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

The computed tomographic (CT) findings in 13 consecutive patients with proven gastric varices were analyzed and correlated with the radiographic, angiographic, and gastroscopic evaluations. In 11 patients, CT clearly identified large (five) or smaller (six) varices located mainly along the posteromedial wall of the gastric fundus and proximal body of the stomach. Well defined rounded or tubular densities that enhanced during intravenous administration of contrast material and could not be distinguished from the gastric wall were identified. Dense, enhancing, round or tubular, intraluminal filling defects were seen in the cases where the stomach was distended with water. In two patients, the CT diagnosis of gastric varices could not be confidently made. All patients had associated intraabdominal collateral circulation, situated medial to the stomach within the lesser omentum, along the distribution of the coronary venous system. In seven patients, the CT examination correctly diagnosed the pathogenesis of gastric varices by identifying hepatic cirrhosis, calcific pancreatitis, and carcinoma of the pancreas.
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PMID:Computed tomographic recognition of gastric varices. 660 94

Regional pancreatectomy refers to an en bloc removal of a tumor in or adjacent to the pancreas with an adequate soft tissue margin and with its regional lymphatic drainage. The pancreatic segment of portal vein is part of the en bloc resection with venous reconstruction by end-to-end anastomosis without a graft. This operation, called a Type I regional pancreatectomy, may utilize either a total or subtotal removal of the pancreas. Localized arterial involvement by a neoplasm necessitates adding a segmental resection of the artery with vascular reconstruction, a Type II procedure. Sixty-one patients have had this procedure from 1972 through 1982. They are a subset of the 270 patients with cancer of the pancreas, ampullary and periampullary regions, duodenum, or terminal portion of the common bile duct who were treated by the author during this period. The 61 consist of 35 patients who had an infiltrating duct adenocarcinoma of the pancreas and 21 who had other kinds of malignant tumors. In addition, four were classified as having pancreatitis and a fifth patient had a pseudolymphoma. The resectability rate is about 30%. The present operative mortality rate is 8%. Approximately one-third of the patients are alive; 43% of the 21 patients with malignant tumors other than infiltrating duct adenocarcinoma of the pancreas are alive with a median survival time of 40 months (3-92 months). Forty-three per cent were Stage I but more than half were T3 or T4 lesions. Twenty-five per cent of patients with Stages II or III are alive. Twenty per cent of patients with infiltrating duct carcinoma of the pancreas are presently alive, 28% died of recurrent disease, and 26% died of other causes; more than 90% of these patients had advanced stage disease (Stage II or III).
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PMID:Regional pancreatectomy for cancer of the pancreas, ampulla, and other related sites. Tumor staging and results. 671 17

On the basis of an analysis of clinical, laboratory and rentgenological data of the examination of 39 patients with pseudotumorous, pancreatitis a conclusion is made that choleduodenography is of major significance among different rentgenological methods. It allows differentiation between pancreatitis and carcinoma of the pancreas head according to the state of extrahepatic ducts and duodenum. In most difficult cases the final diagnosis could be made only by the data of operation biopsy.
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PMID:[Diagnosis of pseudotumorous forms of chronic recurrent pancreatitis]. 671 15

There is ample evidence that a relationship exists between duct epithelial hyperplasia and carcinoma of the pancreas. However, no experimental system exists to investigate the mechanisms involved. A new model is described in the Syrian golden hamster for inducing duct epithelial hyperplasia and nesidioblastosis. The head of the pancreas is wrapped with cellophane tape; ligation of the duct is not involved and there is no evidence of diffuse pancreatitis. Preliminary studies have revealed that this model results in periductal fibrosis in relation to the cellophane thus producing partial duct obstruction. Concomitant with the fibrosis there is duct epithelial hyperplasia in the head of the gland, while peripherally there is ductular proliferation and the initiation of nesidioblastosis. It is believed that this model will be of use in studies of pancreatic carcinogenesis and will thus enhance our knowledge of the interrelationships between etiologic factors, precursor lesions, and pancreatic cancer. This is of particular importance in the early recognition of this neoplasm in man.
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PMID:A new approach to the induction of duct epithelial hyperplasia and nesidioblastosis by cellophane wrapping of the hamster pancreas. 686 94

Burkitt's lymphoma involving the pancreas is relatively common at autopsy. In contrast to the typical appearance of carcinoma of the pancreas, Burkitt's lymphoma can present as diffuse enlargement of the entire gland, due to either tumor induced pancreatitis or tumor lysis pancreatitis seen after chemotherapy. Needle biopsy of the enlarged gland, as in the presented case, is capable of distinguishing uncomplicated acute pancreatitis from the pancreatitis associated with Burkitt's involvement of the organ.
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PMID:Case report. Burkitt's lymphoma of the pancreas presenting as acute pancreatitis. 707 34

The article reports on 78 CT scans of surgically verified diseases of the pancreas, namely, 30 cases of chronic pancreatitis, 12 cases of haemorrhagic-necrotizing pancreatitis, and 36 cases of carcinoma of the pancreas. 12 of these cases were operable, whereas 234 were inoperable. The operable carcinomas were so small that proper diagnosis was effected in 50% only, whereas the inoperable carcinomas eluded CT identification in 17% of the cases only. The most important signs of an operable carcinoma of the pancreas are a well-defined enlargement and inhomogeneity of the parenchyma with reduced contrast, especially on bolus injection, as well as dilatation of the bile duct system. The most essential criteria for inoperability are absence of boundaries, especially towards the dorsal side, with infiltration of the retroperitoneal fatty tissue, and lack of delineation of the large vessels. According to the present state of the art, CT does not supply definite criteria for differentiating between an operable carcinoma of the pancreas and chronic fibrotic pancreatitis. Overstepping of the marginal contours is a reliably distinctive feature between carcinoma and pancreatitis, but it also points to the inoperable nature of the disease. Haemorrhagic-necrotizing pancreatitis is characterized by definite CT criteria, so that diagnosis is easy.
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PMID:[Computer tomographic diagnosis of pancreatitis and pancreatic cancer]. 718 80

The pancreas can be studied for obstructive disease by measuring serum lipase levels in the two stage provocative test. The test is nonspecific but noninvasive and applicable to all stages of pancreatic diseases. In this test, the pancreas is stimulated twice in two hour intervals before measuring the serum enzyme levels: first, with pancreozyin and secretin--the stage 1 test and, second, with pancreozymin, secretin, betazole hydrochloride and morphine sulfate--the stage 2 test. Among the pancreatic enzymes measured, lipase was most reliable. Serum lipase level elevation in the stage 1 test indicates a pancreatic abnormality and it completes the test. Patients who fail to respond to the stage 1 test have either a normal pancreas or pancreatic insufficiency and need the stage 2 test for differential diagnosis. In the stage 2 test, the serum lipase level is elevated in patients with a normal pancreas but not in those with pancreatic insufficiency. As a preliminary study, ten patients with carcinoma of the pancreas, two with pancreatitis and ten in the control group were studied. All patients with a known pancreatic disease demonstrated an abnormality in the test. Two of ten in the control group also had abnormal results. The two stage provocative test may be used prior to undertaking more invasive examinations, such as an arteriogram, in patients who are suspected of having pancreatic disease, yet other tests have failed to indicate it.
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PMID:The two stage provocative test for pancreatic disease by serum enzyme measurements. 735 Jul 1

A blind study of 49 patients with narrowing of the common bile duct or pancreatic duct on endoscopic retrograde cholangiopancreatography (ERCP) was done. The double duct sign appeared in four of eight pancreatic carcinoma patients, but also occurred in 15 of 41 pancreatitis patients. Other signs, which occurred only in carcinoma in prior studies (nodular, eccentric narrowing, and eccentric and irregular rat-tailed stenosis) also occurred in both groups. These results highlight the unreliability of utilizing morphological ductal changes as the only ERCP criteria in differentiating pancreatic carcinoma from pancreatitis. The most reliable criterion for pancreatitis was multiple stenoses in one duct. Pancreatic carcinoma cannot be diagnosed accurately if signs of pancreatitis are also present, and other examinations may be needed.
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PMID:Endoscopic retrograde cholangiopancreatography (ERCP) in pancreatic disease: a reassessment of the specificity of ductal abnormalities indifferentiating benign from malignant disease. 735 12

Endoscopic retrograde pancreatico-cholangiography (ERPC) gave the correct diagnosis in 83% of 269 cases of pancreatitis confirmed by operation, clinical features, laboratory findings and course. It provided the correct diagnosis in 85% of 82 cases of necrosis of the pancreas and pseudocysts confirmed at operation. ERPC is one of the most important methods of investigation in papillary stenosis, because it can demonstrate both ducts and can reveal functional changes, especially delayed emptying. The correct diagnosis of carcinoma of the pancreas, confirmed at operation or histologically, was made in 88% of 107 cases. Endoscopy correctly diagnosed 26 of 27 cases of papillary carcinoma. Biopsy with subsequent histological study and cytological analysis of pancreatic secretion further served to confirm the diagnoses established by ERPC.
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PMID:[Accuracy of endoscopic retrograde pancreatico-cholangiography in the diagnosis of pancreatic disease: an analysis of three thousand investigations (author's transl)]. 747 8

The natural course of the classical symptoms of chronic pancreatitis, i.e. pain, exocrine and endocrine pancreatic insufficiency, was followed up in 335 patients over a median of 9.8 years (mean 11.3 +/- 8.3 years). Pain relief was not obtained in the majority of patients, even after a longterm observation of > 10 years, and severe exocrine and/or endocrine insufficiency, severe duct abnormalities and pancreatic calcifications developed. Alcohol abstinence failed to have a significant beneficial effect on pain. Pancreatic surgery led to pain relief immediately after operation, but later on the pain course between operated and nonoperated patients was not significantly different. Repeated exocrine pancreatic function tests in 143 patients showed that functional exocrine impairment came to a standstill (46%), or improved (11%). At the end of the observation, 22% of 335 patients still had normal endocrine function and only 40% required insulin treatment. Alcohol abstinence had a significant beneficial effect on endocrine, but not on exocrine pancreatic insufficiency. Chronic pancreatitis led to a sharp increase in unemployment and retirement. Pancreatic carcinoma occurred in 3% and extrapancreatic carcinoma in 4%. The mortality rate within the observation period was 22%, pancreatitis-induced complications accounted for 13% of these deaths.
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PMID:[The natural course of chronic pancreatitis--pain, exocrine and endocrine pancreatic insufficiency and prognosis of the disease]. 777 39


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