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

Transient electrocardiographic changes in patients with acute cholecystitis, pancreatitis, and pneumonia have been reported in the past. These changes usually are in the form of T-wave inversion, ST-segment depression, and rarely ST-segment elevation in the absence of coronary artery disease. To the authors' knowledge, this is the first report documenting both left ventricular segmental wall motion abnormality and electrocardiographic changes of myocardial injury in the presence of acute pancreatitis.
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PMID:Electrocardiographic and segmental wall motion abnormalities in pancreatitis mimicking myocardial infarction. 772 Feb 88

A case of pneumonia complicating the course of chickenpox in a previously healthy man is presented. Serious impairment of gas exchange developed, requiring multidisciplinary intensive care management, mechanical ventilation and intravenous acyclovir therapy. Additional complications of hepatitis and pancreatitis occurred. Varicella pneumonia is a potentially life-threatening complication that should be suspected in any adult with chickenpox and respiratory symptoms.
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PMID:Varicella pneumonia: a case report and review. 807 8

Encouraged by the improved results of radical lymphadenectomy in patients with pancreatic carcinoma we designed and carried out a prospective study. Between Jan 88 and Jan 91, 17 patients (group A: cancer of the head of the pancreas, n = 5, periampullary cancer, n = 12) underwent a partial duodenopancreatectomy with radical lymphadenectomy, and 17 patients (group B: cancer of the head of the pancreas, n = 11), periampullary cancer, n = 6) underwent a partial duodenopancreatectomy without lymphadenectomy. Perioperative mortality was 17% (n = 3) in group A and 11.7% (n = 2) in group B. All three deaths in group A were due to erosion and hemorrhage of the completely dissected hepatic artery, and those in group B were due to pancreatitis and pneumonia, respectively. The cumulative 1-, 2- and 3-year survival rates for patients with pancreatic cancer who survived the operation were 50%, 50% and 50% for group A and 25%, 25% and 0% for group B. In patients with periampullary carcinoma 1-, 2-, and 3-year survival rates were all 47% for group A, and 100% for group B.
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PMID:Partial duodenopancreatectomy with radical lymphadenectomy in patients with pancreatic and periampullary carcinomas: initial results. 809 61

Acute pancreatitis in pregnancy and post-partum period, rarely encountered in surgical practice, can have a lethal effect on the mother and the foetus. We report here a case of a 35 year old tertigravida who presented with high grade fever, abdominal pain with distension, tachycardia and tachypnoea. Chest examination and X-rays were suggestive of pneumonia. The abdomen was tense and tender. Peristalsis was absent. Ultrasound revealed presence of fluid in the abdominal cavity which on paracentesis was found to contain Gram positive cocci. Fluid amylase levels were high. On exploratory laparotomy, haemorrhagic oedematous pancreatitis was noticed. The patient expired on the 2nd post operative day.
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PMID:Post-partum pancreatitis. 816 73

We experienced 24 cases of thymoma in the past 17 years. Associated syndromes as myasthenia gravis and pure red cell anemia (PRCA) were found in 7 patients. Preoperative therapies were done for the cases of stage IV. Total resection of the tumor was performed except 3 cases which ended in exploratory thoracotomy. Postoperative therapies were done except the cases of stage I. Each one case of stage III and IV a whose operation ended in exploratory thoracotomy died of tumors, but latter case had some period of PR after chemotherapy. A case of stage I with PRCA died from pneumonia but other cases of autoimmune disease had been well controlled by medical treatment. A case of stage IVb was first admitted to the hospital for paralysis of bilateral lower limb. After resecting the epidural tumor of thoracic spine, chemotherapy (CAV 1 kur) and radiotherapy (4,200 rad) was performed which was effective for minimizing the antero-mediastinal tumor. Though operation ended in exploratory thoracotomy, majority of the tumor was found to be replaced for fibrous tissue which suggested the effectiveness of the combination therapy. But this case died from pancreatitis during the postoperative therapy. In conclusion, combination therapy of surgical resection and adjuvant radiotherapy & chemotherapy including the care for autoimmune disease is important in the treatment of thymoma.
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PMID:[Study of combination therapy for thymoma: a case of stage IV which presented as total spinal block caused by epidural metastasis and which preoperative combination therapy was effective for minimizing the tumor]. 825 26

Fever of unknown origin (FUO) has been defined as an elevation in temperature (38 degrees C) for at least 2-3 weeks despite intensive investigation. The value of immunoscintigraphy with the technetium-99m-labelled anti-granulocyte antibody anti-NCA-95 (BW 250/183, IgG1) was studied retrospectively in 34 consecutive patients with FUO. Every effort was made to confirm a diagnosis, including methods such as ultrasonography, computed tomography, magnetic resonance imaging, bacteriological tests, surgical intervention and clinical follow-up. In 58.8% of the patients, an infectious cause for the fever was found, in 30.2% of the patients, a benign or malignant haematological disease, pancreatitis or thyrotoxicosis was found. No cause for fever could be found in 11%. The overall diagnostic sensitivity and specificity of immunoscintigraphy for infection were 40% and 92% respectively. The positive predictive value was calculated to be 88% and the negative predictive value was calculated to be 52%. False-negative scans were especially noted in patients with endocarditis, pneumonia and small brain abscesses, where the lesions did not exceed a diameter of 0.5 cm. If patients with endocarditis were excluded, the imaging sensitivity and specificity were increased to 57% and 95%. This study demonstrates that 99mTc-anti-NCA-95 scanning is able to localize infectious causes of FUO, other than endocarditis.
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PMID:Use of immunoscintigraphy in the diagnosis of fever of unknown origin. 828 76

This study aimed to determine whether laparoscopic splenectomy is more advantageous than open splenectomy in pediatric patients. Data from 61 patients treated between June 1983 and September 1994 were reviewed. Length of hospitalization, hospital costs, operating time, and postoperative complications were evaluated. Forty-seven patients had open splenectomy. Nineteen of these underwent concomitant procedures. Fourteen patients had laparoscopic splenectomy, and four had concomitant cholecystectomy. The data show a trend toward a 1-day reduction in hospital stay associated with laparoscopic splenectomy (P < .02). Operating time was 83% longer for the laparoscopic approach (P < .001), and operating costs were almost $3,000 more (P < .001) than for open splenectomy. The total hospital cost also was greater for laparoscopic procedures (P < .1), primarily reflective of a more than $3,000 difference for splenectomy alone (P < .02). Two of the fourteen laparoscopic patients (14%) had complications. One patient with Evan's syndrome had pneumonia that required antibiotics. Another patient required conversion to an open procedure because of poorly controlled hemorrhage from a short gastric vessel. Twelve of the open splenectomy patients (25%) had complications: atelectasis (3), fever (4), wound infection (2), pneumonia (1), laryngospasm (1), and pancreatitis (1). The authors conclude that laparoscopic splenectomy is a safe but currently more expensive alternative to open splenectomy, primarily because of the use of disposable instruments. Benefits include a shorter hospital stay, no greater risk of postoperative complications, and subjective improvement in the cosmetic result. Disadvantages include increased operating time and cost. Evaluation of larger series will be needed to determine the significance of the difference in complication rates between the two procedures.
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PMID:A comparison of laparoscopic and traditional open splenectomy in childhood. 863 60

Thirty-eight children (2 months to 26 years of age) underwent esophageal replacement at our institution between 1962 and 1993. Twenty-four patients had esophageal atresia, with the replacement performed at a mean age of 17 months. The remaining patients (37%) had strictures and were older (mean, 7.4 years). Replacement procedures involved the right colon in 61% of cases and the transverse left colon in the others (39%). Sixty-three percent were placed substernally and 37% were done in transthoracic fashion. The average length of stay in the hospital was 34 days (range, 11 to 256 days.) Early complications (within 30 days) included cervical anastomotic leaks (11 patients; 29%) pneumonia (4), would infection (2), pneumothorax/hemothorax (3), wound dehiscence (1), prolonged ventilation (2), vocal cord paralysis (1), Horner's syndrome (1), pancreatitis (1), and perforated graft (1). Despite the incidence of early leaks, only two persisted long-term (more than 3 months). Other late complications included significant proximal strictures (5), and cologastric strictures developed in five patients. Seven cases were considered graft failures (18%), and all of these eventually require graft replacement. Additional problems included redundant graft requiring revision (4) and dumping syndrome (2). There were six cases of intestinal obstruction caused by adhesions. Four of these involved intrathoracic obstruction of the graft and two involved small bowel obstruction. There was only one death, which occurred late and was not related to the primary disease or procedure. Long-term follow-up data were available for 20 patients (53%). The follow-up period ranged from 1 to 33 years (mean, 12 years). Fourteen had excellent results after the initial interposition, being able to eat and function well without any further intervention. Seven patients (18%) have had poor results and 17 (45%) required additional procedures to obtain good functional results. In our experience, the colon continues to be a good option for esophageal replacement, but additional procedures frequently are necessary to optimize the functional outcome. Good results can be expected in the majority of cases, but late problems (ie, redundant colon and poor emptying) are not unusual, and careful follow-up is essential in the management of such patients.
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PMID:Esophageal replacement using the colon: is it a good choice? 886 25

We present a case of acute lethal poisoning by oil of "epazote" (oil of chenopodium), in a 2 y 9 m female. The volatile oil was administered according to the advice of a "curandera" (female healer), in a total quantity of 40 ml. Clinical features of the poisoning were: vomiting, deep coma, seizures, mydriasis, apnea, metabolic acidosis, neurogenic shock and death. The EEG suggested a diffuse encephalopathy, the CT scan with an image of severe brain edema and ventricular collapse. Relevant postmortem findings were brain edema and neuronal necrosis, pneumonia, enteritis, pericholangitis, mild pancreatitis and tubular necrosis. The phytochemical analysis of volatile oil identified ascaridol, the main active compound of the chenopodium herbs, in a quantity of 39 mg/ml (1,560 mg in the dose administered), and Chenopodium graveolens as the plant employed to prepare it. According to the age of the patient, 60 mg of ascaridol would be the recommended dose formerly used in the treatment of parasitic disease. Thus 1,560 mg was 26 times higher than the recommended dose, and exceeded by 56% the dose of 1,000 mg reported as lethal in humans.
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PMID:[Fatal poisoning caused by oil of epazote, Chenopodium graveolens]. 896 84

Forty five patients at the age of 15 to 84 years with signs of infection requiring active antibacterial therapy were treated with cefotetan. In the majority of the patients pulmonary affections such as double pneumonia, pleurisy or bronchopneumonia were stated. In some patients bronchopulmonary pathological processes were associated with pancreatitis, cholecystitis or other diseases of the gastrointestinal tract. A separate group included patients with diseases of the small pelvis organs (pelvioperitonitis, metroendometritis or prostatitis) and diseases of the urogenital system (pyelonephritis) arachnoiditis. In all the patients except for one with bronchopneumonia at the background of chronic myeloleukemia and agranulocytosis the results of the treatment were good and satisfactory. Cefotetan proved to be efficient in the treatment of purulent affections of the skin and subcutaneous fat (abscesses and phlegmona), trophic disturbances at the background of pathological processes in the vessels and pyoseptic condition. Cefotetan practically had no side effects. Only in 2 patients insignificant nausea during the first 2 days of the treatment was recorded. In some patients the antibiotic intramuscular injections were painful with formation of cold infiltrates. After intravenous administration of cefotetan no adverse reactions were observed.
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PMID:[Effectiveness of cefotetan in clinical practice]. 933 42


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