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

A critical "blind" evaluation of 129 randomly selected angiographic examinations was carried out including 37 control patients, 58 patients affected by proven chronic relapsing pancreatitis and 34 patients with cancer of the pancreas. In 48.5% of the control patients a completely normal angiographic picture was found. The false positives were found in 10.8% of chronic pancreatitis and in pancreatic carcinoma in 5.5% of the cases. Equivocal signs were found in 35.2%. The percentage of the false negative results in chronic pancreatitis was 34.4% (of which 8.6% were suggestive of pancreatic cancer). In pancreatic cancer positive results were seen in 70.6% of the cases. The percentage of the false negatives was 26.5% (suggestive of chronic pancreatitis); equivocal signs were found in 2.9% of these patients. Notwithstanding the not-negligible percentage of errors, angiography can be usefully employed in diagnosis of pancreatic disorders.
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PMID:Angiography in chronic pancreatitis and pancreatic cancer. A critical evaluation. 74 14

42 cases of pancreatic cyst in acute (22 cases) pr chronic (20 cases) pancreatitis were seen between 1962 and 1976. Analysis of the case data revealed the following: (1) exact assignment of the cyst to acute or chronic pancreatitis is often possible only by long-term observation; (2) the cysts of chronic pancreatitis are not a uniform group: some (8 cases) apparently occurred in acute pancreatitis through necrotic episodes (pseudocysts), others (12 cases) by a retention mechanism; these "retention cysts" develop later in the course of chronic pancreatitis than the pseudocysts and produce a different clinical picture with better prognosis; (3) barium meal and retrograde cholangiopancreatography proved of diagnostic value' (4) if the cysts persist for more than six weeks operation is indicated because of the high incidence of complications.
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PMID:[Pseudocysts and retention cysts in acute and chronic pancreatitis (author's transl)]. 75 56

47 of 170 cases of chronic pancreatitis observed and controlled in the last 12 years in this department were of unknown etiology (idiopathic form). The age distribution of these 47 cases showed 2 peaks, a "juvenile" group of 9 cases (average age 29 years) and a "senile" group of 38 cases (average age 62 years). Idiopathic "senile" chronic pancreatitis (ISCP) is characterized by advanced age at the time of first manifestation (95% over 50 years), a prevalence of males (81%), a high incidence of calcifications (60%) and a rather benign, often painles course (74%). Clinically there is some overlap between ISCP and painless chronic pancreatitis (PSCP). In contrast to PSCP, ISCP seems, however, to comprise a homogeneous group of patients as far as etiology is concerned, and typical episodes of pancreatitis occurred in about 25% of cases with ISCP. Ther is an unusually high incidence of signs of arteriopathy associated with ISCP. Arteritis of the lower limbs and/or coronary heart disease was detected in 42% of cases, 14 of 17 deaths were due to cardiovascular disease and arteriosclerotic risk factors were found in 87% of the patients. In our experience ISCP seems to be a special form of chronic pancreatitis which can be differentiated from alcohol-induced chronic pancreatitis and from the other forms with rare causes. Furthermore, our findings suggest that a vascular factor is of importance in causing ISCP.
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PMID:["Senile" chronic pancreatitis; a new nosologic entity? Studies in 38 cases. Indications of a vascular origin and relationship to the primarily painless chronic pancreatitis]. 77 3

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

Comparative studies between activity of serumlipase, lipaseevocationstest and endoscopic retrograde cholangiopancreaticography (ERCP) in 45 patients with chronic pancreatitis, pancreatic cysts or pancreatic carcinoma confirm, that elevated enzyme values after caerulein stimulation indicate an alteration of the pancreatic parenchyma. However, this findings does not give information on the etiology of the damage. On the basis of the presented results it seems that the lipase-evocationstest has only limited value as screening method within the total of clinical methods for the assessment of light and medium severe stages of chronic pancreatitis and accompanying forms of pancreatitis. There is no evidence that this method may be used for screening for carcinoma of the pancreas. A positive result gives a valuable information, but the lack of an increase of lipase activity does not exclude the existence of pancreatic affection. In each case with clinical suspicion for pancreatic disease further diagnostic investigation by the ERCP and additional radiographic methods should be performed.
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PMID:[The importance of the serumlipaseevocationtest and the retrograde pancreaticography for the diagnosis of chronic pancreatic affections (author's transl)]. 84 Jan 29

Of 22 patients treated surgically for intractable pain from chronic alcoholic pancreatitis, eight did not show notable dilation of the main pancreatic duct by endoscopic retrograde cholangiopancreatography (ERCP), operative pancreatography, and/or operative and microscopical studies of the pancreas after subtotal pancreatectomy. In all patients, far advanced parenchymal pancreatitis was evident at operation and by microscopical study of the removed portion of the pancreas. These findings indicate that the basic problem in a considerable number of patients with symptomatic alcoholic chronic pancreatitis is not related primarily to obstruction with dilation of the major pancreatic duct, but to intrinsic changes in the parenchymal pancreas. The preoperative use of ERCP and individualization of operative procedures with a preference for subtotal or partial pancreatectomy for symptomatic chronic alcoholic pancreatitis are supported.
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PMID:Absence of pancreatic duct dilation in chronic pancreatitis: surgical significance. 84 51

In a follow-up-series on 37 patients, who had been operated on for pancreatitis, the effect of pancreas insufficiency on the well-being of resected and non-resected patients was examined. Analyses of fatcontent in feces, collected over a three day-period, revealed that all patients with chronic pancreatitis now had a maldigestion, in particular patients with duodenopancreatectomie. Pseudocyst-patients showed no maldigestion. Increased in the bodyweight in most cases could not only be explained by drug-substituion of encymes but was also due to the resection of the pain-producing area of the pancreas.
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PMID:[The loss of exocrine pancreas-function following operation for pancreatitis (author's transl)]. 85 72

The bile ducts were visualised using endoscopic retrograde cholangiopancreatography (ERCP), percutaneous or intravenous cholangiography in 38 patients with non-gallstone chronic pancreatitis. Stenosis of the intrapancreatic portion of the distal common bile duct was demonstrated in 11 patients. Ten of the 11 developed transient cholestasis during exacerbations of their chronic pancreatitis. In six cholestasis eventually persisted requiring surgical relief. Secondary biliary cirrhosis was present in one patient. No evidence of pancreatic carcinoma was found in the patients explored surgically. Ten of the patients are alive more than one year after diagnosis. Chronic pancreatitis was of alcoholic aetiology in 10 of the patients with biliary stenosis. Cholestasis and biliary stricture are common but poorly recognised complications of non-gallstone chronic pancreatitis, especially when pancreatitis is severe and due to alcohol.
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PMID:Chronic pancreatitis: a cause of cholestasis. 85 77

A report is given on 28 resections on patients with chronic pancreatitis with a high frequency of severe destructive lesions in the head of the pancreas. Pseudocysts, single, multiple or extrapancreatic were present in almost 50%. Strictures of the Ductus Wirsungianus were found in 24 cases and 50% had multiple pancreatic stones. In these cases 12 partial and 9 total duodenopancreatectomies and 7 distal resections were performed. All patients with distal resections survived. Only one patient died in the group with partial and total duodenopancreatectomy, which accounts for a postoperative letality of 4.8%. Postoperative there were 4 reoccurrences of pancreatitis, due to further alcohol abusus, 1 patient died from alcohol intoxication. Patients with total seemed to do better than with partial pancreatectomy at a survey 18 months after operation.
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PMID:[Surgical treatment of chronic pancreatitis. Indications and early results]. 85 77

The results of ERP carried out in a series of cases of established and suspected chronic and acute relapsing pancreatitis are presented. Radiological findings are divided into major and minor alterations of the pancreatic secretory system. X-ray findings are easy to interprete in chronic pancreatitis with major alterations. Minor anomalies of the pancreas are difficult to interprete in the absence of supporting evidence. Biliary tract involvement is useful for diagnosis of chronic pancreatitis.
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PMID:An evaluation of endoscopic retrograde pancreatography (ERP) in chronic and relapsing acute pancreatitis. 86 74


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