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

To determine whether retinal abnormalities occur in patients with chronic pancreatitis, ophthalmoscopic and retinal-function evaluation was performed in 28 patients with chronic pancreatitis and 19 healthy subjects. The final threshold of dark adaptation was significantly increased 40 per cent (P less than 0.001) in patients with pancreatitis, whether or not they had steatorrhea. Patients with steatorrhea had a significant decrease of about 42 per cent (P less than 0.001) in the b-wave of the electroretinogram, a measure of both rod and cone function. Seven of the 28 patients complained of difficulty with hight vision; six of these seven had morphologic lesions on ophthalmoscopic examination, confirmed by fluorescein angiography. No correlation was found between any of the retinal abnormalities and the serum vitamin A or zinc levels or glucose tolerance. Non-diabetic retinal lesions and retinal-function abnormalities are common in patients with chronic pancreatitis, even in the absence of steatorrhea.
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PMID:Non-diabetic retinal abnormalities in chronic pancreatitis. 43 61

Endocine and exocrine pancreatic function were investigated in 10 patients after pancreatic trauma or traumatic pancreatitis. There were no cases of overt diabetes mellitus. Three patients had subclinical diabetes. In the secretin-pancreozymin test 5 patients had normal exocrine pancreatic function after trauma, whereas in 3 patients bicarbonate and/or enzyme secretion was diminished, to normalize during an observation time of several years. In the remaining 2 patients a secretin-pancreozymin test could not be performed; one of them had slight steatorrhoea. These results are evidence of a good reserve capacity of the endocrine pancreas, and a good regeneration capacity of the exocrine pancreas, after trauma.
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PMID:[Pancreatic function after injury to the pancreas and traumatic pancreatitis]. 62 37

Jejunal perfusion studies were performed to assess water, electrolyte, d-xylose, and d-glucose transport in 16 patients with chronic calcific pancreatitis (eight with and eight without steatorrhoea) and in 10 control subjects. The patients with steatorrhoea demonstrated significantly less xylose, water, and electrolyte absorption than patients without steatorrhoea and control subjects, when an isosmotic slaine-xylose solution was perfused. On the other hand, when an isosmotic saline-glucose solution was perfused, the patients with steatorrhoea absorbed significantly more glucose, water, and electrolytes than control subjects. Significant correlation was demonstrated between the absorption of xylose as measured by the segmental perfusion technique and the peak serum xylose level during perfusion as well as the five-hour urinary xylose excretion after a 25 g oral dose of xylose. The xylose absorption measured by small bowel perfusion also correlated significantly with pancreatic juice amylase and trypsin concentrations obtained during a standard pancreatic function test.
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PMID:Jejunal monosaccharide, water, and electrolyte transport in patients with chronic pancreatitis. 62 5

To evaluate the predictive value of the evocative test (E.T.) in the diagnosis of pancreatitis, the E.T. was performed in 35 healthy subjects (group I), 65 patients with a presumptive clinical of chronic pancreatitis (group II), and 52 patients with proved chronic pancreatitis (group III). In group I, false positive results were obtained in 11,4% of the patients, the increase in lipase above the upper limit of normal was relatively small. The patients of group II gave abnormal E.T.'s in 63%, reduced faecal chymotrypsin activities being found in 40%, and steatorrhea in 28% of the cases. Positive E.T.'s were associated with abnormal chymotrypsin and faecal fat determinations in 51% and 27%, respectively. In group III,, a positive E.T. was obtained in 60%, the test results show a signifikant negative correlation with the extent of pancreatic exocrine insufficiency. In group of patients with confirmed chronic pancreatitis but without steatorhea, the E.T. was positive in 72%. The E.T. has a limited value in the diagnosis of early stages of chronic pancreatitis.
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PMID:[The significance of the evocative test in the diagnosis of chronic pancreatitis (author's transl)]. 67 58

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

Twenty-eight consecutive patients with idiopathic pancreatitis were studied. Endoscopic retrograde cholangiopancreatography was diagnostic in 21 of 28, while an operation was diagnostic in four of the remaining seven patients. Fifteen of 25 patients had operable disease of the gallbladder, common bile duct, ampulla of Vater or pancreatic duct. Of ten patients who had an operation on the pancreas or biliary tract, or both, for painful attacks of pancreatitis, none had a recurrence in a seven month to three year follow-up study. Two patients had reconstruction of the pancreatic duct for chronic painless steatorrhea, one of whom had marked clinical improvement. Ten of 25 patients had normal biliary tracts with normal or minimally abnormal pancreatic ducts and were treated medically. Visualization of biliary and pancreatic ducts should be attempted by endoscopic retrograde cholangiopancreatography in patients with pancreatitis of unknown cause. Operable lesions were found in 15 of 25 patients, and the postoperative results were excellent.
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PMID:Endoscopic retrograde cholangiopancreatography in the diagnosis and management of nonalcoholic pancreatitis. 68 83

The prevalence of diabetes due to chronic pancreatitis would appear to be increasing. In western countries this is associated with the known increase in alcohol consumption and AIP. Malnutrition may be etiologic in tropical areas. The incidence of diabetes in chronic pancreatitis is dependent on a number of factors. It is more common in alcohol-induced pancreatitis, rarely occurs after the first attack but tends to increase with time and rises markedly in calcific pancreatitis. Abnormal glucose tolerance occurred in 91% of patients with calcific pancreatitis and 70% of patients with noncalific AIP in our follow up of five to 12 years. This stresses the importance of serial regular glucose tolerance tests in these patients (Table I). The insulin-reserve is severely depleted in most patients who do not yet demonstrate abnormal glucose tolerance, indicating that pancreatitis regularly affects the islets and that nearly all patients are potential diabetics. The beta cells appear to respond better to oral glucose, glucagon or secretin than to i.v. glucose suggesting a selective glucose receptor loss or block to hyperglycemia in chronic pancreatitis. The alpha cells seem to be more resistant to the effects of chronic pancreatitis but true hypoglucagonemia was found in 16% of patients. In addition, stimulated growth hormone secretion may be deficient in pancreatic diabetes. These last two factors, among others, may be responsible for the protracted and even fatal hypoglycemia to which some patients with AIP on insulin therapy are liable. The danger of drug-induced hypoglycemia, coupled with the infrequency of vasculopathy, retinopathy and nephropathy in pancreatic diabetes has induced us to keep these patients hyperglycemic and glycosuric rather than in a sugar-free state, as long as symptoms are contained. Recurrent abdominal pain, marked weight loss and associated steatorrhea often raise special problems in the management of the pancreatic diabetic.
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PMID:Clinical and hormonal aspects of pancreatic diabetes. 80 21

Of one hundred and forty-nine patients (101 male and 48 female) 4-67 years of age, 117 were alcoholics and underwent pancreatectomy because of episodic or continuous abdominal pain or complications or chronic pancreatitis. Nineteen patients underwent pancreaticoduodenectomy, seventy-seven 80-95% distal resection, anf fifty-three 40-80% distal pancreatic resection. There were 3 operative death and 30 late deaths 6 months to 11 years post pancreatectomy. Twenty-one patients were lost to followup, 1 to 11 years post pancreatectomy. Ninety-five patients are known to be alive, 4 of whom are institutionalized. Indications for pancreatectomy in addition to abdominal pain include recurrent or multiple pseudocysts, failure to relieve pain after decompression of a pseudocyst, pseudoaneurysm of the visceral arteries associated with a pseudocyst, recurrent attacks of pancreatitis unrelived by non-resective operations, duodenal stenosis and left side portal hypertension. The choice between pancreaticoduodenectomy or distal resection of 40-80% or 80-95% of the pancreas should be based on the principle site of inflammation whether proximal or distal in the gland, the size of the common bile duct, the ability to rule out carcinoma, and the anticipated deficits in exocrine and endocrine function. The risk of diabetes is very significant after 80-95% distal resection and of steatorrhea after pancreaticoduodenectomy. When the disease process can be encompassed by 40-80% distal pancreatectomy this is the procedure of choice.
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PMID:Pancreatectomy for chronic pancreatitis. 101 87

3H-palmitic acid and 14C-tripalmitate dissolved in 1.0 g indian corn oil/kg body weight were administered to 29 patients with chronic pancreatitis and 25 control subjects. For the following 8 h 3H and 14C radioactivity in serum lipids and 14CO2 in expired air were measured at 2-hour intervals. Triglyceride absorption was significantly lowered in the pancreatitis group, while the wide dispersion in healthy subjects precluded reliable information on 14C-triglyceride absorption alone in individual cases. When related to palmitic acid absorption, however, reduced triglyceride absorption was much more evident and could be clearly demonstrated in 21 of the 29 patients with chronic pancreatitis. Since none of them had severe pancreatic insufficiency, the new double isotope method presented here appears to offer a very sensitive means of detecting maldigestion or slowed triglyceride hydrolysis. Compared with the 3H-fatty acid absorption, a relatively reduced triglyceride absorption was found in many cases without steatorrhea or otherwise demonstrable pancreatic insufficiency. Additional measurement of 14CO2 appears to be worthless, since in our patients specific activity of 14CO2 in the expired air was not reduced even in cases with mild steatorrhea.
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PMID:[New procedure in the diagnosis of maldigestion. Studies with 3-H palmitic acid and 14-C tripalmitate in normal subjects and patients with chronic pancreatitis]. 112 60

Clinically evident diabetic microangiopathy (retinopathy and nephropathy) occurred in 18% of diabetic patients with acute pancreatitis and 14% of diabetic patients with chronic pancreatitis. The presence of diabetic retinopathy and nephropathy in patients with pancreatitic diabetes without a family history of diabetes mellitus suggests that these patients have "primary" diabetes mellitus unmasked by the pancreatitis. The occurrence of diabetic microangiopathy is significantly correlated with the duration of diabetes. The frequency of these diabetic complications seems to increase when there is a family history of diabetes in patients whose pancreatitis is simultaneous with or precedes the onset of diabetes. The majority of patients with diabetic microangiopathy were on insulin therapy, but the need for insulin treatment is an indication of the severity of the diabetes, rather than the insulin being a causative factor of the microangiopathy. The degree of steatorrhea in diabetic patients with chronic pancreatitis did not protect against the development of microangiopathy.
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PMID:Diabetic microangiopathy in patients with pancreatitic diabetes mellitus. 118 65


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