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

As of Dec. 1984 we have been involved in the treatment of 55 patients with acute pancreatitis (gallstone associated, 21; alcoholic, 4; postoperative, 11 and others, 19). An attempt was made to grade these patients according to the severity by modification of Bank's criteria, using seven indices such as shock, respiratory failure, renal failure, metabolic abnormalities, hematological disorders, neurological disturbances and abdominal findings including those obtained intraoperatively. We designated mild, moderate and severe pancreatitis according to the sum total of abnormal criteria above. The mild, moderate and severe pancreatitis have zero, one and more than two abnormal indices, respectively. The severity of the pancreatitis correlated well with the pathological finding of the pancreas, the numbers of other organ failures and mortality rate. The mortality rate during admission of the patients with mild, moderate and severe pancreatitis were four, 14.3 and 70.6%, respectively, the overall mortality rate being 27.2%. Recently, we have introduced plasmapheresis into a new candidate for the treatment of acute severe pancreatitis. Our principle for the management of acute pancreatitis is conservative therapy. However, the patients with moderate and severe pancreatitis need more combined therapeutic interventions with surgery, peritoneal lavage and plasmapheresis if the patients indicate no improvement of severity in spite of intensive conservative treatment.
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PMID:[Severity and treatment of acute pancreatitis]. 408 51

In three patients with acute pancreatitis complicated by renal failure recovery followed dialysis and treatment of associated complications. The records of cases of pancreatitis treated at Addenbrooke's Hospital, Cambridge, suggest that renal failure is a grave and not infrequent complication of acute pancreatitis.
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PMID:Renal failure in acute pancreatitis. 507 54

Extrahepatic manifestations due to an immunologic response to a surface antigen of hepatitis B virus have been identified. These include a serum sicknesslike syndrome and a necrotizing vasculitis. The latter is far more important and in indistinguishable histologically from nonhepatitis related polyarteritis. At least 90 cases have been reported in the decade since 1970, and five are added here. The necrotizing vasculitis syndrome results from fibrinoid necrosis and inflammation of small and medium-sized arterial walls recognizable angiographically by arterial microaneurysms and often by visceral infarction and hemorrhage. Renal failure is common and often associated with pulmonary edema. Gastrointestinal symptoms are a prominent feature due to bowel ischemia. Infarction and perforation are significant causes of morbidity and mortality. Necrotizing vasculitis is also one cause of pancreatitis and of cholecystitis. Plain films, contrast studies, computed tomography, and sonography have been shown to be useful in the recognition of these complications.
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PMID:Radiologic recognition of extrahepatic manifestations of hepatitis B antigenemia. 611 55

As there are controversies about the specificity and the sensitivity of the amylase clearance/inulin clearance ratio (Cam/Cin) in the diagnosis of pancreatitis, this ratio has been calculated: (a) in rats with induced pancreatitis with histologically proven lesions; (b) in toxic induced tubulopathy rats with lesions demonstrated histologically and biologically (enzymuria). Hyperamylasaemia was found in 86% of the pancreatitis rats at 24 h, 50% at 48 h and 25% at 60 h. The ratio Cam/Cin was elevated above 2 SD of the control values among 14% of the rats at 24 h, 50% at 48 h and 25% at 60 h. There were no changes in enzyme elimination rates in the urine as compared to control values. Renal histology remained normal. Histological scores expressing a severe haemorrhagic pancreatitis were identical at 24, 48 ad 60 h. In toxic induced tubulopathy rats, amylasaemia remained normal. but the Cam/Cin ratio only increased when the glomerular filtration rate was diminished by 90%. The diagnosis could only be made by hyperamylasaemia in 50% of the histologically proven pancreatitis in the rat. The use of the ratio Cam/Cin does not increase the frequency of a correct diagnosis. Finally, amylase must be only filtered by the kidney as no tubular enzymes appeared in the urine of pancreatitis rats. Furthermore, this ratio is not specific for pancreatitis as it could be elevated in other pathologic states such as severe renal failure.
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PMID:Lack of sensitivity and specificity of the renal clearance of amylase/clearance of inulin ratio in experimental acute rat pancreatitis with a study on the renal handling of amylase. 617 May 16

Acute necrotizing pancreatitis developed in 5 of 405 patients who underwent renal transplantation. All five patients were taking immunosuppressive medication (azathioprine and steroids). Three patients also received rabbit antithymus serum. Alcohol ingestion or cholelithiasis did not play any causative role in the pancreatitis, which began between 7 days and 13 months after renal transplantation. The delay from the time of admission for pancreatitis to surgical exploration was a mean of 17 days. Operative findings included pancreatic necrosis, hemorrhage and abscess formation. All five patients died of the complications of necrotizing pancreatitis--persistent sepsis, respiratory and renal failure, upper gastrointestinal bleeding and disseminated intravascular coagulation. This review demonstrates that prolonged conservative therapy in renal transplant patients with necrotizing pancreatitis is associated with high mortality. The authors believe that earlier surgical intervention will lead to increased survival.
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PMID:Necrotizing pancreatitis in renal transplant patients. 618 Aug 18

Lithiasis of the terminal choledocus raises problems of pre- and intraoperative diagnosis, especially when the evolution is complicated by sclero-inflammatory of the Oddi, chronic pancreatitis, or acute pancreatitis, or with angiocholitis and hepato-renal failure. The high frequency of the lithiasis of the terminal choledocus (37.72% of all cases of biliary lithiasis) makes necessary an improvement of the methods used for the exploration, and evacuation of this type of lithiasis, and for the recovery of the biliary flow. The clinical syndrome in this biliary lithiasis was predominantly of the painful type (in 20.63% of the patients), of the icteric type (58.75%), of the angiocholitic type (8.75%), or it was dominated by pancreatitis (5.95%) or peritonitis (3.06%). In the 126 cases of lithiasis of the terminal choledocus the authors have applied the following procedures: external biliary drainage (50 cases with one death), choledochduodenostomy (42 cases with 4 deaths), papillosplincterotomy of the Oddi (34 cases with 6 deaths). The high postoperative death rate (8.75%) may be related to the fact that surgery was performed in late stages in patients aged over 50 years, with severe anatomoclinical forms (icterocholangitis), with increased anesthetic and surgical risks, as well as that of postoperative complications.
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PMID:[Details of diagnosis and surgical treatment in terminal choledochal lithiasis]. 621 97

Haemodynamic data were obtained during haemodialysis on 21 occasions in 7 patients with septicaemia and pancreatitis, and in 5 patients with primary renal failure without septicaemia or pancreatitis. In the former group of patients there was a lowering of the blood pressure 30, 60, 90 and 120 minutes after haemodialysis had been initiated, which was significantly greater than in the later group. The drop in the blood pressure was caused by a decreased cardiac output. The pulmonary wedge pressure dropped in all patients. Peripheral resistance and heart rate did not change during the whole procedure.
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PMID:[Circulatory behavior in critically ill patients during hemodialysis]. 647 65

A 42-year-old man undergoing maintenance hemodialysis suffered an attack of acute pancreatitis. Convential treatment resulted in quick recovery. 10 days after its onset his hands and feet became swollen, hot, red and painful. Multiple intramedullary osteolytic lesions of the metatarsals, metacarpals and phalanges, with cortical destruction and a number of fractures were found. These lesions subsided over many weeks and did not recur. We believe that such acute osteolytic lesions following pancreatitis are not 'renal osteodystrophy' as such, but should be recognized as a possible complication in renal failure patients.
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PMID:Acute osteolytic lesions following pancreatitis in a dialysis patient. 661 73

beta-Galactosidase and associated activities (beta-glucosidase and beta-fucosidase) have been studied in rabbit and bovine liver and rabbit spleen. The physico-chemical (optimal pH, pI, MW) and kinetical (Km, Vmax, Ki) properties were determined for all the activities. Two enzyme forms were separated in rabbit spleen. beta-Galactosidase, beta-fucosidase and beta-glucosidase activities were catalyzed by the same enzyme in rabbit and bovine liver. The enzyme from bovine liver showed nonlinear double-reciprocal plots, suggesting a substrate-activation model, and the presence of more than one binding site in the enzyme. The enzyme activities of several glycosidases were determined in human sera fom control groups and from patients with diabetes mellitus, pancreatitis, hepatitis, cirrhosis, stomach and breast cancer, myocardial infarction and renal failure. The results show significantly different enzyme levels for several glycosidases in all the studied diseases. Experimentally-induced diabetes mellitus, alcoholism and nephrotoxicity in rats showed different glycosidase levels in several tissues, as compared with control groups.
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PMID:[Glycosidases of mammals: association of activities and changes of levels in some disorders]. 681 36

A retrospective study of severity symptoms in a series of 102 patients operated upon for acute haemorrhagic pancreatitis showed that the risk of death was much significantly higher when shock (p less than 0,00001) and renal failure (p less than 0,0001) were present. The association, during the post-operative period, of shock and renal failure with one of the following symptoms: digestive haemorrhage, psychic disorders, pulmonary oedema, post-operative peritonitis and evisceration invariably proved fatal. It is suggested that controlled therapeutic trials should be carried out in patients presenting with these complications.
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PMID:[Acute haemorrhagic pancreatitis. Criteria of letality (author's transl)]. 696 96


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