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

Gastrointestinal diseases are notoriously protean in their modes of expression. The patient's description of symptoms is particularly important, but psychologic, physiologic, and social factors can cause data-base unreliability. Many of the patients termed crocks have symptoms referable to the gastrointestinal system, and they are at considerable health risk, since they usually alienate health care personnel. Patients with pancreatitis usually have a history of heavy alcohol intake which also needs treatment. Behavioral disturbances are related to toxic psychosis. Pancreatic carcinoma has a higher incidence of associated psychiatric symptoms than other types of cancer. Biologic, psychologic, and environmental factors all interact dynamically to cause peptic ulcer disease. There is a high correlation between the severity of inflammatory bowel disease and degree of emotional disturbances.
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PMID:Psychosomatic aspects of gastrointestinal disease. 110 97

Subcutaneous fat necrosis, a type of panniculitis, is a rare entity that is manifested by painless or painful subcutaneous nodules on the legs, buttocks, or trunk and is associated with pancreatitis or carcinoma of the pancreas, either of which may be asymptomatic. The histopathological findings are pathognomonic and consist of subcutaneous focal fat necrosis and "ghost-like" cells with thick, shadowy walls and no nuclei. Arthritis, particularly of the ankles, is a commonly associated finding. Distant foci of fat necrosis in pancreatic disease are probably due to the local action of hematogenous-borne trypsin and lipase. Since the underlying pancreatic disease may be asymptomatic, histopathologic study of all cases of panniculitis should be considered.
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PMID:Subcutaneous fat necrosis associated with pancreatic disease. 112 53

Chronic pancreatitis and carcinoma of the pancreas are being diagnosed with increasing frequency throughout the world. When both occur together, the question of their causal relationship arises. Secondary chronic pancreatitis following carcinoma of the pancreas is relatively frequent and can be proven histologically in at least 10% of pancreatic cancers. How often primary chronic pancreatitis develops into carcinoma is controversial. So far, there are only a few prospective clinical studies of chronic pancreatitis which cover this problem. We have followed 146 cases of chronic pancreatitis for an average of 8.7 years. Two thirds of our patients show pancreatic calcifications. Our series includes a family with congenital pancreatic insufficiency. So far only one adenocarcinoma of the head of the pancreas has been diagnosed in a 58-year-old male. Another 57-year-old male patient died from a solid metastatic carcinoma, probably of pancreatic origin. Therefore, the incidence of pancreatic cancer in our series is 0.7 and 1.4% respectively. However, 8 more patients suffering from extrapancreatic malignancies have turned up during the follow-up period: 2 cancers of the tongue, 2 colonic carcinomas, 2 bladder papillomas, and 1 bronchial and 1 gastric carcinoma. Our studies indicate that carcinoma of the pancreas probably does not occur more frequently in chronic non-hereditary pancreatitis than in the average population. A review of the literature suggests that there may be a higher incidence of carcinoma in families with hereditary chronic pancreatitis. The frequency of extrapancreatic cancer in our patients is remarkable. As pancreatic carcinoma is rare in chronic pancreatitis there is no reason for early aggressive surgery, e.g. pancreatectomy, in these patients.
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PMID:[Pancreatic carcinoma in chronic pancreatitis]. 114 57

Winslow's lobe, the postero-inferior lobe of the head of the pancreas, gives rise to special angiographic appearances owing to its posterior position in relation to the axis of the superior mesenteric artery. It displaces the superior mesenteric artery laterally and forwards, and may also obstruct the vein. In 12 cases of pancreatitis, these signs were usually due to a pseudo-cyst of this lobe of the pancreas, the angiographic discovery of which provided greater accuracy in diagnosis. In 4 cases of carcinoma of the pancreas, there was also irregular stenosis of the first few jejunal arteries, the diagnostic interest of which is important.
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PMID:[Angiographic diagnosis of lesions of Winslow's lobe of the pancreas (author's transl)]. 115 10

Gray scale scanners allow the demonstration of much more anatomical detail than was possible with the older type scanners. The initial step in the ultrasonic examination of the pancreas is display of the anatomical detail of the portal vasculature which provides a guidepost to the pancreas. Pancreatitis is characterized by a diffusely enlarged echo-free pancreas. Pancreatic pseudocyst is almost always an echo-free unilocular fluid collection. The size of a pancreatic pseudocyst can be measured so that progress can be assessed. Pseudocysts located in the region of the tail of the pancreas may be best demonstrated by scanning from the back over the left kidney. Pancreatic pseudocysts may be partly solid. Pancreatic carcinoma appears as a localized relatively echo-free, poorly defined solid mass which attenuates the ultrasound beam. Pancreatic carcinoma smaller than 2 cm in diameter are particularly difficult to diagnose by ultrasonic examination. Pancreatic carcinoma may be difficult to distinguish from chronic pancreatitis. Dilated bile ducts can be demonstrated and point to extrahepatic biliary obstruction. Serial ultrasonic scans have been suggested as a means of monitoring the response of pancreatic tumors to therapy. The relative diagnostic value of endoscopic retrograde cannulation of the pancreatic ducts and ultrasound has not as yet been established. Ultrasonic examination is easier to perform and less expensive than any other pancreatic imaging procedure other than the upper gastrointestinal barium examination.
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PMID:Ultrasonic examination of the pancreas. 120 74

Carcinoma of the pancreas is seen in 1.2 percent of autopsies. Often it is not possible to determine definitely: whether it is a carcinoma of the head of the pancreas, of the papilla, or of the distal part of the common bile duct (periampullary carcinoma). 90 percent of these carcinomas arise in the small ducts. They cannot be recognized by ERCP until spreading into the main duct has occurred. Differential diagnosis is concerned mainly with differentiating between chronic pancreatitis and carcinoma of the pancreas. Chronic pancreatitis and carcinoma of pancreas are not mutually exclusive; on the contrary they are closely related in diagnosis and pathogenesis. There can be no carcinoma of the pancreas without pancreatitis. For an accurate diagnosis which is vital, a diagnostic laparotomy should be performed at an early stage.
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PMID:[Carcinoma of the pancreas: pathologic anatomy (author's transl)]. 120 2

Hypotonic duodenography has opened up new dimensions in the diagnosis of space-occupying lesions of the head of the pancreas. The procedure with out intubation has become routine over the last few years. Differentiation between severe alterations caused by chronic relapsing pancreatitis and those caused by a carcinoma of the pancreas is only seldom possible, whereas inflammatory swellings and tumors of Vater's Papilla are easily recognized. Endoscopy is necessary for confirmation of the diagnosis. When jaundice is already present, transhepatic cholangiography can yield more information; in the pre-icteric phase intravenous cholangiography can also be useful. More complicated diagnostic procedures should not be applied until all conventional roentgenologic methods have been exhausted.
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PMID:[Carcinoma of the pancreas: conventional roentgenologic procedures (author's transl)]. 120 3

Isoamylase analysis of the serum and urine of a patient with anaplastic spindel cell carcinoma of the pancreas revealed that virtually all of the serum amylase and almost all of the urine amylase behaved chromatographically as the salivary (S) type. Both the serum and urine amylases were bound by a substance derived from a macroamylase complex which had been shown to bind only salivary amylase and to lack any affinity for pancreatitis (P) type amylase. The ratio of amylase to creatinine clearance was markedly increased (12.5%) without evidence of acute pancreatitis at autopsy and despite the presence of only a minute amount of P-type isoamylase in the serum.
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PMID:Nonpancreatic-type hyperamylasemia associated with pancreatic cancer. 127 25

Malignant tumours both of the pancreatoduodenal zone and of other organs situated close to or remote from it occupy a certain place among various etiopathogenetic factors of acute pancreatitis. Complication of the neoplastic process of these organs by acute carcinogenic pancreatitis (ACP) has an effect on the clinical picture of the disease as well as on the therapeutic tactics and the outcomes of the treatment. According to the authors' data (30 patients), ACP occurs in primary carcinoma of the pancreas and in its secondary involvement (metastases and growth of tumours of other organs into the pancreatic tissue). The article discusses the causative factors and clinical forms of ACP, the specific features of their diagnosis and therapeutic tactics. Purposeful nonoperative and operative treatment of ACP makes it possible to reduce the mortality in malignant diseases and prolong the patients' survival.
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PMID:[Acute pancreatitis in primary and metastatic tumors of the pancreas]. 171 52

Ultrasonic assessment of the pancreas is rendered difficult by interposed gas-containing loops of bowel and stomach. In 50% of the cases, meteorism and ileus prevent the diagnosis of acute pancreatitis. In the case of chronic pancreatitis, focal pancreatitis and carcinoma of the pancreas, too, further diagnostic procedures (CT, ERCP, fine-needle aspiration) are required. As a rule, the caliber of the pancreatic duct can readily be assessed, and may, for example, indicate a carcinoma in the head of the pancreas. Splenomegaly and focal or diffuse parenchymal lesions are detectable by ultrasonography, although an etiological differentiation is not usually possible. The most common lesions are the so-called "bland" splenic cysts. Of importance is the diagnosis of rupture of the spleen, which requires immediate treatment.
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PMID:[Diagnosis of gastroenterologic diseases with sonography. Part 3: Pancreas and spleen]. 176 39


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