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

The useful laboratory tests in the pancreatitis study are revised. A short description of the procedures, its sensibility and specificity, availability and indication is made. In acute pancreatitis the different enzymatic determinations in serum and urine that are used to establish the illness diagnosis and prognosis are described and also, the results of other substances assays like some acute phase reactants that can be useful as prognostic factors. In chronic pancreatitis the different levels in which pancreatic insufficiency can be studied are described as well as the test that can be done in each case. The complexity, specificity and sensibility of direct tests is analyzed. Nevertheless functional exploration methods that constitute a useful alternative as pancreolaurly, PABA or the recently proposed plasmatic amino acids and marked triglicerids with C13 are also mentioned. The clinical laboratory in the diagnosis of pancreatitis is complementary to the image methods and it is considered indispensable to perform at least two precise methods and it is considered indispensable to perform at least two precise methods of enzymatic determination in serum and an indirect test or another non invasive test that should be validated in each group for the study of gastroenterologic patients.
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PMID:[The clinical laboratory in the study of pancreatitis]. 774 23

Pancreatitis occurs in up to 15% of patients with cystic fibrosis and pancreatic sufficiency, but the possibility of its occurrence in patients with pancreatic insufficiency has not been recognized. We describe a patient with homozygous delta F508 cystic fibrosis and typical symptoms of pancreatic insufficiency (greasy, fatty stools) in whom pancreatitis developed.
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PMID:Chronic pancreatitis in a patient with cystic fibrosis and clinical pancreatic insufficiency. 777 4

The natural course of the classical symptoms of chronic pancreatitis, i.e. pain, exocrine and endocrine pancreatic insufficiency, was followed up in 335 patients over a median of 9.8 years (mean 11.3 +/- 8.3 years). Pain relief was not obtained in the majority of patients, even after a longterm observation of > 10 years, and severe exocrine and/or endocrine insufficiency, severe duct abnormalities and pancreatic calcifications developed. Alcohol abstinence failed to have a significant beneficial effect on pain. Pancreatic surgery led to pain relief immediately after operation, but later on the pain course between operated and nonoperated patients was not significantly different. Repeated exocrine pancreatic function tests in 143 patients showed that functional exocrine impairment came to a standstill (46%), or improved (11%). At the end of the observation, 22% of 335 patients still had normal endocrine function and only 40% required insulin treatment. Alcohol abstinence had a significant beneficial effect on endocrine, but not on exocrine pancreatic insufficiency. Chronic pancreatitis led to a sharp increase in unemployment and retirement. Pancreatic carcinoma occurred in 3% and extrapancreatic carcinoma in 4%. The mortality rate within the observation period was 22%, pancreatitis-induced complications accounted for 13% of these deaths.
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PMID:[The natural course of chronic pancreatitis--pain, exocrine and endocrine pancreatic insufficiency and prognosis of the disease]. 777 39

The aim of the present study was to investigate the exocrine pancreatic function after recovery from necrotizing pancreatitis. The exocrine function was analysed in 53 patients who had recovered from their first attack of necrotizing pancreatitis. In a group of 23 patients (Group A), three follow-up studies were performed between four weeks and 12 months after recovery from acute pancreatitis. A second group of 30 patients (Group B) was submitted to only one function test 18 months after recovery from acute necrotizing pancreatitis. Exocrine pancreatic function was observed after endogenous stimulation using the Lundh test meal. In Group A, after four weeks 74% of the patients had mild-to-moderate insufficiency, while 26% suffered from severe impairment of pancreatic function. Twelve months after recovery, only 16% of the patients showed a normal pancreatic response, while 84% still had pancreatic insufficiency of variable severity. In Group B, 13% of the patients showed a normal pancreatic response, while mild-to-moderate insufficiency was observed in 81%. Severe pancreatic insufficiency was measured only in 6% of these patients. After recovery from necrotizing pancreatitis persistent global or dissociated functional insufficiency is found in 80-85% of the cases. Individual pancreatic enzyme secretion varies quiet considerably during the course of recovery in the follow-up period.
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PMID:Exocrine pancreatic function after recovery from necrotizing pancreatitis. 778 37

The frequency of acute or chronic pancreatitis in primary hyperparathyroidism has decreased from the former 5-10% to 1-2% thanks to earlier diagnosis and operative treatment. Chronic pancreatitis, which occurs only in prolonged primary hyperparathyroidism, should therefore virtually disappear. We investigated this topic in a prospective long term study of chronic pancreatitis (1963-1992). Over the last three decades 336 patients with chronic pancreatitis have been studied at regular intervals. 245 suffered from alcohol-induced (84% with calcifications) and 91 from non-alcohol-induced chronic pancreatitis (77% with calcifications). The average period of observation in the group with non-alcohol-induced chronic pancreatitis was 10.6 years. Primary hyperparathyroidism was found in 6 patients (4 male, 2 female), i.e. 6.6% of non-alcohol-induced chronic pancreatitis (100% with calcifications). They were evenly distributed over the 30 years' study period. 3 patients had acute attacks of pancreatitis prior to the diagnosis of chronic calcific pancreatitis (2 months, 3 + 8 years). In 3 patients with primary painless chronic calcific pancreatitis the condition was diagnosed twice incidentally and once because of diabetes mellitus. Chronic pancreatitis was diagnosed 3 times before primary hyperparathyroidism (8.3 +/- 2.1 years), once simultaneously and twice afterwards (2 + 14 years). In three patients chronic pancreatitis was initially misinterpreted as alcohol-induced. Severe exocrine pancreatic insufficiency was present in 4 of 5 patients (no data in one), and diabetes mellitus in 3 of 6 patients. At the time of diagnosis of primary hyperparathyroidism, mean serum calcium was 3.08 +/- 0.43 mmol/l.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Chronic pancreatitis and primary hyperparathyroidism]. 807 34

Mucinous ductal ectasia (MDE) is an uncommon disease characterized by a patulous duodenal papilla extruding mucus, and a pancreatogram showing dilation with amorphous filling defects, communication of the mass with the pancreatic duct, the mass usually being located in the head of the pancreas. We have recently treated three men and three women, mean age 66 years, with MDE. All had abdominal pain, while 33% had the clinical picture of pancreatic insufficiency. Three patients had recurrent pancreatitis, and three had biliary obstruction. Endoscopic retrograde cholangiopancreatography and imaging studies showed a patulous papilla draining mucus in six, pancreatic duct dilation in six, filling defects in six, and communication between the cystic mass and the pancreatic duct in five. A distinct finding not previously reported was a separate pancreatic and biliary orifice in two. Three patients had cancer, two cases being metastatic and one being found at surgery (not suspected preoperatively). Therapy included endoscopic biliary drainage in two, surgery in three, while one refused surgery. Of the operated patients, two underwent resection, one of whom had benign disease and the other cancer; both patients are doing well 14 and 32 months after surgery, respectively. One patient underwent pancreatojejunostomy without symptomatic relief, and developed cholangitis 18 months after surgery that was successfully treated with endoscopic drainage. The other two patients treated with biliary drainage died one and 13 months later, respectively. We conclude that MDE has characteristic pancreatographic and endoscopic findings, and that it is commonly associated with malignant degeneration. Surgical resection is the treatment of choice, since MDE is premalignant, and surgery may be curative when the malignancy is resectable.
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PMID:Mucinous ductal ectasia: cholangiopancreatographic and endoscopic findings. 807 50

Intraoperative electron beam radiotherapy (IORT) is clinically used as a potential adjunctive treatment to surgery of locally advanced pancreatic and gastric cancer. The tolerance of the pancreas to IORT was studied in 15 adult beagles, divided in 3 groups of 5 beagles in which 25, 30 or 35 Gy IORT was delivered through a 6-7 cm circular lucite cone with 6-8 MeV electrons to the pancreas and medial wall of the duodenum. The dogs were followed for endocrine and exocrine pancreatic insufficiency. Two dogs (13%) developed radiation-induced morbidity which consisted of a common bile duct stenosis and an enterocolic fistula, as was confirmed at autopsy after 8 and 18 months, respectively. After a follow-up of 1 year, none of the dogs had developed pancreatitis, diabetes or exocrine insufficiency. There was a significant reduction in serum insulin levels and glucose clearance rates without overt diabetes for 30 Gy and 35 Gy (p < 0.05). No significant changes were found for 25 Gy. This study suggests that 25 Gy IORT to the pancreas may be used clinically, and that higher IORT doses may induce endocrine pancreatic insufficiency in the long-term.
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PMID:Intraoperative irradiation of the canine pancreas: short-term effects. 812 87

Eighteen patients with acute hemorrhagic necrotizing pancreatitis who survived from operation were followed up for 12 to 43 months. Late complications including pancreatic external fistula, pseudocyst, hyperglycemia, etc were reviewed. The pancreatic juice was collected through endoscopic cannulation. The volume and HCO3- concentration of the pancreatic juice and three kinds of pancreatic enzymes were measured. The results demonstrated that inspite of anatomic abnormality or functional impairment of the pancreas, the pancreatic insufficiency rarely manifested to be marked because of the compensative ability of the viable exocrine pancreas.
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PMID:Long-term results of surgical treatment for acute hemorrhagic necrotizing pancreatitis. 824 20

The natural course of the classical symptoms of chronic pancreatitis, i.e. pain, exocrine and endocrine pancreatic insufficiency, was followed up in 335 patients over a median of 9.8 years (mean 11.3 +/- 8.3 years). Pain relief was not obtained in the majority of patients, even after a long-term observation of > 10 years, and severe exocrine/endocrine insufficiency, severe duct abnormalities and pancreatic calcifications developed. Alcohol abstinence failed to have a significant beneficial effect on pain. Pancreatic surgery led to pain relief immediately after operation, but later on the pain course between operated and nonoperated patients was not significantly different. Repeated exocrine pancreatic function tests in 143 patients showed that functional exocrine impairment came to a standstill (46%), or improved (11%). At the end of observation, 22% of 335 patients still had normal endocrine function and only 40% required insulin treatment. Alcohol abstinence had a significant beneficial effect on endocrine, but not on exocrine pancreatic insufficiency. Chronic pancreatitis led to a sharp increase in unemployment and retirement. Pancreatic carcinoma occurred in 3% and extrapancreatic carcinoma in 4%. The mortality rate within the observation period was 22%, pancreatitis-induced complications accounted for 13% of these deaths.
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PMID:Natural course in chronic pancreatitis. Pain, exocrine and endocrine pancreatic insufficiency and prognosis of the disease. 835 56

The familial hyperchylomicronaemia syndrome is a hereditary disorder of lipoprotein metabolism caused by lipoprotein lipase (LPL) deficiency, apolipoprotein(apo) CII deficiency or LPL inhibition. This syndrome, which is characterized by hyperchylomicronaemia, attacks of epigastric pain, recurrent pancreatitis and the presence of eruptive xanthomas, may ultimately lead to necrotizing pancreatitis or pancreatic insufficiency. Treatment consists of lifelong adherence to a low-fat diet to prevent hyperchylomicronaemia and its sequelae. We describe here the clinical course of a patient with acute pancreatitis due to hyperchylomicronaemia based on hereditary LPL deficiency. The different causes of the familial hyperchylomicronaemia syndrome and its therapy will be discussed and an update is presented of our knowledge concerning the basic molecular defects of this hereditary disorder.
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PMID:The familial hyperchylomicronaemia syndrome. 844 22


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