (8%) of 73 histologically proven pancreatic carcinomas. In three of a total of seven cases studied, the initial CT diagnosis was pancreatitis. The CT features of cysts secondary to pancreatic carcinoma were identical to those of pseudocysts in pancreatitis. All cases had masses of varying sizes suggestive of carcinoma or pancreatitis. Even in retrospect, two cases were difficult to differentiate from pancreatitis with pseudocysts. Our results indicate that whenever pancreatic cysts are encountered in patients of cancer age without a history of pancreatitis, further examinations including percutaneous aspiration biopsies should be performed to exclude malignancy.
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PMID:Pancreatic cysts caused by carcinoma of the pancreas: a pitfall in the diagnosis of pancreatic carcinoma. 628 83

Diagnostic and therapeutic features are discussed with respect to a case of digestive hemorrhage from false pancreatic cyst, a rare, often unrecognized complication of this lesion. Typical forms are rarely observed, and recurrent or unexplained hemorrhage, particularly when associated with pancreatitis, should suggest the diagnosis. Arteriography is of both diagnostic and therapeutic value. Treatment has frequently to be directed both towards the disease as well as the complication and surgical excision is usually required.
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PMID:[Hemorrhagic complication of a false cyst of the pancreas]. 633 11

The first case of a cystadenoma of the pancreas occurring in an African patient is reported. cystadenoma of the pancreas is a rare tumour. It should be suspected when a patient presents with a pancreatic cyst but without a history of pancreatitis, alcoholism or abdominal trauma. Estimation of the serum amylase level, selective coeliac and superior mesenteric arteriograms, and endoscopic retrograde pancreatography (ERP) are helpful in making the preoperative diagnosis. The ERP appearances in cystadenoma of the pancreas are described.
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PMID:Cystadenoma of the pancreas: report of a case diagnosed by endoscopic retrograde pancreatography. 694 May 53


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