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Query: UMLS:C0030305 (
pancreatitis
)
16,014
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
An oral pancreatic function test (PFT) using the synthetic peptide N-benzoyl-L-tyrosyl-p-aminobenzoic acid can assess pancreatic exocrine function, since urinary recovery of the ingested dose is an indirect index of chymotryptic activity. We have studied 34 subjects using this oral PFT, which correctly distinguished the control group (8 subjects) from the
pancreatitis
group (10 patients), results correlating well with Lundh test findings. However, the test was falsely abnormal on 9 out of 16 occasions in patients with bowel or liver disease. We therefore conclude that the present test cannot distinguish small-bowel disease from pancreatic disease, which is often the diagnostic problem, and is also frequently falsely abnormal in the presence of
chronic liver disease
.
...
PMID:The diagnostic value of the oral pancreatic function test. 31 36
Significant differences exist in the prevalence of most gastroenterological emergencies in tropical compared with temperate countries. Both ethnic and environmental (often clearly defined geographically) factors are relevant. The major oesophageal lesions which can present acutely in tropical countries are varices and carcinoma; bleeding and obstruction are important sequelae. Peptic ulcer disease (and its complications), often associated (not necessarily causally) with Helicobacter pylori infection, has marked geographical variations in incidence. Emergencies involving the small intestine are dominated by severe dehydration, and its sequelae, resulting from secretory diarrhoea, most notably cholera. However, enteritis necroticans ('pig bel' disease), paralytic ileus (sometimes caused by antiperistaltic agents) and obstruction (secondary to luminal helminths, volvulus and intussusception) are other important problems, especially in infants and children. Enteric fever is occasionally complicated by perforation and haemorrhage; the former (which is notoriously difficult to manage) is accompanied by significant mortality. Ileocaecal tuberculosis is a major cause of right iliac fossa pathology--sometimes associated with malabsorption; amoeboma is an important clinical differential diagnosis. The colon can be involved in invasive Entamoeba histolytica infection (which, like complicated enteric fever, is difficult to manage if the fulminant form, with perforation, ensues), shigellosis, volvulus and intussusception. Acute colonic dilatation occasionally follows Salmonella sp., Shigella sp., Campylobacter jejuni, Yersinia enterocolitica and rarely E. histolytica infections. Acute hepatocellular failure is a major cause of morbidity and mortality in the tropics and subtropics. It usually results from viral hepatitis (HBV, sometimes complicated by HDV, and HCV), but there is a long list of differential diagnoses. Hepatotoxicity resulting from herbs, chemotherapeutic agents or alcohol also occurs not infrequently.
Chronic liver disease
and its sequelae (often long-term results of viral hepatitis) are commonplace. Haematemesis and hepatocellular failure are usually very difficult to manage due to a lack of sophisticated support techniques in developing countries. Invasive hepatic amoebiasis usually responds well to medical management; however, spontaneous perforation can occur and the consequences of this are serious. Pyogenic liver abscess, although far less common than amoebic 'abscess', carries a bad prognosis whatever the method(s) of management. Hydatidosis and schistosomiasis also involve the liver, and helminthiases are important in the context of biliary tract disease. Gall stones are unusual in most tropical settings. Acute pancreatitis is overall unusual, but chronic calcific
pancreatitis
can present as an acute abdominal emergency.
...
PMID:Gastroenterological emergencies in the tropics. 176 26
A 65-yr-old alcoholic man with a history of calcific
pancreatitis
presented with massive hematemesis complicated by lipothymia. Physical examination disclosed stigmata of
chronic liver disease
. The laboratory picture was predominantly of cholestatic type with impaired liver protein synthetic activity. Emergency esophagogastroduodenoscopy was unable to provide definitive diagnosis, but reendoscopy with a side-viewing duodenoscope revealed active bleeding through the ampulla of Vater. An ultrasound examination showed a large, complex pancreatic lesion that computed tomography showed to be a pancreatic pseudocyst with an inside pseudoaneurysm. A visceral angiography revealed an anomalous arising of the common hepatic artery from the superior mesenteric artery and a pseudoaneurysm of the gastroduodenal artery at its origin. A second massive hemorrhage required an emergency operation, and surgical liver biopsy revealed focal steatosis. In conclusion, bleeding of a pancreatic pseudoaneurysm may be massive but intermittent, and side-viewing duodenoscopy, even prolonged, is essential in the diagnosis.
...
PMID:Hemoductal pancreatitis secondary to gastroduodenal artery-ruptured pseudoaneurysm: a rare cause of hematemesis. 195 Dec 46
A 33-year-old man, vaccinated against hepatitis B virus, working in an hemodialysis unit, pricked himself with a needle used in a patient. Four weeks later he developed acute hepatitis along with acute pancreatitis. The
pancreatitis
resolved, but the liver disease ran a chronic course. The diagnosis of hepatitis non-A-non-B (NANB) was made on the following criteria: (a) epidemiologic circumstances, (b) exclusion of other causes of acute and/or
chronic liver disease
, (c) chronic indolent course, and (d) compatible histological features. The diagnosis of acute pancreatitis was made with clinical, biological, and radiological data. We believe that the
pancreatitis
was related to the NANB viral infection, as they began simultaneously and other causes of
pancreatitis
were eliminated. Such an association has been reported mainly with hepatitis B and exceptionally with hepatitis A. It has also been observed in the course of fulminant NANB viral hepatitis, but we believe this to be the first case associated with a benign form of NANB.
...
PMID:Acute pancreatitis associated with non-A-non-B hepatitis. Report of a case. 210 6
Acute causes and chronic risk factors for the development of acute renal failure were analyzed in prospective acquired data of 261 patients in a medical ICU. The population was divided into a group requiring dialysis treatment for established renal failure (n = 95) and a collective maintaining mild renal insufficiency (n = 166). Bivariate and linear discriminant analyses revealed that, above all, variables related to bacterial infections (sepsis and administration of antibiotic agents) and
pancreatitis
contributed to the discrimination, followed by bleeding, volume depletion, and
chronic liver disease
in the discriminant function. Bivariate analysis also yielded significant results for mechanical ventilation, CNS depression, and surgery. The importance of the nephrotoxic properties of aminoglycosides may be outweighed by their role as an indicator of severe infectious disease. The overall correct classification rate of the discriminant function was 78.5%, which reflects the importance of the predictor variables, but does not allow individual predictions.
...
PMID:Impairment of renal function in medical intensive care: predictability of acute renal failure. 218 66
Elevated values of pancreatic-type amylase activity in serum were found in 59% of patients with liver cirrhosis not complicated with renal failure, in 67% of patients with chronic renal failure not complicated with hepatopathy and in 95% of patients with chronic renal failure complicated with hepatopathy. In all the three groups, a significant positive correlation was found between the pancreatic-type amylase and intestinal isoenzyme of serum alkaline phosphatase which is an asialoglycoprotein. However, in
pancreatitis
a prevalence of an increase in pancreatic-type amylase with respect to intestinal alkaline phosphatase was found. A multivariate analysis showed that in chronic renal failure not complicated with hepatopathy, and in chronic renal failure complicated with
chronic liver disease
, the changes in calcium homeostasis and also the liver disorder, respectively, contribute significantly to the above-normal values for pancreatic-type amylase.
...
PMID:Role of secondary hyperparathyroidism and liver function in hyperamylasemia in chronic renal failure. 241 93
Macroamylasemia is a condition characterized by a serum amylase activity increase due to complex macromolecules whose large size prevents its urinary excretion. It cannot be consistently correlated with any particular disease state, and should be regarded as a benign chemical derangement. The major clinical importance of macroamylasemia is the confusion of this condition with other causes of hyperamylasemia and its prevalence in the population, comprised between 1 and 2%. Macroamylasemia should be considered in any patient with elevated levels of serum amylase activity whose serum lipase and urine amylase levels are normal, in the face of unimpaired renal function. Confirmation rests on the demonstration of a macromolecular amylase component in the serum by means of chromatography, ultracentrifugation and electrophoresis. In this report, we, describe a patient with
chronic liver disease
caused by alcohol, occasional abdominal pain and persistent hyperamylasemia, though to be due to
pancreatitis
, but subsequently shown to be due to a macroamylase.
...
PMID:[Macroamylasemia or pancreatitis? A diagnostic problem]. 244 75
Carcinoembryonic antigen (CEA) was measured in whole serum and in serum extracted with perchloric acid by microradioimmunoassay in patients with benign and malignant diseases of the liver and pancreas. The level of detectability was 5 ng per ml. This level or greater was present in the serum of 50% of patients with chronic diffuse liver disease, 64% with
pancreatitis
, 94% with cancer of the digestive system, and 3% of controls. The incidence of levels of CEA of 5 ng/ml or more differed for various categories of
chronic liver disease
: from 22% in active chronic hepatitis, 46% in primary biliary cirrhosis, 63% in hepatoma, 78% in cryptogenic cirrhosis, and 88% in alcoholic cirrhosis; levels of CEA correlated with degrees of impairment of liver function as judged by bromsulphalein retention and serum levels of alkaline phosphatase and transaminase. In
pancreatitis
, 64% of cases had levels of CEA ranging from 5 to 20 ng/ml and in cancer of the pancreas 94% had levels above 5 ng/ml and 50% above 20 ng/ml.
...
PMID:Carcinoembryonic antigen in serum in diseases of the liver and pancreas. 472 56
Trypsin and chymotrypsin concentrations were determined in 180 spot stool specimens from 110 control patients in hospital. The lower limit of normality for each enzyme was placed at the 5% level: 95% of this population excreted feces containing more than 100 mug. of chymotrypsin and 30 mug. of trypsin per g. of feces. Chymotrypsin concentrations appeared to be a more reliable guide to pancreatic function than trypsin concentrations.Fecal chymotrypsin concentrations were subnormal in five patients with chronic pancreatitis, borderline in one patient with relapsing
pancreatitis
, subnormal in one patient after pancreatectomy, and subnormal in five of nine with carcinoma of the pancreas. Subnormal concentrations of fecal chymotrypsin were found in seven of 21 patients with
chronic liver disease
related to alcoholism, eight of 32 with a partial gastrectomy, three of 10 with adult celiac disease and five of 16 with psoriasis.It appears that the determination of fecal chymotrypsin concentrations provides a valuable screening test for pancreatic exocrine deficiency. However, normal results may be found in some patients with pancreatic disease and subnormal values may occur in some patients with other conditions.
...
PMID:Fecal chymotrypsin and trypsin determinations. 555 Mar 76
In order to detect early pancreatic changes in chronic alcoholism, we reviewed pancreatograms (ERP) in 35 patients with alcoholic
chronic liver disease
who had no clinical evidence of
pancreatitis
. The patients were grouped by the length of history of alcohol intake (group 1: 5-15 years; group 2: more than 15 years), and on the basis of daily alcohol intake (group 1: 100-150 g/day; group 2: 150-200 g/day; group 3: more than 200 g/day). Pancreatic changes were present at ERP in 48.6% of patients, suggesting mild
pancreatitis
in 15 patients and advanced
pancreatitis
in two. Pancreatic lesions were significantly more frequent (p less than 0.01) in those who took more than 200 g of alcohol each day. There was no correlation with the length of history of alcoholism or with hepatic lesions. Our data confirm that asymptomatic
pancreatitis
is frequent in chronic alcoholism and that ERP can detect pancreatic lesions not otherwise demonstrable.
...
PMID:Early detection of pancreatic lesions in chronic alcoholism: diagnostic accuracy of ERP. 651 28
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