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

Gastrointestinal (GI) complications developed in 19 (7.2%) of 265 patients after renal transplantation, and 3 (16%) patients died. Complications included colon perforations, colonic bleeding, small-bowel infarction, pancreatitis, subphrenic abscess, and upper GI tract bleeding. Ulcers located in the second portion of the duodenum developed in six patients; four of them required operation for massive hemorrhage, which occurred during or immediately after the administration of high-dose methylprednisolone for rejection. However, the association of methylprednisolone and colon perforation was not clear from this report. Early diagnosis and prompt operation for surgical-type GI complications in transplant recipients contribute to a low mortality.
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PMID:Management of surgical gastrointestinal complications in renal transplant recipients. 37

Three hundred forty of 5,086 patients undergoing operations on the extrahepatic biliary trees at the Swedish and University of Washington Hospitals in Seattle between 1956 and 1970 required reoperation on this system. This figure for reoperations did not include procedures for subhepatic or subphrenic abscess and/or wound complications. The most common cause for reoperation was an attempt to retrieve a residual or recurrent common duct stone (26.8% of the cases). The second most common cause for re-exploration was a tumor obstructing the common bile duct (18.9%). Less frequent causes for secondary surgery were stenosis of the ampulla of Vater (10.3%), bile duct injury (12.1%), pancreatitis (10.3%), inflammatory stricture (1.5%), cystic duct remnant (5%), and many other less important problems. Thus 4.7% or almost one in 20 of all our biliary operations were secondary. We feel that operative cholangiograms supplemented by manometry are the useful adjunct towards finding otherwise undetectable biliary pathology, whether on the basis of stones, tumors, or structures. We also feel that placement of T-tubes with a large arm going to the surface will allow the removal of most stones left behind after common bile duct explorations with the assistance of directable stone baskets.
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PMID:Causes for 340 reoperations on the extrahepatic bile ducts. 44 99

This study reviews low velocity gunshot wounds of the left upper quadrant of the abdomen and presents four cases recently treated at Boston City Hospital. All patients sustained multiple intraabdominal organ injuries and underwent prompt exploration. Hypotension on admission seemed to be the most reliable sign for a prolonged and complicated hospital course. The essential preoperative studies in stable patients should include a chest x-ray and intravenous pyelogram. Intraoperatively, injury to the body or tail or the pancreas is best managed by distal pancreatectomy and sump drainage. Exploration of the retroperitoneum is warranted for bleeding from the kidney. Initial maneuvers should be designed to control hemorrhage from the renal pedicle. If this is unsuccessful or the renal parenchyma is badly fragmented, nephrectomy should be performed. The complications noted in our patients, infection (pneumonia and left subphrenic abscess) and hemorrhage, are comparable to those reported in most large series. Pancreatic complications (fistulas, pseudocysts, and pancreatitis) were not noted.
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PMID:Gunshot wounds of the left upper abdominal quadrant associated with multiple intraabdominal injuries. 49 64

Although the presence of a pleural effusion is almost always indicative of an intrathoracic problem reflection will yield a certain number of extrathoracic causes, such as hypoproteinemia, Meigs' syndrome pancreatitis and subphrenic abscess. The kidney is a close neighbor of the diaphragm and pleural cavity, and a case of renal stone associated with a small ipsilateral pleural effusion, which regressed with resolution of the primary process, is reported.
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PMID:Nephrogenic pleural effusion. 83 Sep 58

Pancreatico-jejunostomy end to side after resection of the pancreatic tail, or side to side following longitudinal cleaving of the pancreatic duct, was performed in 29 patients suffering from chronic relapsing or acute recurring pancreatitis. A follow-up study with observation time ranging from 6 months to 10 years is presented. The patients were allotted to three groups according to the severity and extent of the inflammatory involvement at operation. The diagnostic findings obtained at the preoperative evaluation correlated well to these groupings. In some patients, however, the inflammatory process was mainly confined to the ductal system, as revealed by pancreatography, while in others the changes were most marked in the parenchyma, as found at histologic examination. 21 caudal pancreatico-jejunostomies and 8 longitudinal anastomoses were performed. Overall results were excellent in 20 patients, good in 6, fair in 3, and poor in none. The rate of postoperative complications was low; no mortality, one spontaneously healed anastomosis insufficiency, subphrenic abscess developed in 2 instances and postoperative diabetes in 5. Only one patient had a recurrent attack of acute pancreatitis postoperatively. Re-anastomosis was successfully performed.
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PMID:Pancreatico-jejunostomy in chronic pancreatitis. An appraisal of 29 cases. 115 67

The authors performed 20 laparoscopies in patients previously submitted to abdominal surgery, in whom after clinical evaluation by the medical staff, the existence of intra-abdominal affection was still questioned. In this study group 14 patients exhibited more than 19 days old former abdominal incisions while in six patients they were recent ones. The incisions were median and para-median, McBurney incisions and Pfannenstiel incisions; one patient had been previously submitted to laparoscopy. The laparoscopic findings were hemoperitoneum, encapsulating peritonitis, ascites, subphrenic abscess, acute adnexitis, acute traumatic pancreatitis, genital tuberculosis, acute cholecystitis and one case of peritonitis due to a hollow viscus perforation by a fish bone. In one patient presenting encapsulating peritonitis the laparoscopic examination was complicated by a hollow viscus perforation.
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PMID:Emergency laparoscopy in patients submitted previously to abdominal surgery: a study of 20 cases. 184 26

The width of the right anterior extrarenal tissue is increased on ultrasound examination in patients with abdominal inflammatory disease. Thickened perirenal fascia associated with acute pancreatitis has previously been reported on computed tomography. A case report has described increased echogenicity of the pararenal space on ultrasound in children with pancreatitis but increased width of the space between the liver and the renal capsule has not hitherto been described in association with inflammatory disease in the abdomen in adults. We have observed it in acute cholecystitis, acute pancreatitis, acute appendicitis, a perforated duodenal ulcer, a leaking anastomosis with a right subphrenic abscess following total gastrectomy and in a patient with septicaemia and liver abscesses. Normal values were obtained in 100 patients without detectable or known disease and were found to be between 1 and 6 mm (mean 2.5 mm) in men and 1 and 5 mm (mean 1.8 mm) in women. The patients with abdominal disease who demonstrated this sign had values ranging from 9-11 mm (mean 10 mm).
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PMID:The renal rind sign: a new ultrasound indication of inflammatory disease in the abdomen. 305 83

Ultrasound plays a major role in the evaluation of mass lesions in the postoperative period. Diagnostic pitfalls may occur in post-splenectomy cases when stomach and bowel loops settle into the splenic fossa and simulate mass lesions. While true masses such as subphrenic abscess, pancreatitis and pancreatic pseudocyst are essentially unchanging in appearance or location when scanned in varying patient positions, pseudomasses of stomach or bowel loops often do change, Awareness of possible post-splenectomy pseudomass is important in order to avoid confusing the gastrointestinal tract with a pathological condition.
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PMID:Post-splenectomy: true mass and pseudomass ultrasound diagnosis. 735 22

Pseudoaneurysms of the splenic artery have been well described in association with pancreatic pseudocysts secondary to pancreatitis. We present a case of a ruptured splenic artery pseudoaneurysm 14 years after splenectomy for trauma which, at that time, was complicated by a subphrenic abscess.
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PMID:Rupture of splenic artery pseudoaneurysm. 748 20

Prospective analysis of the first three hundred patients who underwent laparoscopic cholecystectomy was carried out in three surgical centres of Hong Kong. Over a 20-month period, 300 consecutive patients were recruited, including elective and emergency cases. The indications for laparoscopic cholecystectomy were symptomatic gallstones (78%), cholangitis (6%), pancreatitis (5%) and cholecystitis (11%). Patients with common duct stones (12) had preoperative endoscopic sphincterotomy and stone extraction prior to cholecystectomy. Laparoscopic cholecystectomy was accomplished successfully in 287 patients. Thirteen patients (4.3%) required conversion to open cholecystectomy. The reasons for conversion were: inability to identify cystic duct and common bile duct clearly (6); bleeding (5); Mirizzi syndrome (1); and slippage of cystic duct clip (1). The median operation time was 80 min with a range of 28-270 min. The median hospital stay was 3 days. Seventy-five per cent of patients required only a single dose of pethidine injection. None of the patients required blood transfusion. The overall complication rate was 7%. These included mild cellulitis of the subumbilical wound (3%) and postoperative chest infection (3%). One patient developed subphrenic abscess which resolved on percutaneous drainage under ultrasound guidance. Iatrogenic injury to the common bile duct was seen in one patient who had an impacted stone at Hartmann's pouch. With adequate training laparoscopic cholecystectomy can be performed safely. The advantages over open cholecystectomy are less wound pain, better cosmesis and shorter convalescence.
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PMID:Laparoscopic cholecystectomy: results of first 300 cases in Hong Kong. 751 26


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