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)

Among the patients with acute cholecystitis, those at the age of 20-45 years account for 12.6%. Of them, 50.9% develop complications: choledocholithiasis, obstructive jaundice, cholangitis, pancreatitis etc. The main method for treatment of the patients is the operation within 24-48 hr from the moment of their admission with intraoperative diagnosis of pathology of the extrahepatic bile ducts. There were no lethality, postoperative complications were noted in 9.3% of the patients.
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PMID:[Diagnosis, surgical treatment procedure and results in acute cholecystitis in young patients]. 259 7

An investigation of specific course of the disease in 911 patients operated upon for acute cholecystitis with bilirubinemia has shown that mechanical jaundice resulting from choledocholithiasis takes place in a third of the patients. Obstruction of the bile duct was confirmed in 27.1% of the patients during cholangiography. Prevalence of a number of factors was noted indicating of a toxic lesion of the liver (destructive forms of acute cholecystitis in 81.0% of the patients, higher level of bilirubinemia in long terms of the disease, the presence of coexistent pancreatitis in 30.5%, cholangitis--in 39.3%). An investigation of 207 bioptates of the liver in acute cholecystitis has revealed fatty degeneration of hepatocytes in 56.5%, pericholangitis--in 43.0%, cholestasis--in 21.3% of the cases. The cause of jaundice in acute cholecystitis mainly is an alteration of the hepatic cells due to pyo-resorptive intoxication manifested as cholestasis and hepatitis.
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PMID:[Pathogenesis of jaundice in acute cholecystitis]. 259 23

Under study were 56 observations of posttraumatic cholecystitis and pancreatitis in patients with polytrauma without a direct injury of the gallbladder and pancreas. Diagnostics of posttraumatic cholecystitis and pancreatitis is based on data of laparoscopic and ultrasonic examinations. Treatment of acute cholecystitis in the postshock period of trauma disease is operation, while treatment of posttraumatic pancreatitis must be started with intensive therapy.
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PMID:[Acute diseases of the gallbladder and pancreas in patients with severe trauma and shock (characteristics of the diagnosis and treatment)]. 263 42

Thirty-two consecutive patients with impacted ampullary or distal common bile duct stones were managed prospectively. Preoperative indications for surgery were obstructive jaundice in 13 patients (40.6%), acute cholangitis in 7 patients (21.9%), biliary pancreatitis in 6 patients (18.8%), acute cholecystitis in 5 patients (15.6%), and chronic cholecystitis in 1 patient (3.1%). No patient had a prior cholecystectomy, and all stones were removed retrograde during cholecystectomy and open-duct exploration. There were no deaths, one retained stone in the biliary radicals, two episodes of mild pancreatitis, one superficial wound infection, and one minor bile leak. All patients have done well on follow-up. This study demonstrated that impacted biliary stones can be consistently and successfully extracted by the supraduodenal approach with minimal morbidity and no mortality, without resorting to duodenotomy and sphincter ablation.
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PMID:The surgical management of impacted common bile duct stones without sphincter ablation. 267 92

The authors report a case of fatal leptospirosis due to Leptospira icterohaemorrhagiae revealed by typical signs of acute cholecystitis and associated with pancreatitis in a 73 year old patient presenting with gallstones. The initial clinical findings were highly suggestive of severe but typical cholecystitis and the final diagnosis was only considered when the patient's condition worsened despite surgery, with increasing obstructive jaundice and multiple organ failure. Pancreatitis was an autopsy finding. Misleading, especially gastrointestinal symptoms are frequent in leptospirosis. Hence an early diagnosis is an essential condition for a successful antibiotic management in severe cases of leptospirosis. This possibility should be considered whenever a patient presents with infectious obstructive jaundice. The patient has to be questioned concerning possible contact with contaminated animals and, when in doubt, the presence of specific antibodies should be investigated.
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PMID:[Leptospirosis caused by Leptospira icterohaemorrhagiae of the pseudo-surgical type: a case]. 271 6

Based on the examination of 1050 patients the authors make a conclusion of great significance of renoscintigraphy, ultrasonic scanning and thermography for differential diagnostics of acute pyelonephritis, acute cholecystitis and pancreatitis.
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PMID:[Radionuclide, ultrasonic and thermographic methods of examination in the differential diagnosis of acute pyelonephritis and diseases of the abdominal organs]. 285 79

In a series of 120 patients with periarteritis nodosa (PAN), 50 had gastrointestinal manifestations; 34 had transient abdominal pain which regressed spontaneously or in response to corticosteroid therapy and required no further investigation. Thirty one more serious episodes occurred in the remaining 26 patients. Eight of these were in fact the initial signs of PAN and 13 required laparotomy. There were 20 episodes of abdominal pain (peritonitis: 9, pancreatitis: 4, acute cholecystitis: 2, duodenal ulcer: 3, intestinal infarction: 1, unexplained pain without diagnosis at laparotomy: 1) and 11 of gastrointestinal hemorrhage (melaena or hematemesis: 4; hematochezia: 5). Clinical and biological features of patients with and without gastrointestinal manifestation were not significantly different except for cardiac involvement which was significantly more frequent (p less than 0.05) in the second group. Corrected survival rates were significantly lower (p less than 0.05) in patients with gastrointestinal manifestations. These results show that, in patients with PAN, digestive manifestations, particularly perforations, carried a poor prognosis. Nevertheless exploratory laparotomy and surgery unrelated to PAN (eg appendicectomy) were well tolerated.
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PMID:[Digestive manifestations of periarteritis nodosa in a series of 120 cases]. 286 41

Endoscopic sphincterotomy is the treatment of choice for choledocholithiasis after cholecystectomy. Its role has been expanded to treat choledocholithiasis in patients with gallbladders still in place. The authors report their experience with endoscopic sphincterotomy, with emphasis on the safety of the procedure, in high-operative-risk patients with choledocholithiasis and gallbladder in situ. Stones were successfully removed in 72 of 75 patients (96%); 1 required an emergency operation and 2 an elective one. Complications included bleeding, pancreatitis and cholangitis; there were no associated deaths. Follow-up of 54 of the patients, who had associated cholelithiasis at the time of endoscopic sphincterotomy, showed that 14 died of causes unrelated to the biliary tract. Of the others, 14 underwent cholecystectomy for failure of endoscopic sphincterotomy (2), acute cholecystitis (4) or persistent biliary tract symptoms (8). The other 26 patients were well after a mean follow-up of 30.4 months; 1 had mild biliary tract symptoms. Ultrasonography in 16 of the 26 patients showed persistent cholelithiasis in 12. Life-table analysis revealed a 15% probability of acute cholecystitis within 5 years of endoscopic sphincterotomy.
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PMID:Fate of the gallbladder with cholelithiasis after endoscopic sphincterotomy for choledocholithiasis. 291 Mar 74

The purpose of this study was to determine the incidence of death as the initial manifestation of cholelithiasis. Records of patients who died or underwent cholecystectomy for gallstone-related disease at Duke University Medical Center between 1976 and 1985 were reviewed. Thirty patients died, six of whom (20%) had previous episodes of biliary pain and stone documentation. Twenty-four (80%) were asymptomatic (three with previous incidental diagnosis of cholelithiasis). Reason for admission included acute cholecystitis (nine), pancreatitis (eight), biliary pain (six), cholangitis (four), jaundice (one), and endocarditis (one). Three patients died of gallstone complications without surgical intervention; one patient had renal failure and two had septicemia. Other causes of death were: sepsis (seven patients), cardiac failure (six), pulmonary complications (four), renal failure (three), cerebrovascular accident (three), liver failure (two), pancreatitis (one), and gastrointestinal bleeding (one). During this period, 1731 cholecystectomies were performed without mortality. In this group, the patients were younger (50 +/- 8 years vs. 64 +/- 13 years, p less than 0.001), and had a lower incidence of cirrhosis (p less than 0.001) and diabetes (p less than 0.002). The sex ratio was inverted (p less than 0.001). This study demonstrates that death from gallstones is uncommon (three cases per year), as is death from their initial clinical manifestation (1.2%). The risk of death is two- and ninefold higher in patients with acute cholecystitis or acute pancreatitis. Age, cirrhosis, and diabetes are important determinants of outcome.
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PMID:Deaths from gallstones. Incidence and associated clinical factors. 291 58

The relative indications for operative common duct exploration (CDE) and endoscopic sphincterotomy (ES) in treating common duct stones are often unclear. This prospective study compared CDE and ES in treating choledocholithiasis after excluding patients with acute cholecystitis, idiopathic pancreatitis, sphincter of Oddi dysfunction and malignant disease. One hundred and two patients had 105 CDE and a further 50 patients had 57 ES. Of the patients having CDE, 76 also had cholecystectomy for gall-bladder (GB) disease while 26 had prior cholecystectomy. With ES, in 16 the GB was present and not removed while 34 patients had had prior cholecystectomy. Hospitalization was significantly less following ES. There was one peri-operative death after CDE and none after ES. There were two late biliary-related deaths, 3 and 27 months after ES, in patients who developed acute cholecystitis. In post-cholecystectomy patients having ES, complications were fewer and less severe after ES (15%) than CDE (41%). In patients with an intact GB, peri-operative complications occurred in 30% after cholecystectomy and CDE. Following ES alone, complications occurred in 33% with the majority of these complications arising from the diseased GB. It is concluded that the optimal treatment for post-cholecystectomy patients with bile-duct stones is ES. In elderly patients with an intact GB, the bile-duct stones can be treated by ES; whether subsequent cholecystectomy is necessary should be assessed on the likelihood of future GB complications.
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PMID:Common duct exploration or endoscopic sphincterotomy for choledocholithiasis? 293 Mar 74


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