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)

Medical treatment of gastric and duodenal ulcerations has recently been improved and extended by anti-aggressive and protectively acting drugs (e.g., H2-receptor antagonists and carbenoxolone sodium). However, antacids and anticholinergic treatment are still being used in modern ulcer management. The most important therapeutical measures against chronic relapsing pancreatitis are abstinence from ethanol and surgical treatment of biliary or pancreatic duct obstructions. Symptomatic management--pancreatic enzyme substitution and analgetics, antacids, anticholinergics--is adequate in pancreatic insufficiency and during acute exacerbation, respectively.
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PMID:[Therapy of peptic ulcer and chronic pancreatitis]. 1 65

A retrospective study of 49 patients with chronic obstructive and chronic calcific pancreatitis is presented. All patients were operated upon and underwent either a partial pancreatectomy or internal drainage of the ductal system into a Roux-en-Y loop of jejunum. The criteria for selection of operation are discussed, and the follow-up of the two operative groups is given. In patients selected as described, internal drainage provided better relief of pain and was accomplished with a lower operative mortality and morbidity and with less postoperative pancreatic insufficiency.
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PMID:Surgery for chronic pancreatitis. Drainage versus resection. 44 18

Two patients with annular pancreas are described. The diagnosis was established unequivocally with endoscopic retrograde cholangiopancreatography before operation. In both patients there was pancreatitis of the annular pancreas. The first patient also had congenital absence of the ventral pancreas and pancreatic insufficiency. The second patient subsequently developed gastric outlet obstruction. The literature is reviewed.
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PMID:Diagnosis of annular pancreas with endoscopic retrograde cholangiopancreatography. 48 38

A follow-up investigation of 20 patients, surgically treated for acute haemorrhagic necrotising pancreatitis, was performed in an average of 2 3/4 years after the operation. Twelve patients showed manifest diabetes mellitus, four further cases had a suspicious oral glucose tolerance test. Only one patient was insulin dependent. A secretin-pancreozymin test performed in 15 patients showed a dissociated or global pancreatic insufficiency in 13 cases. The extent of the endocrine and exocrine functional disturbance did not correlate with the extent of surgery. Postoperative functional defects were readily improved therapeutically in most cases. Only in patients who continued to consume alcohol were there digestive disturbances. The results indicate that the functional state of the remaining pancreas does not only depend on the extent of surgery but also on the extent of already existing or persisting toxic inflammatory damage and on the regenerative capacity of the remaining parenchyma.
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PMID:[Long-term results after operative treatment of acute haemorrhagic necrotising pancreatitis (author's transl)]. 51 Jan 95

Information from 72 patients from 7 families in England and Wales confirms that hereditary pancreatitis is inherited as an autosomal dominant conditions with limited penetrance. The degree of penetrance is approximately 80%. These patients have had recurrent attacks of abdominal pain starting from childhood or young adult life. The mean age of onset in the 7 families studied was 13.6 years. There were two peaks, with maximum numbers at 5 years and 17 years. The second peak was thought to represent genetically susceptible individuals having pain brought on by alcohol rather than representing evidence of genetic heterogeneity. Five of the 7 families had members with both childhood and adult ages of onset. Only 4 patients out of 72 had life-threatening disease and in the majority of cases the attacks of pain were of nuisance value only. Hereditary pancreatitis was implicated in only 1 patient's death and this was not definite. Patients appear to get better after a period of symptoms usually as they approach middle age, or after a severe attack. In older patients alcohol, emotional upsets, and fatty food appear to precipitate attacks. Pancreatic insufficiency (5.5%), diabetes mellitus (12.5%), pseudocysts (5.5%), and haemorrhagic pleural effusion are uncommon complications. Portal vein thrombosis occurred definitely in 2 patients and was suspected in 3 others. Carcinoma of the pancreas was not found in any of 72 patients studied in detail; however, 2 members from a family not visited personally had chronic pancreatitis and malabsorption going on to carcinoma. They may have suffered from a different disease. Genetic linkage information was too slight for many definite conclusions. However, there was no suggestion of linkage with any of the markers tested.
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PMID:Hereditary pancreatitis in England and Wales. 67 83

This study was designed to assess the functional efficiency of the ageing small intestine and the possible role of malabsorption in old people with nutritional deficiencies. Fifty subjects aged 65 to 92 years were studied, of whom 33 presented with anaemia, chronic diarrhoea or bone pains, and 17 were apparently healthy 'controls' with no relevant symptoms. Tests of intestinal function included blood xylose and iron absorption curves, a double isotope Schilling test, faecal fat, urinary indican and small bowel radiology, with duodenal aspiration and jejunal biopsy in some cases. On the basis either of steatorrhoea or at least two other abnormal parameters of absorption, there were 15 cases of malabsorption. Thirteen of these had symptoms but two were 'controls'. Four of these had duodenal diverticulosis, two had the post-gastrectomy syndrome, and one had calcific pancreatitis. Malabsorption in the remaining eight cases was not fully explained. The age range of this last group was 72--86 years; one of them had a contaminated small bowel and two showed some evidence of pancreatic insufficiency. Malabsorption emerged as a significant cause of low levels of serum iron, haemoglobin and calcium. The blood xylose test is a useful screening procedure for intestinal malabsorption in old age, but full evaluation calls for investigation of pancreatic function.
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PMID:The ageing gut: a study of intestinal absorption in relation to nutrition in the elderly. 68 55

An increase in fasting cholecystokinin (CCK) levels has been reported in patients with pancreatic insufficiency, but the relationship of these findings to the clinical conditions has not been established. We, therefore, measured fasting serum CCK-like immunoreactivity in 70 patients with chronic relapsing pancreatitis (CRP) (38 non-surgically treated and 32 previously surgically treated) and in 44 healthy subjects. The radioimmunoassay detected three circulating forms of CCK. The mean value of the CCK levels in CRP (260.3 +/- 300.8 pg/ml) was significantly higher than that of the controls (56.6 +/- 61.7 pg/ml) (p less than 0.001), but in 39 (56.7%) of the 70 CRP cases the CCK was in the normal range. A smaller overlap with the controls was observed in the non-surgically than in the surgically treated patients (45 vs. 71.8%). In the 38 non-surgically treated CRP cases no relationship was observed between the CCK levels and each of the following parameters: age, length of history, presence or absence of pancreatic calcification, nutritional and alcoholic habits, and the results of exocrine function tests. The absence of the last-mentioned correlation is somewhat unexpected if the high CCK levels are due to the interruption of a feedback loop for CCK secretion. However, previous pancreatic surgical drainage and/or treatment with pancreatic enzymes, present in almost all these patients, could have an effect on CCK behaviour.
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PMID:Fasting serum cholecystokinin immunoreactivity in chronic relapsing pancreatitis. 74

We describe a new method for measuring pancreatic and salivary-type amylases in serum that requires no electrophoresis or chromatography. An inhibitor protein (from wheat) with a 100-fold greater specificity for human salivary than for human pancreatic amylase was used to analyze mixtures of the two enzymes. The concentration of pancreatic and salivary amyalase was determined in 141 normal sera (72 men and 69 women). Statistically significant differences were found for serum pancreatic amylase between mean and women, higher values being shown in women. No sex-related difference was found for the salivary component of serum amylase. With this method, the increase in serum amylase activity in pancreatitis was shown to be attributable to the pancreatic component. In mumps, the increase is attributable to the salivary component. In pancreatic insufficiency, serum pancreatic amylase activities were significantly lower than in the controls. Our method is simple and rapid; our results agree well with those of other authors who used chromatographic or electrophoretic methods.
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PMID:Differential serum amylase determination by use of an inhibitor, and design of a routine procedure. 83 45

97 chronic alcoholic patients were investigated with regard to exocrine pancreatic function. Chronic calcifying pancreatitis was radiologically established in 7.2% of the cases. Secretin-pancreozymin tests were performed in 30 patients. Pancreatic insufficiency was found in 8 patients, while 8 patients showed marked hypersection. The daily faecal fat excretion in 10 other patients with partial gastrectomy and Billroth II operation was 5.3 g. Pancreatic disorders were, thus, detected in 53.2% cases of chronic alcoholism. This is higher than expected for Austria.
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PMID:[Exocrine pancreatic function in chronic alcoholics in Austria (author's transl)]. 87 90

A further Swiss family with hereditary chronic relapsing pancreatitis is reported. Five members definitely have the disease, while in 4 subjects the condition is suspected. The five proven cases are a mother and her four children. All suffer from recurrent attacks of abdominal pain which started between the 8th and 20th year of life, and in all of them exocrine pancreatic insufficiency and pancreatic calcifications can be demonstrated. The mother has had diabetes mellitus since the age of 40 and 3 of the 4 children also have the disease, with age of onset between 15 and 29. In 3 patients insignificant traces of aminoacids could be detected in the urine. At 16 years one male patient had a pseudocyst of the pancreas surgically removed. All the others are treated conservatively. Reports on approximately 25 families with this disease have been published so far. The condition is inherited as an autosomal dominant disorder. Typically, the clinical symptoms begin during childhood or early adolescent life. The pathogenesis is unknown. It is possible that an abnormal pancreatic juice is produced which causes the intracanalicular calcifications. The treatment is identical to that in the non-hereditary forms, i.e. generally conservative. Recently some authors have favored a more aggressive approach consisting of pancreatico-jejunostomy or partial resection of the pancreas.
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PMID:[Swiss family with chronic relapsing calcifying pancreatitis]. 89 47


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