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

Pancreatic reflux during radiomanometry is more frequent during acute and chronic pancreatitis. In acute pancreatitis, it is due in 1 case out of 3, to distal obstruction which must be overcome very rapidly. There is no prognostic significance. Santorini's duct when opacified and when it opens into the duodenum, permits one to suggest a better prognosis than in cases of canalicular pancreatitis. In chronic pancreatitis, reflux is twice as common and 3 times more often organic. When Wirsung's duct is dilated, there is almost always a distal obstacle at the level of the sphincter of Oddi due to a gall stone. If chronic pancreatitis is associated with gall stones, sphincterotomy should be carried out.
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PMID:[Pancreatic reflux into Wirsung's duct during peroperative biliary radiomanometry in acute and chronic pancreatitis (author's transl)]. 88 26

Aneurysms of the small pancreatic and peripancreatic arteries have been reported in chronic pancreatitis, pancreatic pseudocysts, atherosclerosis, trauma, and on a congenital basis. This paper presents for the first time an example of aneurysm formation in acute gas-abscess pancreatitis.
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PMID:Pancreaticoduodenal artery aneurysms in gas abscess pancreatitis. 89 28

Unmodified synthetic somatostatin, given as a 200-microgram intravenous bolus, plus 200 microgram infused over 3 hours, had no effect on basal plasma insulin and pancreatic glucagon-like immunoreactivity (GLI) levels, both in controls and in patients with chronic pancreatitis. Somatostatin inhibited insulin-hypoglycaemia-induced pancreatic GLI release in controls and in patients with pancreatitis, and prolonged the insulin-induced fall in blood glucose in the patients. Arginine, presumably via insulin release, caused a fall in free fatty acids (FFA) in controls, which was inhibited by somatostatin. Somatostatin abolished the rebound rise in plasma FFA in patients with pancreatitis after insulin-hypoglycaemia. This effect may be related to inhibition of pancreatic GLI release or may be a direct action of somatostatin on lipolysis.
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PMID:The effects of somatostatin on hormonal and metabolic responses in chronic pancreatitis. 89 37

Because of the differently selected groups of patients due to a narrow indication for pancreatic surgery, a direct comparison of the results of conservative and surgical therapy is not possible. A follow-up survey of 348 patients with proven chronic pancreatitis showed that patients suffering from uncomplicated pancreatitis should be treated conservatively as long as possible, for 70% (77 out of 109) will improve. In 2/3 of our patients with chronic pancreatitis, surgical treatment became necessary. As to the recurrence of pancreatitis and the lethality, resecting techniques were more successful (72%: 107 out of 148) than the non-resecting ones (61%: out of 91). The cooperation of the patient is crucial for the prognostic outcome regardless of the kind of treatment; especially the elimination of alcohol intake is essential. The most important accompanying or/and succeeding disease is diabetes mellitus, which impairs the long term prognosis especially because of the hazard of postoperative irreversible hypoglycemia. Optimal treatment of patients with chronic pancreatitis can only be accomplished on an individual basis and on the basis of a close cooperation of internists and surgeons.
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PMID:[Chronic pancreatitis--conservative versus surgical treatment under prognostic aspects]. 90 64

A report is presented on the results of the follow-up examination of 43 patients who had been previously operated on chronic pancreatitis. Clinical data such as the patients' well being, their ability to work were collected and specific tests for the function of the pancreas such as fat-content in faeces and glucose-tolerance-test were made. It was shown, that the pancreas-resected patients felt better in themselves. Moreover, their clinical picture was superior to that of non-resected patients although they had initially required a longer postoperative rehabilitation phase. Pseudocysts, which had been drained, showed no diminution of the pancreas function, nor any tendency to rest-pancreatitis.
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PMID:[Long term results following surgical therapy for chronic pancreatitis (author's transl)]. 90 95

The CEA concentration in duodenal fluid after secretin-CCK stimulation has been investigated in 16 patients with pancreatic disease (6 with pancreatic carcinoma and 10 with chronic pancreatitis), 9 with non-pancreatic disease, and 10 control subjects. The purpose was to study whether the determination of CEA in duodenal fluid during the secretin-CCK test can give any additional information for the diagnosis of pancreatic disease and for differentiation between pancreatitis and carcinoma. We found that high values of CEA in duodenal fluid do not necessarily indicate pancreatic carcinoma. Moreover, the level may be elevated in non-pancreatic disease.
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PMID:The CEA concentration in duodenal fluid in patients with pancreatic disease. 92 16

Long strictures of the intrapancreatic portion of the common bile duct were found in 6 patients with chronic pancreatitis. These strictures were responsible for painless obstructive jaundice, recurrent cholangitis, secondary biliary cirrhosis, and chronic abdominal pain difficult to distinguish from that caused by pancreatitis. Endoscopic retrograde cholangiopancreatography and intraoperative cholangiography were invaluable in making the diagnosis and in planning surgical correction. Decompression of the biliary tree by anastomosis of the gallbladder or common duct to the small intestine completely relieved symptoms and allowed liver function to improve significantly. Common duct stricture as a complication of chronic pancreatitis should be considered in the differential diagnosis of extrahepatic biliary obstruction and whenever surgical treatment of chronic pancreatitis is contemplated.
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PMID:Persistent obstructive jaundice, cholangitis, and biliary cirrhosis due to common bile duct stenosis in chronic pancreatitis. 94 56

Eighty-seven examinations of the pancreas in 52 patients with acute or chronic pancreatitis and 31 examinations in 31 normal subjects were reviewed. Demonstration of the portal and splenic veins served as a guidepost to the pancreas. The normal pancreas was indistinguishable from the surrounding tissues in a substantial minority of examinations, and the ultrasonic characteristics of the normal pancreas were quite variable. Acute pancreatitis was found to be characterized by swelling, loss of internal echoes, and loss of distinction between the pancreas and splenic vein. In 50% of patients with chronic inactive pancreatitis, the pancreas could not be identified. Ultrasound should precede endoscopic retrograde cholangiopancreatography whenever a pseudocyst might be present.
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PMID:Gray-scale ultrasonic properties of the normal and inflamed pancreas. 94 1

The authors study in chronic pancreatitis the morphology of Wirsung's duct in 31 patients who had undergone repeated operations, 23 of them were submitted in a first stage to an anastomosis between the pancreatic duct and the digestive tract. The main causes of failure were obstructions of the anastomosis, biliary complications and continuation of the pancreatic disease. The difference in prognosis between pancreatitis with a dilated pancreatic duct, and those with a filiform duct, is perhaps due to lesions of different histological appearance and course. The best results were obtained in patients able to give up alcohol and in whom it was possible to carry out a broader anastomosis on a dilated and unobstructed pancreatic duct.
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PMID:[Wirsung's duct and chronic pancreatitis. Changes in the morphology of the pancreatic ducts after pancreatic duct shunts. 23 cases followed-up]. 95 85

Apparent obstruction of the main pancreatic duct was seen on the endoscopic retrograde pancreatogram in 50 patients. The final diagnosis was pseudocyst in 15, neoplasm in 15, chronic pancreatitis in 8, acute recurrent pancreatitis in 3, and abscess in 2. Seven patients were normal. This series emphasizes the broad differential approach necessary when confronted with ductal obstruction. Diagnosis is facilitated by accurate evaluation of the ductal and extraductal characteristics, especially the ductal detail at the point of termination.
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PMID:The significance of pancreatic ductal obstruction in differential diagnosis of the abnormal endoscopic retrograde pancreatogram. 98 5


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