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

An intraduodenal diverticulum in 54 year old woman which caused alcalculous cholecystitis and pancreatitis is described. The diverticulum was missed at the first operation, performed for acute cholecystitis. Before the second it was interpreted as a pancreatic cyst. At the second intervention, the cyst wall was excised through a duodenotomy. Histological examination of the wall of the diverticulum is crucial for correct diagnosis.
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PMID:A case of intraduodenal diverticulum imitating choledochocele. 812 48

The authors report their experience from 136 fine needle ultrasound (FN-US)-guided biopsies and laparoscopies. The pancreatic diseases considered by these methods were as follows: 9 cases of Pancreatitis, 11 cases of Pancreatic cysts, 5 cases of endocrine cancer, 109 cases of Exocrine cancer and 2 not conclusive cases. Diagnostic accuracy of FNB and laparoscopy was evaluated for each group and, in particular, for cancer patients. In the latter group, FNB helped to detect abdominal diffusion in 25 cases (33%) while laparoscopy, including laparoscopic washing, revealed a micro-diffusion in 31 cases (55%), the latter not shown previously by CT, RNM and US. The combination of these methods allows us to confirm the advanced stage of the majority of pancreatic cancers at onset. Furthermore, this seems to be a very reliable method to select resectable patients, thus avoiding useless, sometimes hazardous and expensive further investigation.
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PMID:Ultrasound-guided fine needle biopsy and laparoscopy in the study of pancreatic masses: report on 136 cases. 878 Sep 30

In this paper the authors describes a rare case of renal hydatidosis complicated by post acute pancreatitic cyst. There have been no reports up till now either of any physiopathological between the development of hydatid cysts in the vicinity of the pancreas and subsequent pancreatitis, or of any correlation between long-term albendazole therapy and acute pancreatitis. In our particular case, however, the volumetric increase of the renal cyst caused external compression of the pancreas and the consequent slowing-down of bilio-pancreatic flow, which probably led to the development of acute pancreatitis. Since, in our opinion, the pancreatic pseudocyst required surgical removal, we decided to perform the operation there and then; intraoperative examination of the cystic fluid and the presence of daughter cysts confirmed the suspected diagnosis of hydatidosis, of clear renal origin since it was closely attached to the upper pole and continued along the upper calyces renales; the cyst was easily detached from the lower and posterior edge of the liver, and was completely removed, together with its pericystium, which was detached from the lower surface of the liver and from the inferior subhepatic vein; only a tiny disk of pericystium was left in communication with a calyx, sutured to the rest of the kidney. The pancreatic cyst was drained by means of a mesocolic Roux-loop cysto-jejunostomy.
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PMID:Renal hydatidosis. Discussion of a clinical case complicated by post acute pancreatitic cyst. 979 58

Compared to pseudocyst formation after prior pancreatitis, true cysts of the pancreas are rare. Pancreatic cysts with irregular wall components or a mucinous content raise the suspicion for the presence of a cystic neoplasm, and surgical resection is recommended. A case of a patient with a history of prostate cancer is described in whom a cyst of the pancreatic tail was discovered incidentally. Based on the radiographic features, which did not support the presence of a serous cystadenoma, a spleen-preserving distal pancreatectomy was performed. Histologic features were characteristic for a lymphoepithelial cyst (LEC) of the pancreas, lined with thinned squamous epithelium surrounded by benign lymphoid tissue. Since LECs of the parotid gland, which are associated with acquired human immunodeficiency, are frequently related to Epstein-Barr virus (EBV) infection, EBV in situ hybridization was performed and did not reveal evidence for EBV. Twenty-eight instances of pancreatic LECs have been reported, primarily affecting adult males, without evidence of increased numbers of EBV-positive cells. The pathogenesis, differential diagnosis, and clinical implications of lymphoepithelial pancreatic cysts are discussed.
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PMID:Lymphoepithelial cyst of the pancreas. No evidence for Epstein-Barr virus-related pathogenesis. 1045 24

Fast magnetic resonance (MR) imaging of the rat pancreas was carried out using a snapshot method to observe three-dimensional (3D) and temporal development of the pancreatic cyst after experimental pancreatitis. Acute pancreatitis was induced by a retrograde infusion of the trypsin-taurocholate solution into the pancreatic duct in 23 rats, of which seven survived for one month. Under 2% enflurane anesthesia, (1)H images of the rat abdomen were taken by a 4.7 T magnetic resonance spectrometer under spontaneous breathing. 3D images of the pancreas and cyst were reconstructed from the axial, sagittal and coronal images taken before, 24 h, 7 days, 14 days, 21 days and 28 days after the induction of pancreatitis. The 3D images reconstructed from different slice orientations at each time point showed good agreement with each other. The calculated volumes of the cyst on 7th, 14th, 21st, and 28th day were 0.3 +/- 0.1, 0.8 +/- 0.3, 2.1 +/- 0.6, 6.5 +/- 1.3 mL, respectively. The cystic fluid volume on 28th day was 6.4 +/- 1.4 mL, which confirmed reliability of volume measurement by MR imaging. Fast MR imaging (snapshot) together with 3D reconstruction allows us to understand the detailed chronological and spatial development of pancreatic cyst after acute pancreatitis in rats.
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PMID:Time-course magnetic resonance imaging of rat pancreatic cyst after experimental pancreatitis. 1112 5

Results of treatment of 87 patients with cystic pancreatic formation were analyzed. In 38 patients pancreatic cyst had formatted after destructive pancreatitis, in 28--after pancreatic trauma, in 6--due to virsungolithiasis, in 9--cystadenoma was revealed, in 6--cystadenocarcinoma. In 29 patients operation of internal drainage of cyst was performed. Basing on accumulated experience the authors recommend to perform puncture-cathetherizational intervention under ultrasonic investigation and computeric tomography control, when nonformated or complicated pancreatic cyst is present; in the treatment of uncomplicated nonformated pancreatic cyst the operation of internal drainage, using different organs, stomach, duodenum, small intestine, constitutes the method of choice. When it is impossible to perform puncture-cathetherizational intervention, external drainage of cyst and complex conservative therapy may become the method of choice for the treatment of complicated pancreatic cyst. In the presence of benign cystose tumor it is necessary widely apply radical operation--pancreatic resection. The largest frequency of complications occurrence have been noted after external drainage of cyst, performance of cystogastrostomy, pancreatic resection for cystadenoma and cystadenocarcinoma. The principal of them are: the external pancreatic fistula occurrence (in 9.1% of observations), the cyst recurrency (in 5.7%), erosive hemorrhage (in 4.6%), pancreatitis (in 5.4%), suppuration of postoperative wound (in 8%), stenosis of cystodigestive anastomosis (in 2.3%). Postoperative mortality was 6.8%.
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PMID:[Surgical treatment of cysts and cyst-like formations of pancreas]. 1254 16

A 4-month-old boy presented with 9 days of abdominal distension. The abdomen was tense, distended, and nontender, with a fluid wave. Hypoalbuminemia, hyponatremia, high lipase, normal amylase, high ascitic fluid: lipase, amylase, and serum-ascites albumin gradient < 1.1 were present. Abdominal CT showed large ascites, edema, and pancreatic cyst. No improvement was noted with bowel rest, TPN, albumin, furosemide, octreotide, and paracentesis. Endoscopic retrograde cholangiopancreatography showed disrupted pancreatic duct and a cyst. Pancreatic duct stenting was complicated by early outward migration of the stent and was thus ineffective. An exploratory laporatomy revealed a cyst. Cystogastrostomy resolved the pancreatitis and ascites. The patient was discharged off TPN and tolerating enteral nutrition. Pancreatic ascites is rare, producing few or no symptoms in infants. In conclusion, our patient may have had viral pancreatitis, complicated by a disrupted duct and/or ruptured pseudocyst with ascites formation. Medical management was ineffective. Surgery appears to have been curative.
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PMID:Pancreatic ascites in an infant: lack of symptoms and normal amylase. 1456 Sep 86

There have been only a few reports of autoimmune pancreatitis complicated with pancreatic cyst and such cysts are rare, probably due to the absence of severe tissue necrosis and/or lack of stasis of the pancreatic juice in this condition. However, during a follow-up of 48 patients with this disease, we found 3 patients with pancreatic cysts, and this enabled us to evaluate their clinicopathological findings. Between September 1994 and July 2003, we treated and followed 48 patients with autoimmune pancreatitis, and found 3 patients with pancreatic cyst formation that was responsive to corticosteroid therapy. All of the patients with cysts had high serum IgG4 concentrations. After corticosteroid therapy, rapid resolution of the pancreatic cysts was observed. Immunostaining with goat polyclonal antibody for each IgG subclass showed severe infiltration of IgG4-positive plasma cells in the cyst wall in one patient. The high serum IgG4 concentration and favorable response to corticosteroid therapy suggests that a highly active state of the inflammatory process is closely associated with cyst formation, and that a corticosteroid-responsive pancreatic cyst is a characteristic feature of autoimmune pancreatitis.
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PMID:Corticosteroid-responsive pancreatic cyst found in autoimmune pancreatitis. 1608 95

Cystic tumors of the pancreas are less frequent than solid lesions and are often detected incidentally, as many of these lesions are small and asymptomatic. However, they may be associated with pancreatitis or have malignant potential. With advancements in diagnostic imaging, cystic lesions of the pancreas are being detected with increasing frequency. Many lesions can cause a pancreatic cyst, most being non-neoplastic while approximately 10% are cystic tumors, ranging from benign to highly malignant tumors. With increasing experience it is becoming clear that the prevalence of pseudocyst among cystic lesions of the pancreas is lower than usually presumed. A presumptive diagnosis of pseudocyst based on imaging appearance alone can cause a diagnostic error, and neoplastic cysts of the pancreas are particularly susceptible to this misdiagnosis, which can result in inappropriate treatment. Cystic tumors of the pancreas are formed by serous or mucinous structures showing all stages of cellular differentiation. According to the WHO classification, they can be subdivided on the basis of their histological type and biological behavior into benign tumors, borderline tumors, and malignant tumors. Cystic pancreatic tumors can be subdivided into peripheral (serous cystadenomas, mucinous cystic tumors, solid and papillary epithelial neoplasms, cystic islet cell tumors), which do not communicate with the main pancreatic duct, and ductal tumors (mucinous tumor), according to their site of origin. On the basis of imaging criteria alone, it can be very difficult to differentiate non-tumoral cystic lesions from neoplastic ones. The management of these patients is complex, and it is important to correlate imaging findings with knowledge of the patient's symptoms and of the natural history and predictors of malignancy in pancreatic cysts.
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PMID:Cystic tumors of the pancreas. 1686 Nov 36

A 39-year-old Japanese man was admitted to our hospital after experiencing recurrent episodes of pancreatitis over the previous 2 years. On the first episode, he had been admitted to our hospital with elevated serum amylase levels and epigastralgia. Abdominal computed tomography (CT) revealed a diffuse, uncircumscribed area with heterogeneous density in the pancreas. No previous history of pancreatitis, gallstones, drinking, or abdominal injury was elicited. Magnetic resonance cholangiopancreatography (MRCP) demonstrated that the Wirsung duct was unconnected to the Santorini's duct. Endoscopic retrograde cholangiopancreatography through the papilla of Vater and accessory papilla revealed an enlarged ventral pancreatic duct, pancreas divisum, and a cystic lesion in the pancreatic body. On the second and third episodes, endoscopic drainage of the pancreatic pseudocysts through the accessory papilla and ultrasonography-guided transmural drainage were unsuccessful. A follow-up CT and MRCP demonstrated that the pancreatic cyst had enlarged to 9 x 8 cm in diameter. A laparoscopy-assisted cystgastrostomy was performed with an intragastric approach. An anastomosis was performed using an endoscopic linear stapler through the small cystotomy and gastrotomy openings on the posterior wall of the stomach. The postoperative clinical course was uneventful. Over 6 months later, the patient remains well and with a good quality of life. A laparoscopy-assisted cystgastrostomy, using an intragastric surgical technique, offers a safe, less-invasive procedure for cyst drainage by the pancreas divisum.
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PMID:Pancreatic cyst associated with pancreas divisum treated by laparoscopy-assisted cystgastrostomy in the intragastric approach: a case report and a review of the literature. 1757 Jul 78


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