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)

23 deaths of patients with severe asthmatic dyspnea were analyzed. There was no correlation between clinical presentation and cause of death certified by post-mortem examination. The cause of death was found outside the airways in 14 patients. Of diagnostic-therapeutic implications are the relative frequency of spontaneous pneumothorax (5) and pulmonary embolism (3). Six times another cause of death was discovered (like tumor invasion, arterial thrombosis, hemorrhagic pancreatitis, myocardial infarction). Acute asthmatic death was prone to happen in the middle-aged asthmatic with less than two years of bronchial asthma. Here like in 5 patients with chronic obstructive airways disease lack of awareness of the seriousness of the patients' state, sometimes cessation of cortisone long-term therapy, seldom abuse of bronchodilator-aerosols seems to be important for the lethal outcome.
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PMID:[Death from or in asthma ? (author's transl)]. 63 97

450 successive celioscopic cholecystectomies (May, 1990-April, 1992) are reported for 312 cases of uncomplicated gallstone (69%) operated electively and 138 cases operated in emergency, including 120 cases of acute cholecystitis, 17 cases of biliary pancreatitis and 1 case of angiocholitis. Immediate conversion into laparotomy was required in 10 cases (2.2%) either for technical reasons (1.1%) or because of lithiasis of the common bile duct (1.1%). The stay in hospital lasted an average of 2.2% days for elective admission and 3.3 days for emergent admission. The average operating time was 65 minutes (75 minutes until May, 1991, and 55 minutes between May, 1991 and April, 1992). Preoperative retrograde cholangiography was performed in 67 cases and intraoperative cholangiography in 16 cases. Second surgery was required for suture in one case because of cholerrhagia in a secondary duct of the gallbladder bed. This cholerrhagia would not have been amenable to simple aspiration. One patient (0.2%) died of myocardial infarction at D + 10. Complications include 4 cases of pulmonary embolism, 3 cases of cystic biliary fistula without second surgery and 4 cases of umbilical hernia. A more peculiar case is that of a patient admitted 5 months after surgery for gangrenous acute cholecystitis. This patient was admitted for fever and epigrastric pain. He had a very low-flow duodenocutaneous fistula of uncertain origin. This patient was not operated again. This may not be a complication connected to celioscopic surgery. Celioscopic cholecystectomy is superseding conventional cholecystectomy. Surgeons' efforts should strive at eliminating operative errors, reducing postoperative morbidity, improving techniques and instruments, teaching celioscopic surgery and extending its indications to other intraabdominal operations.
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PMID:[Laparoscopic cholecystectomy. Apropos of 450 cases]. 134 88

Thirty patients (23 women, 7 men, mean age 53 [24-77] years) with symptomatic radiolucent gallbladder stones were treated by litholysis with methyl tert-butyl ether (MTBE), introduced through a catheter inserted into the gallbladder either by the percutaneous-transhepatic route (n = 19) or the transpapillary route (n = 11). Correct placing of the catheter was more frequently successful by the percutaneous-transhepatic route than the transpapillary one (90 vs 73%). The duration of lysis (median: 7 h and 8 h, respectively) and the proportion of stones which were completely dissolved immediately after lysis (53 vs 55%) were similar in both groups. Supplemented by subsequent oral therapy, the success rate at 6 months was higher in the percutaneous-transhepatic group (83 vs 64%), however, recurrences were more frequent. In the percutaneous-transhepatic group there was one case of gall-bladder leak and one catheter dislocation, and in the transpapillary group there was one case of pancreatitis, one of induction of ether anaesthesia and one pulmonary embolism. MTBE lysis is a relatively speedy and effective mode of non-operative therapy for gall-bladder stones. The percutaneous-transhepatic method is suitable for younger patients with a normal gall-bladder. The transpapillary procedure is preferable for older patients, and also when gall-bladder puncture proves difficult or when there is concurrent choledocholithiasis.
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PMID:[Lysis of gallstones with methyl tert-butyl ether: percutaneous transhepatic or transpapillary?]. 191 31

The initial activity in the field of organ transplantation always brings some organizational and medical difficulties. We describe the first year experience in the field of kidney transplantation at the Transplantation Unit of Padua University. Sixteen kidney transplants from cadaver donors have been performed. A double drug therapy (cyclosporine and steroids) as immunosuppression was used in 9 patients and a triple drug protocol (cyclosporine, steroids, azathioprine) was used in 7. Two patients also received monoclonal antibodies because of steroid resistant rejection. The technical problems we observed include one case of ureteral duplication corrected with uretero-ureteral anastomosis and one substenosis of an ureteral cystoanastomosis corrected with endoscopic dilatation. Among the complications related to immunosuppressive therapy we had one case of severe cyclosporine nephrotoxicity. Two patients died after few months with a functional graft because of pulmonary embolism and because of severe hepatitis complicated by pancreatitis. At an average of six months follow-up all the remaining patients have a good functioning graft.
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PMID:[Renal transplantation. 1st year's experience at a new center]. 239 42

Eight instructive clinical case reports on younger women demonstrate the actual problem of severe adverse reactions (ADR) associated with oral contraceptives. Complications consisted of cerebral arterial thrombosis, peripheral arterial thrombosis, cerebral embolism, pelvic vein thrombosis, pulmonary embolism, thrombosis of the sinus sagittalis, recurrent pancreatitis and focal nodular hyperplasia of the liver. Contraindications of hormonal contraception (i.e. heavy smoking) were not always taken seriously by the prescribing physician. The data bank of the Medicines Commission of the German Medical Association contributed 648 cases to draw an ADR frequency profile, according to age, doses, duration of prescription and deaths. 25 deaths in close connection to oral contraception intake were reported, mostly caused by arterial or venous thromboembolism. Deaths predominantly were reported in women less than or equal to 30 years old, mostly following exposition to low-dose-preparations and after relatively short duration of intake (less than or equal to 3 years). These non-representative observations call for strict consideration of contraindications and use of low-dose-preparations, even in younger women.
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PMID:[Oral contraceptives: undesirable effects in internal medicine]. 273 25

We report four patients with a protracted history of acute pancreatitis complicated by infected pseudocysts or abscesses. Ultrasonography showed that each patient had cholelithiasis. Endoscopic biliary sphincterotomy was performed resulting in the release of stones, gravel, or pus in all four cases. Three of the patients had successful percutaneous abscess drainage, and one patient was drained surgically. The abscesses all resolved, but one patient died suddenly of acute pulmonary embolism. The other three patients are well. We recommend this combined approach to pancreatic abscess drainage because, if there is obstruction to the flow of pancreatic juice at the ampulla of Vater, it is likely that the pancreatitis and abscess will fail to resolve.
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PMID:The combination of endoscopic sphincterotomy and percutaneous abscess drainage in the management of complicated biliary pancreatitis. 295 Jan 6

During the last three decades it has become clear that removal of the spleen, for any reason, is not a benign procedure. In both adults and children splenectomy places the patient at significantly higher risk of overwhelming infection, compared to the normal population. The risk of the post-splenectomy septic syndrome is lifelong and is not eliminated by the administration of polyvalent pneumococcal vaccine. Thus far, the reported rate of overwhelming sepsis in asplenic individuals has ranged from 2.5-13.5%. As more long-term follow-up data become available, it is likely that the true incidence will be 5-10%. In addition to this late complication, splenectomy increases the frequency of adverse events, including death, in the immediate postoperative period. Infections, particularly pulmonary and abdominal sepsis, constitute the majority of the complications. The mortality rate from postoperative sepsis is substantial. Atelectasis, pancreatitis/fistula, pulmonary embolism and bleeding at the operative site are also relatively common occurrences following splenic removal. These alarming statistics have spurred surgeons to change their attitudes concerning splenectomy for trauma, both accidental and iatrogenic. Nonoperative management of hemodynamically stable patients with isolated splenic injury and splenorrhaphy in patients requiring laparotomy are now firmly entrenched in the surgical armamentarium. Patients in whom splenectomy is necessary are given polyvalent pneumococcal vaccine and are instructed to seek early medical attention for febrile illnesses. Splenic autotransplantation and lifelong prophylactic antibiotic therapy have been used in some centers, but their clinical value remains to be proven.
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PMID:Complications of splenectomy. 332 38

Oral contraceptive (OC) use is discussed as a factor in various diseases and disorders of internal medicine. Studies show a significant increase in the risk of developing thromboembolism, pulmonary embolism, cerebrovascular incidents, and coronary infarction among OC users. These problems are caused by changes in blood coagulation, hemodynamics, fibrinolysis, and the damaging of vascular walls, all of which are attributable to OC use. OC use leads to a minor hypertension in 1% of users during the first year of use and in 2.5% by the fifth year. This is initially caused by increased angiotensinogen production in the liver; later, sodium retention caused by the gestagen OC component, mineralocorticoid activity and vascular damage play a part in causing this hypertension. Glucose tolerance is reduced by OCs; lipid metabolism is affected in many ways: e.g. elevation of plasma triglyceride levels. OC users run an increased risk of developing hepatic tumors. Jaundice, Budd Chiari syndrome, gall stones, and pancreatitis have all been observed among OC users. Contraindications to OC use are listed.
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PMID:[Internal medicine problems regarding contraception. Part I]. 744 16

Severe hypertriglyceridemia causing pancreatitis is a rare complication of pregnancy, usually occurring in the second and third trimesters. Treatment includes a very low-fat diet, intravenous fluids, total parenteral nutrition, and plasma apheresis. In this article, the authors report the case of a pregnant woman who presented with a plasma triglyceride level of 65 mmol/L, abdominal pain, and a threatened abortion at 8 weeks of gestation. Treatment included restriction of dietary fat to below 10% of total calories, liquid protein supplementation, multiple hospitalizations for treatment with intravenous fluids, and total parenteral nutrition. Continuous intravenous heparin was started at 29 weeks of gestation for pulmonary embolism. This was associated with a dramatic decrease in plasma triglyceride levels. A normal female child was born at 37 weeks of gestation. The mother's weight at 2 weeks postpartum was 15 lb below her pregnant weight. It was concluded that a successful pregnancy is possible even when plasma triglyceride levels are very high early in the pregnancy.
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PMID:Successful outcome in severe pregnancy-associated hyperlipemia: a case report and literature review. 790 Jul 43

The treatment of biliary lithiasis has changed during the past 20 years. Cholecystectomy remains the gold standard for cholelithiasis, but many options are available for calculi of the common bile duct. Among them are surgical open or laparoscopic choledochotomy, biliary-enteric anastomosis, transduodenal sphincterotomy (TDS), endoscopic sphincterotomy. With the aim to describe the current place of TDS, we reviewed the patients operated on in our department between 1976 and 1992. We found 78 patients with a mean age of 58 years (26-89 years). 34 (43%) of them had acute cholecystitis, with 26 being operated on urgently. 47 (60%) were jaundiced, 15 (19%) had pancreatitis and 12 (15%) had cholangitis before operation. Indications for TDS have been impacted stone or absence of progression of the contrast medium on intraoperative cholangiography in 71 patients (91%). 3 patients died (1 pulmonary embolism, 1 sepsis of pulmonary origin, 1 MOF syndrome complicating preoperative necrotizing pancreatitis). 30 patients (38%) had complications, of which 20 were directly related to TDS. Hemorrhage occurred in 4 cases, and resolved spontaneously without transfusion. Hyperamylasemia occurred in 17 instances, but clinical pancreatitis developed in only 1 case, with complete resolution. 1 duodenal fistula healed after conservative therapy. No death is attributable directly to TDS. Today, the importance of endoscopic sphincterotomy is increasing. This retrospective study shows that TDS, if performed with caution, does not increase the operative risks even in emergent operations. During surgical exploration of the common bile duct, TDS is indicated to remove an impacted stone, or as a bilio-enteric anastomosis if multiple stones are present with a thin common duct.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Current status of surgical transduodenal papillotomy]. 803 53


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