Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0030305 (pancreatitis)
 16,014 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The prevalence of cholelithiasis in Jamaican adults with SS disease was studied by plain abdominal radiograph in 206 patients and by oral cholecystogram in 126 (61%) of these patients. Gallstones were found in 57 (28%) of patients, were more common in females than males, and increased with age and hemolytic rate. The majority of gallstones were visible on the plain abdominal radiograph, only 17% of patients with gallstones having only radiolucent stones. Nonfunctioning oral cholecystograms were common (10%) in agreement with observations by previous workers. Gallstones were noted in the common bile duct in 2 patients. In general there was no clear relationship between the presence of cholelithiasis and clinical symptomatology. Complications, such as pancreatitis and malignant change in the gall bladder, recognized to be associated with cholelithiasis in the general population, have not been clearly related to cholelithiasis in SS disease. More information is needed before a logical policy can be evolved for surgical intervention in cholelithiasis in SS disease.
 ...
PMID:Cholelithiasis in Jamaican patients with homozygous sickle cell disease. 60 34

Ultrasound is high frequency mechanical vibration. As far as is presently known, there are no harmful effects of ultrasound at the energy levels used in currently available commercial ultrasonic scanners. Ultrasonic studies are independent of organ function, are painless, and require nor special preparation. Ultrasonic scanning is useful in the diagnosis of pancreatic disease, especially in the detection of complications of pancreatitis such as pancreatic abscess or pseudocyst, and in diagnosing pancreatic carcinoma. Gallstones and dilation of the biliary tree can be detected ultrasonically even when the patient is jaundiced. Primary liver tumors and hepatic metastases can often be demonstrated. Intraabdominal abscesses are better investigated by ultrasound than by any other means currently available. Ultrasonic scanning also provides a sensitive means of detecting ascites. Ultrasonic control of needle placement has been suggested for pancreatic and liver biopsy, for aspiration of intraabdominal fluid collections, and for percutaneous transhepatic cholangiography. Ultrasonic B-mode scans provide undistorted images of cross sections through the abdomen which can be used in radiotherapy planning to localize tumor masses and to place kidney shields accurately. Organ volumes can be estimated from a set of ultrasonic B-mode scans without any assumptions being made as to the shape of the organ.
 ...
PMID:The use of ultrasound in the diagnosis of gastroenterological disease. 76 96

Screening stools for gallstones in patients with acute pancreatitis has been found to be a valuable diagnostic procedure in clinical practice. It is particularly helpful to know that a patient with pancreatitis has gallstones and, therefore, the disease is probably caused by the passage of these stones. A detailed description of the technique employed for stool screening is presented. The procedure was applied in 51 patients recovering from an attack of gallstone pancreatitis,in 51 control patients with known gallstones disease but without acute pancreatitis, and also in 10 patients with acute alcoholic pancreatitis Gallstones were found in the feces in 47 of the 51 patients with gallstone pancreatitis (92.1%), in only 6 of the 51 control cases (11.8%) (chi square = 62.84; P less than 0.0001), and in none of the 10 patients with alcoholic pancreatitis. In the group with gallstone pancreatitis, the finding occurred within 10 days after the attack. Oral cholecystography was also accomplished an average of 12.7 days after the attack in 38 of the 61 pancreatitis patients (28 with biliary and 10 with alcoholic pancreatitis). In 27 of the 28 patients with gallstone pancreatitis (96.4%) and in 4 of the 10 patients with alcoholic pancreatitis, radiologic evidence of cholelithiasis was found. There were 19 patients with gallstone pancreatitis who did not have a cholecystogram accomplished because of jaundice, recurrent pancreatitis, previous cholecystectomy, and pregnancy. These results suggest that screening stools is as accurate and reliable as cholecystography for the diagnosis of gallstones in individuals with pancreatitis. In addition, this method has three definite advantages over cholecystography: There are no contraindications; it requires no special equipment or personnel; and it can be used much earlier than cholecystography in patients recovering from an attack of acute pancreatitis. Screening stools for gallstones should be considered an elective diagnostic procedure for current clinical application.
 ...
PMID:The usefulness of stool screening for diagnosing cholelithiasis in acute pancreatitis. A description of the technique. 83 59

The stools of 45 patients with proven gallstones pancreatitis were screened for gallstones. An equal number of peripheral with gallstones but without pancreatitis served as the control group. Gallstones were found in the stools of 38 of the 45 patients (84 percent) with gallstone pancreatitis and in only five (11 percent) patients of the control group. The patients with gallstone pancreatitis experienced a relief of symptoms and a decrease in the levels of serum amylase and bilirubin prior to rectal passage of the stones. Operative cholangiography revealed reflux of contrast material into the pancreatic duct of 67 percent of the patients with gallstone pancreatitis and in only 18 percent of the controls. Of the 38 patients that passed stones, 30 cholangiograms (79 percent) demonstrated a functioning common channel. it would appear that a functioning common channel is necessary for reflux and in addition favors stone passage. This study suggests that the pathophysiology of gallstone pancreatitis relates to the temporary impaction of migrating stones at the ampulla of Vater.
 ...
PMID:Gallstone pancreatitis: pathophysiology. 96 32

A 75-year-old woman was subjected to biliary surgery 38 years after partial gastrectomy for ulcer. There was a history of gallstones of 10 years duration, pentagastrin-resistant achylia, cholecystolithiasis and choledocholithiasis complicated by stenosis of papilla of vater, cholecystitis and pancreatitis. Peroperative cholangiography and biliary tract surgery were performed. On the third postoperative day heavy jaundice and hemolysis developed, leading to death of the patient. Culture of bile taken at operation revealed strains of Clostridium perfringens and Escherichia coli. Autopsy showed a picture of gas gangraena of the liver and Clostridium septicemia. The role of achylia, blind loop, and biliary obstruction in bile surgery is stressed.
 ...
PMID:Clostridium septicemia following biliary surgery in a gastrectomized patient. 112 39

Extracorporeal shock wave lithotripsy of gallstones is a safe and well-tolerated procedure. Patients are now treated without general anesthesia and, increasingly, on an outpatient basis. Skin petechiae and transient hematuria are the most common side effects. Episodes of biliary colic are common in the follow-up period, but more serious adverse side effects such as cholecystitis and pancreatitis are distinctly uncommon. It is estimated that only 15% to 20% of all patients with symptomatic cholelithiasis are suitable lithotripsy candidates. As our knowledge of the procedure grows, it seems clear that the best results are obtained in patients with solitary radiolucent stones less than or equal to 20 mm, with stone-free rates at 12 months above 80%, for this selected group of patients. Adjuvant oral bile-acid dissolution therapy should be used in conjunction with gallstone lithotripsy. Gallstone recurrence remains to be established by clinical studies. Therapy for gallstones in 1991 has to be reevaluated by an interdisciplinary approach, taking into account not only open cholecystectomy, but also other modalities such as medical dissolution, laparoscopic surgery, percutaneous cholecystolithotomy and extra-corporeal shock wave lithotripsy. The appeal of the laparoscopic approach will substantially reduce the pool of patients for lithotripsy. Nevertheless, lithotripsy will continue to be a viable treatment option for patients with a single radiolucent stone. It is an outpatient procedure and doesn't require any incision or general anesthesia.
 ...
PMID:[Extracorporeal gallbladder lithotripsy: technology, practical methods, results and current value]. 133 49

The introduction of laparoscopic cholecystectomy, improvements in ultrasound technology and the success of endoscopic sphincterotomy have raised new questions regarding the role of intraoperative cholangiography. Our aim was to analyse the ability of preoperative clinical and ultrasound assessments to detect common duct stones in 86 patients with symptomatic cholecystolithiasis who then underwent cholangiography after percutaneous cholecystolithotomy. Six patients gave a history suggestive of common duct stones (either jaundice, cholangitis or pancreatitis). Ultrasound showed a dilated common duct in four patients (normal < 6 mm), and one of these had a stone demonstrated in the duct. The latter patient and one other with a dilated common duct had stones on cholangiography (which were extracted at ERCP), no stones were demonstrated in the other two. Ultrasound correctly identified common duct stones in two and excluded common duct stones in four others with a history suggesting the presence of stones. For patients undergoing laparoscopic cholecystectomy we would advocate the use of preoperative ultrasound instead of intraoperative cholangiography, and that endoscopic retrograde cholangiopancreatography is performed in the small number of patients shown to have a dilated duct or common duct stone.
 ...
PMID:Can cholangiography be safely abandoned in laparoscopic cholecystectomy? 842 51

Despite intense interest in laparoscopic cholecystectomy, biliary lithotripsy (BL), by avoiding the need for general anesthesia, could remain a useful alternative in approximately 10% of patients with symptomatic gallstones. The poor stone clearance rates reported by the Dornier National Biliary Lithotripsy Study has led to disenchantment with biliary lithotripsy. However, the results may reflect the relatively low kV (18.7 +/- 1.7) used. We have compared symptomatic gallbladder stone/cholecystolithiasis patients with one to five stones of aggregate diameter < 60 mm treated with one to three sessions on an MPLS 9000 (Dornier) lithotripter at moderate kV (22.7 +/- 1.7 kV; mean number of shocks 1473 +/- 356) with a similar group treated with high kV (26 kV, mean number of shocks 1357 +/- 507). Ultrasound stone diameter measurements were made pre- and post-BL; 12-wk results are reported. Treatment safety was assessed by recording adverse experiences and serum, urine, hematology, and chemistry. For patients with single stones, the high kV treatment took significantly (p < 0.05) less time (74 +/- 30 min) than moderate kV treatment (118 +/- 33 min). At 3 months, the moderate kV-treated single-stone group had a residual maximum fragment size of 3.2 +/- 3.3 mm versus 1.8 +/- 2.3 mm in the high kV-treated single-stone group. The 3-month stone-free rate for patients with single stones treated at high kV was 44% compared with 46% for the moderate kV-treated group (NS). At 1 wk, 11 patients had microscopic or macroscopic hematuria and six patients had mildly elevated liver function tests. At 6 wk, however, all urine and hematological measurements had returned to normal. Two patients suffered pancreatitis, one in each group. High kV BL appears to be safe and, for patients with single stones, gives better fragmentation and takes less time to administer than moderate kV. Whether a high kV treatment protocol can achieve improved long-term stone-free rates remains to be assessed.
 ...
PMID:Safety and efficacy of high kV biliary lithotripsy: preliminary experience. 144 35

Controversy exists over whether pregnancy is a risk factor for gallstone formation; however, changes in hepatobiliary function do occur during pregnancy to create a lithogenic environment; these changes include gallbladder stasis and secretion of bile with increased amounts of cholesterol and decreased amounts of chenodeoxycholic acid. In women with existing gallstones, pregnancy may bring out symptoms, including pain and even acute cholecystitis. This may be more common during the postpartum period than during pregnancy itself; however, the overall occurrence of symptomatic biliary disease in association with pregnancy is low. The effects of pregnancy, if any, on pancreatic exocrine function are undefined. Acute pancreatitis can occur during pregnancy but does not appear to do so with either increased or, alternatively, decreased frequency. The concept of pancreatitis caused by pregnancy per se is not valid, although in susceptible women with lipid disorders, hypertriglyceridemia can occur and serve as an etiologic factor. Gallstones are a common cause of pancreatitis, but in contrast to nonpregnant women, alcohol is unusual as a cause. Although the presentation of both acute cholecystitis and acute pancreatitis may be similar to that in the nonpregnant state, the differential diagnosis of both these disorders is expanded because of unique pregnancy-related conditions and the shift of abdominal viscera by the enlarging uterus. The diagnosis is clinical and supported with conventional laboratory studies and ultrasound; management is supportive and in most patients successful. Cholecystectomy is seldom necessary during pregnancy, either for acute cholecystitis or gallstone pancreatitis, but can be safely performed if necessary after the first trimester. Endoscopic papillotomy and stone removal for choledocholithiasis are possible during pregnancy and may be the treatment of choice for this unusual condition. Specific enteral or parenteral nutrition may be necessary in women with pancreatitis associated with hypertriglyceridemia.
 ...
PMID:Gallstone disease and pancreatitis in pregnancy. 147 36

The most certain symptomatic manifestation of gallstones is episodic upper abdominal pain. Characteristically, this pain is severe and located in the epigastrium and/or the right upper quadrant. The onset is relatively abrupt and often awakens the patient from sleep. The pain is steady in intensity, may radiate to the upper back, be associated with nausea and lasts for hours to up to a day. Dyspeptic symptoms of indigestion, belching, bloating, abdominal discomfort, heartburn and specific food intolerance are common in persons with gallstones, but are probably unrelated to the stones themselves and frequently persist after surgery. Many, if not most, persons with gallstones have no history of pain attacks. Persons discovered to have gallstones in the absence of typical symptoms appear to have an annual incidence of biliary pain of 2-5% during the initial years of follow-up, with perhaps a declining rate thereafter. Gallstone-related complications occur at a rate of less than 1% annually. Those whose stones are symptomatic at discovery have a more severe course, with approximately 6-10% suffering recurrent symptoms each year and 2% biliary complications. The far higher rates of symptom development reported in a few studies raise the possibility that these incidence estimates may be too low. The best predictors of future biliary pain are a history of pain at the time of diagnosis, female gender and possibly obesity. The risk of acute cholecystitis appears to be greater in those with large solitary stones, that of biliary pancreatitis in those with multiple small stones, and that of gallbladder cancer in those with large stones of any number. Drugs that inhibit the synthesis of prostaglandins may now be the treatment of choice in patients with gallstones who are suffering acute pain attacks. Persistent dyspeptic symptoms occur frequently following cholecystectomy. A prolonged history of such symptoms prior to surgery and evidence of significant psychological distress appear to be the best predictors of unsatisfactory outcome.
 ...
PMID:Symptoms of gallstone disease. 148 6


1 2 3 4 5 6 7 8 9 10 Next >>