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

The treatment is described of 17 patients with presumed viral hepatitis who developed hepatic coma unresponsive to standard conservative measures. Five patients were considered for treatment by exchange transfusion. Four were treated, with transient improvement in two, but all died. Nine patients were considered for treatment by heterologous liver perfusion. Six were treated, with transient improvement in two and complete recovery in one. The last patient remains well 12 months later. Dialysis in four patients had no effect on the coma; the addition of albumin to the dialysate did not increase the extraction of bilirubin. The clinical course in most cases was irregular. Complications were common, the most important being cerebral oedema with medullary coning, bleeding, bacterial infection, hypoglycaemia, and pancreatitis. Heterologous liver perfusion was the most efficient method of removing bilirubin. However, it is not yet clear whether it is more effective than exchange transfusion in the treatment of the patient.
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PMID:Management of hepatic coma complicating viral hepatitis. 530 40

Intrahepatic cholelithiasis is commonly associated with suppurative cholangitis and occurs equally in males and females. Patients usually present with a history of recurrent symptoms and a differential diagnosis which includes viral hepatitis, pancreatitis, myocardial infarction and perforated ulcer. Cholangiography including stereocholangiography is essential for localizing intrahepatic stones and ductal strictures. The guiding operative principle is to drain all infected bile distal to ducts obstructed with stones or stricture. This may also necessitate a bilioenterostomy with or without partial hepatic resection. Although these procedures are formidable in an acutely ill patient, a more simple but inappropriate choledocholithotomy and t-tube drainage done proximal to an obstructed intrahepatic duct will be ineffective and may result in continued sepsis and death.
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PMID:Twenty-two year experience with the diagnosis and treatment of intrahepatic calculi. 639 Jul 56

200 patients with pancreatitis were examined for various concomitant and previous diseases, and socioeconomic factors, in a retrospective study. This pancreatitis group (PG) was compared with a control group (CG) of 250 patients. Most frequent amongst the etiological factors, were biliary diseases, especially a state after cholecystectomy. Second in rank, was chronic alcoholism. For women, the incidence was highest in the 7th decade; for men, there was a double peak in the 4th and 6th decade, respectively. The incidence was about equal for both sexes. The following factors were found to play no essential role in the PG: type of profession, cigarette consumption, gastric and/or duodenal ulcers, partial gastric resection, renal and cardiac insufficiency, viral hepatitis, liver cirrhosis of hypertriglyceridemia. There is a significant accumulation of mumps in the history of the PG, which had gone along without any clinically detectable affection of the pancreas in childhood, in practically all cases.
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PMID:[Social profile and accompanying diseases in acute and chronic pancreatitis (author's transl)]. 700 47

Viral hepatitis affections are sometimes associated with endocrine or exocrine pancreatic disorders. An acute necrotizing hemorrhagic pancreatitis seems to be the prerogative of the fulminating forms. The demonstration of HBS fluorescence in the pancreatic acini cells in one patient suggests the possible etiopathogenic role of HB virus in some cases, apart from the other factors involved.
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PMID:[Fulminant hepatitis B virus associated with acute pancreatitis. Report of two cases (author's transl)]. 723 45

Dr. Wagner's description of an advanced macronodular cirrhosis is compatible with end-stage liver disease due to a variety of causes. An alcoholic etiology seems more probable than chronic viral hepatitis since such a diagnosis might also account for the chronic pancreatitis, unless it was related to the cholelithiasis. However, Dr. Wagner's description favors a diagnosis of biliary pigment sludge related to hemolysis. Furthermore, the controversy over the extent of Beethoven's alcohol consumption and the absence of mention of pancreatic calcification weakens the case for an alcoholic etiology. On the other hand, Dr. Wagner's emphasis of bluish-green pigmentation of the liver, blackish pigmentation of the spleen, and an arteropathy of the hepatic vessels suggests the probability of hemochromatosis, which diagnosis is also in keeping with Beethoven's medical history. In this regard the composer's history of recurrent obscure abdominal pain, commencing in his third decade, is especially in keeping with hemochromatosis. As many as a third of patients present with recurrent abdominal pain, and eventually up to 40% of cases develop significant abdominal pain in the course of their disease. While some of these cases of abdominal pain have been attributed to hepatoma, ascites, pancreatitis, perisplenitis, or diabetic neuropathy, the majority remain ill-defined (32). Even so, the diagnosis of hemochromatosis remains unproved in the absence of a histological examination and measurement of hepatic iron concentration. It is proposed that the combined additive, toxic effects of alcohol and iron were the most likely cause of Beethoven's cirrhosis.
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PMID:Was Beethoven's cirrhosis due to hemochromatosis? 777 Jun 48

A 13 year old boy who was admitted for acute viral hepatitis due to hepatitis A virus developed acute pancreatitis which resolved completely with conservative treatment. Extensive evaluation did not reveal any other cause of pancreatitis and it was presumed that hepatitis A may result in acute pancreatitis.
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PMID:Acute pancreatitis in hepatitis A infection. 869 83

Diseases of the gastrointestinal tract and liver are very common in Bangladesh. Gastroenterology as a dedicated specialty was initiated in 1977 at the Institute of Postgraduate Medicine and Research in Dhaka. One more centre was set up later and these centres are providing specialized diagnostic and therapeutic services. These centres are also imparting training in endoscopy and 49 endoscopists trained so far are providing services in 22 centres around the country. Clinical gastroenterologists are also being trained in a 3 year Master's degree course and three specialists have already completed this. A Gastroenterology Society was formed in 1988 and has held three national scientific conferences and 20 regional meetings. Research in special problems of the country has also been initiated and work on aspects of peptic ulcer disease, chronic calcific pancreatitis and chronic viral hepatitis has been conducted. The demand for gastrointestinal services is high and the specialty has attracted a good number of young doctors. Gastroenterology is likely to grow in size and quality in Bangladesh.
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PMID:Development of gastroenterology in Bangladesh. 919 95

Association of hepatitis viruses with acute pancreatitis in the setting of nonfulminant viral hepatitis is rare. We report six cases of nonfulminant viral hepatitis complicated by acute pancreatitis, including the first documented case of hepatitis E virus (HEV) associated acute pancreatitis. The other five patients had acute viral hepatitis caused by hepatitis A infection. Besides features of viral hepatitis, the presence of typical abdominal pain, high serum amylase, and ultrasound or CT scan features suggested the diagnosis of acute pancreatitis. This complication generally developed in the initial phase of the hepatitic illness. All of the patients had mild to moderate pancreatitis that recovered uneventfully with conservative treatment.
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PMID:Acute pancreatitis associated with viral hepatitis: a report of six cases with review of literature. 1044 66

Coxsackieviral infections have been linked etiologically to multiple diseases. The serotype CB4 is associated with acute pancreatitis and autoimmune type 1 diabetes. To delineate the mechanisms of host survival after an acute infection with CB4 (strain E2), we have investigated the role of nitric oxide (NO), generated by the inducible form of nitric oxide synthase (NOS2), in viral clearance and pancreatic beta-cell maintenance. Mice deficient in NOS2 (NOS2-/- mice) and their wild-type (wt) counterparts were injected with CB4, after which both groups developed severe pancreatitis, hepatitis, and hypoglycemia within 3 days. Within 4 to 7 days postinfection (p.i.), most of the NOS2-/- mice died and at a strikingly higher mortality rate than wt mice. Histological examination of pancreata from both infected NOS2-/- and infected wt mice revealed early and complete destruction of the pancreatic acinar tissue, but intact, insulin-stained islets. When examined up to 8 weeks p.i., neither surviving NOS2-/-mice nor surviving wt mice developed hyperglycemia. However, the clearance of infectious CB4 was different between the mice. The spleens of NOS2-/- survivors were cleared of infectious virus with kinetics similar to that of wt mice, but the livers, pancreata, kidneys, and hearts of the NOS2-/- groups cleared virus more slowly than those of the wt group. This delayed clearance was particularly prominent in the livers of infected NOS2-/- mice, which also showed prolonged histopathological features of viral hepatitis. Taken together, this outcome suggests that NOS2 (and NO) is not required for the prevention of pancreatic beta-cell depletion after CB4 infection. Instead the critical actions of NOS2 apparently occur early in the host immune response, allowing mice to survive and clear virus. Moreover, the data support the existence of an organ-specific dependency on NO for a rapid clearance of CB4.
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PMID:A critical role for inducible nitric oxide synthase in host survival following coxsackievirus B4 infection. 1127 93

Polyarteritis nodosa (PAN) is a necrotizing arteritis of small and medium-sized vessels. It may present with hypertension and/or renal insufficiency. Peripheral neuropathy, myopathy, joint pains, testicular pain, and ischemic myalgias may also be seen. Gastrointestinal involvement may lead to gangrene of the bowel, peritonitis, perforation, intra-abdominal hemorrhage, and pancreatitis. The cutaneous manifestations include tender subcutaneous nodules grouped along the course of superficial arteries of the lower extremities, with or without an overlying livedo reticularis. Although multisystem involvement is characteristic, sometimes only one organ or system may be involved. Associations with viral hepatitis (both B and C) and streptococcal infection have been established for PAN. Recurrent strep infections of the upper respiratory tract, streptococcal glomerulonephritis and rheumatic fever have previously been linked to PAN. This report extends the spectrum of associated streptococcal infections to include necrotizing fasciitis.
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PMID:Cutaneous polyarteritis nodosa after streptococcal necrotizing fasciitis. 1151 22


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