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

Hospital charts and operative notes on 2,000 consecutive cholecystectomies performed between 1965-1984 for benign gallbladder disease were reviewed and computer analyzed. Patients were divided into five age categories (1-29, 30-49, 50-69, 70-79, 80 years and above). Fifteen variables were examined for each age category, including total number, sex, presenting symptoms (jaundice, acute cholecystitis, pancreatitis), intraoperative findings (presence of stones, common bile duct width and stones), operative procedures, bile cultures, histology, postoperative course and mortality. In addition to critically assessing performance and permitting comparison with other series, this age-related analysis suggests the following conclusions: The female predominance in age category 1 diminishes in categories 4 and 5. Acute cholecystitis and suppurative cholangitis occur in 44% of age category 5, compared to 14-24% in other age categories. Intraoperative fluorocholangiography is mandatory; common bile duct stones were found in 14% of age category 1. Age category 2 seems to be the group least susceptible to choledochal pathology. Acalculous cholecystitis is closely related to gangrenous changes, especially (almost selectively) in age categories 4 and 5. The frequency of infected bile rises with age, and is found in 90% of patients in age category 5. Mortality from operations for benign gallbladder disease is ten times higher in patients over 70 years of age compared to younger patients. An ultrasonographic study should be performed before any major laparotomy, especially in the aged, in order to diagnose silent stones, and prepare the patient for concomitant cholecystectomy. Elective cholecystectomy in age categories 4 and 5 is still accompanied by high mortality rates.
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PMID:Age profiles of benign gallbladder disease in 2,000 patients. 359 74

In the first part of our review, we discussed the general evaluation and clinical presentation of the various hepatic infections occurring in patients with AIDS. In addition, we focused on specific hepatic parenchymal infections. In this article, we will discuss the major clinical syndromes arising from opportunistic infections affecting the gallbladder (acalculous cholecystitis), biliary tree (AIDS-cholangiopathy), and pancreas (pancreatitis). Acalculous cholecystitis can develop in patients with AIDS who have not experienced the severe precipitating physiologic stresses normally required in patients without AIDS. The most common presentation is with right upper quadrant (RUQ) pain and tenderness. The diagnosis is a clinical one since there is no standard test, other than surgery. Cholecystectomy is the treatment of choice. The most common AIDS-associated infective complication of the biliary tree is AIDS-cholangiopathy. This is best viewed as a form of secondary sclerosing cholangitis resulting from a variety of opportunistic infections within the biliary tree. Affected persons present with RUQ pain and have marked elevations in the canalicular enzymes, alkaline phosphatase, and gamma-glutamyl transferase. Morphologic abnormalities are identified by endoscopic retrograde cholangiopancreatography. These include stricturing, dilatation, and beading of the biliary tract. Endoscopic sphincterotomy of the papilla of Vater may provide symptomatic relief for patients with papillary stenosis. Opportunistic infections within the pancreas gland have been documented in both pre- and postmortem studies. However, the true incidence of pancreatitis related to infections is unknown. The presentation is similar to that of pancreatitis from other causes. A computerized tomogram of the abdomen is the investigation of choice. Tissue aspiration or biopsy of the pancreas is required to demonstrate the presence of an opportunistic infection. The management is usually supportive, as it is rare that a specific infection is identified and treated.
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PMID:Hepatobiliary and pancreatic infections in AIDS: Part II. 1136 92

Acute pancreatitis and acalculous cholecystitis have been occasionally reported in primary acute symptomatic Epstein-Barr virus infection. We completed a review of the literature and retained 48 scientific reports published between 1966 and 2016 for the final analysis. Acute pancreatitis was recognized in 14 and acalculous cholecystitis in 37 patients with primary acute symptomatic Epstein-Barr virus infection. In all patients, the features of acute pancreatitis or acalculous cholecystitis concurrently developed with those of primary acute symptomatic Epstein-Barr virus infection. Acute pancreatitis and acalculous cholecystitis resolved following a hospital stay of 25days or less. Acalculous cholecystitis was associated with Gilbert-Meulengracht syndrome in two cases. In conclusion, this thorough analysis indicates that acute pancreatitis and acalculous cholecystitis are unusual but plausible complications of primary acute symptomatic Epstein-Barr virus infection. Pancreatitis and cholecystitis deserve consideration in cases with severe abdominal pain. These complications are usually rather mild and resolve spontaneously without sequelae.
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PMID:Pancreatitis and cholecystitis in primary acute symptomatic Epstein-Barr virus infection - Systematic review of the literature. 2743 48