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

Despite the proposal that somatostatin or its stable analogue, octreotide (SMS-201,995), may exert an ameliorating effect on acute pancreatitis, data concerning its beneficial effect in this situation are conflicting. This study examines the effects of octreotide on acute pancreatitis, resulting from the retrograde injection of a bile salt (taurocholate) plus saturating trypsin into the common bile-pancreatic duct of the rat. Octreotide given before the induction of pancreatitis significantly reduced the levels of serum amylase and lipase, ascites amylase concentration, degree of leukocyte infiltration, and focal areas of pancreatic tissue necrosis. In contrast, administration of octreotide as soon as 5 min following induction had no demonstrable ameliorating effects on the pancreatitis. These results indicate that octreotide may have application to prophylaxis of acute pancreatitis in cases where bile salts may play a role in pathogenesis, but may not be beneficial in established acute pancreatitis.
Pancreas 1991 Sep
PMID:A somatostatin analogue is protective against retrograde bile salt-induced pancreatitis in the rat. 171 27

Seventy-eight cases of severe acute pancreatitis were admitted to Mie University and its affiliated hospitals. These were subdivided into Group I (1976-1983) and Group II (1984-1989). The rate of early death was 34.8% in Group I and 9.3% in Group II. Among operated cases, peritoneal drainage alone was not effective with the worst mortality rate of 47.1%, especially in gallstone pancreatitis, with a 100% mortality rate. Early detection of infected necrosis or abscess using enhanced CT and subsequent drainage should be performed in cases of severe acute pancreatitis. A total 1182 cases of severe acute pancreatitis out of 12,309 cases of acute pancreatitis were collected in Japan by Saito et al., who belong to the Research Committee of Intractable Diseases of the Pancreas supported by the Japanese Ministry of Health and Welfare. Furthermore, 473 cases of severe acute pancreatitis in the Japanese literature reported from 1987 to 1990 were reviewed. Then, surgical indications and procedures were discussed. The incidence of necrosectomy has been increased to 10.3% from 3%, and biliary drainage procedure increased for severe acute pancreatitis. Indication of necrosectomy with or without open drainage method should be carefully evaluated in each institution.
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PMID:Surgery in acute pancreatitis. The Japanese experience. 174 47

During a 5-year period, 74 patients with pancreatic injuries were managed by distal pancreatic resection at nine referral trauma centers. Patient ages ranged from 4 to 72 years. Injury mechanism was blunt trauma in 34 (46%) patients, gunshot wound in 27 (36%), stab wound in 11 (15%), and shotgun blast in two (3%). There were 19 class II, 50 class III, and 5 class IV pancreatic injuries. The resection comprised up to 33% of the pancreas in 21 (28%) patients, from 34% to 66% in 45 (61%), and greater than 67% in eight (11%). The pancreatic resection margin was closed with staples in 44 (59%), silk sutures in 20 (27%), and polypropylene sutures in eight (11%). Of 32 patients in whom the spleen was uninjured, the spleen was left intact in 17 (53%). There were nine (12%) deaths. The cause of death was irreversible shock in three patients, multiple organ failure in five, and severe head injury in one. Pancreas-related complications occurred in 32 (45%) of 71 patients who survived the initial operation. Intra-abdominal abscess developed in 24 patients; 11 were managed by percutaneous drainage alone. Pancreatic fistula developed in 10 patients; eight closed spontaneously from 6 to 54 days. Other pancreas-related morbidity included pancreatitis (6), pseudocyst (2), and hemorrhage (2). Exocrine insufficiency was not evident in any patient and diet-controlled hyperglycemia occurred in one individual following 80% pancreatic resection.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Distal pancreatectomy for trauma: a multicenter experience. 174 29

This review summarizes the role of radiologic tests, especially CT, in the diagnosis and assessment of acute pancreatitis and its complications. Consideration of the underlying pathologic changes of complicated pancreatitis and their radiographic correlates allows identification of the presence, extent, and nature of local complications. This information can be crucial in making appropriate management decisions. Based on these data, general guidelines for the appropriate use of CT in acute pancreatitis can be formulated. Patients with clinically mild pancreatitis in whom the diagnosis is secure probably do not require imaging as long as they respond appropriately to conservative management. In patients with clinically severe pancreatitis, early CT should be performed to evaluate the extent and nature of local complications. If radiographic changes are mild and the patient responds to conservative management, no further imaging is needed. If the patient does not respond appropriately or clinically worsens, follow-up CT should be performed, seeking delayed complications. Patients in whom the initial CT shows severe pancreatitis and peripancreatic inflammatory changes should be followed with serial CT to assess resolution. Initially, serial CT should be performed every 1-2 weeks, or sooner if clinically indicated. If at any time there is clinical suspicion of infection, aggressive use of FNA is indicated. The decision to intervene, whether for infectious or sterile complications of pancreatitis, must still be made on clinical grounds. CT can be helpful in choosing the appropriate means of intervention.
Pancreas 1991
PMID:The radiologic assessment of acute pancreatitis and its complications. 178 47

This overview clearly documents the critical diagnostic and therapeutic role for endoscopic intervention in pancreatitis. Further, although at the forefront of endoscopic development, the new therapeutic techniques discussed offer promise, suggesting cautious optimism. Their ultimate role in treatment of pancreatic disorders must await clarification of appropriate indications, safety, efficacy, and long-term benefit.
Pancreas 1991
PMID:Endoscopic intervention in pancreatitis. 178 49

Accurate predictors of severity in acute pancreatitis are sorely needed. At present, Ranson's scores provide useful information, some of which is recorded too late to be of maximal usefulness. APACHE-II scores on the day of admission and thereafter appear to provide important prognostic information that may enable the clinician to optimize patient care. CT scans, particularly those with bolus injection of i.v. contrast, help enormously in distinguishing interstitial from necrotizing pancreatitis. Most serum markers have not proven to be reliable in making this distinction.
Pancreas 1991
PMID:Predictors of severity in acute pancreatitis. 178 56

Copper and zinc are both secreted by the pancreas but are necessary for pancreatic secretion. We have studied the effects of a 4- or 8-week zinc or copper-deficient diet associated with or without lipid or protein deficiency on rat pancreatic secretion after stimulation by secretin, cerulein, or intraduodenal oleic acid. Twenty animals were in the control group; 40 rats were fed a copper-deficient diet (20 copper-deficient only and 20 copper- plus lipid-deficient). Ninety rats were deprived of zinc (30 of zinc-deficient only, 30 zinc-plus protein-deficient, 30 of zinc- plus lipid-deficient). Only the zinc- plus lipid-deficient diet for 8 weeks decreased basal bicarbonate and basal protein secretion (-42 and -70%, respectively, of the control values). Stimulated secretion was not markedly altered by copper deficiency while zinc deficiency, zinc plus protein deficiencies, and zinc plus lipid deficiencies suppressed almost responses to hormonal stimulation: After 8 weeks, the maximal protein response to oleic acid was reduced to 19.00 +/- 3.40, 18.58 +/- 3.00, and 12.04 +/- 2.91 microgram/30 min/g body weight in zinc- zinc and protein-; and zinc- and lipid-deficient diet, respectively, versus 39.87 +/- 6.33 microgram/30 min/g body weight (p less than 0.05) in controls. In all types of stimulation, lipid deficiency potentiated the deleterious effect of zinc deficiency on pancreatic secretion. This might be paralled with an extremely low level of lipid in the diet of people living in countries in which nutritional pancreatitis is observed and with the relative risk of developing an alcoholic chronic pancreatitis being increased by a low fat diet.
Pancreas 1991 May
PMID:Effects of zinc and copper deficiency associated with protein or lipid deficiency on rat exocrine pancreatic secretion. 186 68

Perfusion of the main pancreatic duct in cats with a dilute solution of bile salts increases ductal permeability. Subsequent perfusion of a permeable duct with activated pancreatic enzymes results in acute edematous pancreatitis. Simultaneous infusion of 16-16 dimethyl-PgE2 converts edematous pancreatitis to acute hemorrhagic pancreatitis (AHP). AHP may be associated with a reduction in pancreatic blood flow; it is certainly associated with increases in microvascular permeability. Low dose dopamine is a splanchnic vasodilator and may also reduce pancreatic microvascular permeability through beta agonist effects. In these studies, we investigated the effect of dopamine in an established feline model of biliary AHP. We also studied its effect on blood flow in both normal pancreas and after induction of AHP. We found that dopamine significantly reduced the degree of pancreatic inflammation, even when administered up to 12 h after onset of biliary AHP. However, the drug had no significant effect on blood flow either in normal pancreas or in the gland affected by hemorrhagic pancreatitis. We concluded that the effect of dopamine was most likely due to its ability to reduce pancreatic microvascular permeability.
Pancreas 1991 Jul
PMID:The effect of dopamine in a model of biliary acute hemorrhagic pancreatitis. 187 97

The effect on endogenous beta-endorphins of a new synthetic protease inhibitor was studied in acute pancreatitis. Pancreatitis was induced by the injection of autologous bile mixed with trypsin into the main pancreatic duct after ligation of the accessory duct. Plasma beta-endorphin concentrations and cardiovascular function were measured. Ten dogs (control group) were given 10 ml/kg/h of lactate Ringer's solution intravenously beginning 1 h before the induction of pancreatitis and continuing throughout the experiments. Six dogs received an intravenous infusion of 3 mg/kg/h of a new synthetic protease inhibitor, E-3123 (4-(2-succinimidoethylthio)4-geranidinobenzoate methanesuLfonate), in lactate Ringer's solution soon after the induction of pancreatitis. Plasma beta-endorphin concentrations in the control group increased significantly. However, plasma beta-endorphin levels in the protease inhibitor group did not increase as in the control group. The protease inhibitor infusion improved hypotension, myocardial depression, and plasma lactate, suggesting that the inhibitory effect of the protease inhibitor on beta-endorphin release contributed to the improvement.
Pancreas 1991 Jul
PMID:Effect of a new synthetic protease inhibitor on beta-endorphin release during acute pancreatitis in dogs. 187

Acute pancreatitis may result from viral infections, including mumps, coxsackie B, Epstein-Barr, and varicella. However, viral pancreatitis has not been reported after immunization with viral vaccines. We report the occurrence of acute pancreatitis in an adult who had received measles, mumps, and rubella II vaccine (MMR II).
Pancreas 1991 Jul
PMID:Pancreatitis caused by measles, mumps, and rubella vaccine. 187 5


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