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

The association of chronic pancreatitis with diabetes is not very common. Men are the usual victims and ethylism the usual cause. The most common age of onset is between 40 and 50. Insulin treatment is much more frequent than for idiopathic diabetics. Diabetic heredity is probable. Calcifying pancreatitis is the most frequent form. Micro and macroangiopathic complications are found. A statistical comparative study with a matched series of idiopathic diabetics reveals no difference in the onset of vascular complications. The rate of triglycerides is statistically lower in pancreatitis (p less than 0.001). The other biological rates are the same (cholesterol, uricemy, alpha 2 macroglobulin). Diabetic stability is no more difficult to obtain than for idiopathic diabetics. In most cases the diet should be wide and alcohol must be prohibited.
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PMID:[Diabetes and chronic pancreatitis. Report of twenty cases (author's transl)]. 23 6

Twenty patients with massive abdominal hemorrhage related to chronic pancreatitis, pancreatic neoplasms and arteriovenous malformations were studied angiographically. Abdominal hemorrhage drained most frequently into the gastrointestinal tract, but also flowed through cutaneous drain sites and fistulas, intraperitoneally, into pseudocysts and once into a large pancreatic tumor. The most common angiographic observation in pancreatitis was pseudoaneurysm formation. Both patients with arteriovenous malformation had dilated, racemose feeding arteries and early dense filling of the draining veins. Three patients had pancreatic carcinoma and documented bleeding from gastroesophageal varices related to portal or splenic vein occlusion by the tumor. Five patients were treated by vasopressin infusion, balloon tamponade, or therapeutic embolization.
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PMID:Angiography of massive hemorrhage secondary to pancreatic diseases. 30 42

The experience with 131 patients with 157 pseudocysts is reported. One hundred and twenty patients with 146 pseudocysts underwent 165 operations. There were ten operative deaths (8.3%) three of which were not attributable to the pseudocyst or its operative management. Sixteen patients died six months to 14 years after operation. Deaths in six of the 16 patients were in part attributable to pancreatitis or complications of pseudocyst management. The operative mortality was highest in patients undergoing incision and drainage and cystoduodenostomy. Other factors influencing mortality unfavorably included postoperative gastrointestinal hemorrhage from a pseudocyst; rupture or fistulization of the cyst into the gastrointestinal tract if associated with hemorrhage, and evidence of common duct obstruction, or the location of cysts in the head or uncinate process of the pancreas. Visceral angiography should be performed on all patients with pseudocysts. The risk of massive gastrointestinal or intra-abdominal hemorrhage is highest in the 10% of patients having pseudoaneurysms associated with their pseudocysts. Incision and drainage of pseudocysts is associated with a high rate of recurrence of the cyst and continued pain. Incision and drainage should only be used if the cyst is infected, or the cyst wall is not mature enough to hold sutures. Cystogastrostomy and cystojejunostomy are the procedures of choice for mature cysts. The presence of a pseudoaneurysm visualized on preoperative visceral angiography is an indication for an excisional operation as are the presence of multiple cysts, compression of the common duct or duodenum by the cyst, evidence of left sided portal hypertension, recurrent cysts or evidence of chronic pancreatitis.
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PMID:Pancreatic pseudocyst--operative strategy. 30 51

Lowered, normal or raised alpha1-antitrypsin levels were found in 81 patients with acute or chronic relapsing pancreatitis and pancreatic carcinoma. 51 patients with chronic pancreatitis did not have alpha1-antitrypsin deficiency. Thus, in contrast to other reports, alpha1-antitrypsin deficiency and chronic pancreatitis do not seem to be in common association.
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PMID:alpha1-Antitrypsin in pancreatic diseases. 31 Apr 4

The abnormalities of the humoral immune phenomena in pancreatitis may be summarized on the grounds of published evidence and of the present results as follows: 1. Circulating anti-pancreas antibodies are present in acute pancreatitis as also after its cure, and in chronic pancreatitis. 2. The appearance of soluble immune complexes in pathological amounts was demonstrated in the sera of the patients by radiobioassay in acute pancreatitis of identified aetiology 3 to 4 weeks after onset. On the evidence of follow-up studies over 1 to 8 months the immune complexes were found to persist at increased levels after complete cure of acute pancreatitis. Soluble immune complexes were demonstrable in pathological amounts in the cases of chronic pancreatitis as well. 3. In acute pancreatitis the total serum complement titres decline fast and after a few weeks persistent hypocomplementaemia develops in a number of cases. 4. The possible role of circulating soluble immune complexes and of the complement system in pancreatitis is discussed, and it is suggested on the grounds of the present data that acute pancreatitis is associated with a specific and nonspecific immune sensitization, still demonstrable in a number of cases after a few months.
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PMID:Abnormalities in humoral and cellular immune activity in pancreatitis. I. Study of the humoral immune system. 31 Nov 32

By the use of [11C]methionine and positron computed tomography (PCT), images of the pancreas were obtained in 32 patients. The injection of between 10 and 20 mCi of this product enables four to six transverse sections to be obtained. Seventeen of the patients studied had no exocrine pancreatic disease, and in all these cases the pancreas was clearly visible. In four cases of pancreatic carcinoma and one of retroperitoneal tumor, there were abnormalities visible. In five cases of chronic pancreatitis, no pancreatic uptake was observed. In a sixth case, concentration was visible, but only in the head of the pancreas. One case of acute pancreatitis, which showed no concentration during the acute phase, returned to normal after recovery. When visible, the pancreas was easily located and distinguishable from the intestinal image, except in two cases that were uninterpretable for technical reasons. No false positive or negative was observed, but a differential diagnosis between cancer and pancreatitis was impossible.
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PMID:[11C]methionine pancreatic scanning with positron emission computed tomography. 31 98

A total of 61 pancreatectomies for chronic pancreatitis are reported. The operative mortality rate was 21% and the later mortality rate 29%, although caused by diabetes. The results are so poor that this method should only be performed in extreme situations. Left or right resection of the main inflammation site is proposed as an alternative. To prevent recurrence of the pancreatitis, the in situ remaining part of the pancreas should be sclerosed by occlusion of the pancreatic duct system.
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PMID:[Is total pancreatectomy still responsible treatment for chronic pancreatitis? (author's transl)]. 31 8

The computed tomography gives direct visualisation of the pancreas in a transverse section. Form, size, and changed consistency of the organ can be diagnosed. Being a non-invasive technique it does not stress the patient, and can be applied to the severly ill with acute haemorrhagic pancreatitis. Other indications are chronic pancreatitis, pancreatic abscess, pseudo-cyst and cancer. The differential diagnosis of cancer, especially from chronic pancreatitis, may be difficult. Further methods of investigation such as arteriography or endoscopic retrograde pancreatography may also have to be used.
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PMID:[Computed tomography of the pancreas (author's transl)]. 31 19

The diagnosis of both acute and chronic pancreatitis continues to be a challenge despite the development of new techniques and the refinement of old methods. The problem is best approached by the application of a combination of tests which can provide a reasonable degree of sensitivity and specificity applicable to the different forms of pancreatitis. In acute pancreatitis an elevation of serum amylase and amylase/creatinine clearance ratio is diagnostically useful. In chronic pancreatitis, several tests are needed to enhance the diagnostic yield, and such tests can include the secretin-pancreozymin test, ERCP, fecal fat measurement, Lundh test meal, and the administration of the synthetic peptide BZ-Ty-PABA.
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PMID:Laboratory aids in the diagnosis of pancreatitis. 34 Aug 13

In Germany alcohol is responsible for 40--60 per cent of cases with chronic or chronic relapsing pancreatitis. The histologic lesions for a long time remain clinically asymptomatic. Their degree depends on the duration and the total amount of alcohol which is ingested. Promoters of alcoholic damage to the pancraes are a high intake of fat and protein and a genetic disposition. Acute application of alcohol leads to an inhibition of pancreatic secretion when the entrance of gastric acid into the duodenum is prevented. Otherwise a weak stimulation occurs with release of secretin. Chronic application of alcohol after a few months abolishes the initially seen inhibition and leads to an increase of enzyme secretion of the gland. The raised concentration of protein in the pancreatic juice is the cause of precipitation of protein plugs, and thus probably leads to the alterations which are typical for chronic pancreatitis.
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PMID:[Effect of alcohol on the human and animal pancreas (author's transl)]. 35 68


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