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

A 4-month-old boy presented with 9 days of abdominal distension. The abdomen was tense, distended, and nontender, with a fluid wave. Hypoalbuminemia, hyponatremia, high lipase, normal amylase, high ascitic fluid: lipase, amylase, and serum-ascites albumin gradient < 1.1 were present. Abdominal CT showed large ascites, edema, and pancreatic cyst. No improvement was noted with bowel rest, TPN, albumin, furosemide, octreotide, and paracentesis. Endoscopic retrograde cholangiopancreatography showed disrupted pancreatic duct and a cyst. Pancreatic duct stenting was complicated by early outward migration of the stent and was thus ineffective. An exploratory laporatomy revealed a cyst. Cystogastrostomy resolved the pancreatitis and ascites. The patient was discharged off TPN and tolerating enteral nutrition. Pancreatic ascites is rare, producing few or no symptoms in infants. In conclusion, our patient may have had viral pancreatitis, complicated by a disrupted duct and/or ruptured pseudocyst with ascites formation. Medical management was ineffective. Surgery appears to have been curative.
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PMID:Pancreatic ascites in an infant: lack of symptoms and normal amylase. 1456 Sep 86

Components of the activated complement cascade are considered to play a pivotal role in ischemia-reperfusion-induced organ injury. With the use of intravital epifluorescence microscopy, we investigated the effect of complement inhibition by the recombinant soluble complement receptor 1 (sCR1; TP10) on the effect of macromolecular microvascular permeability, functional capillary perfusion, and leukocyte endothelium interaction in postischemic pancreatitis. Anaesthetized Sprague-Dawley rats were subjected to 60 min of normothermic pancreatic ischemia induced by microclipping of the blood-supplying arteries of the organ. Rats who received sCR1 (15 mg/kg body wt iv; n = 7) during reperfusion showed a significant reduction of permeability (1.77 +/- 1.34 x 10(-8) cm/s; n = 7) of tetramethylrhodamine isothiocyanate-labeled albumin injected 90 min after the onset of reperfusion compared with vehicle-treated animals (6.95 +/- 1.56 x 10(-8) cm/s; n = 7). At 120 min after the onset of reperfusion, the length of red blood cell-perfused capillaries (functional capillary density) was significantly improved (from 279 +/- 15.7 to 330 +/- 3.7 cm(-1); n = 7) and the number of leukocytes adherent to postcapillary venules was significantly reduced (from 314 +/- 87 to 163 +/- 71 mm(-2); n = 7) by sCR1 compared with vehicle treatment. Complement inhibition by sCR1 effectively ameliorates pancreatic ischemia-reperfusion-induced microcirculatory disturbances and might be considered for treatment of postischemic pancreatitis.
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PMID:Soluble complement receptor 1 preserves endothelial barrier function and microcirculation in postischemic pancreatitis in the rat. 1469 6

Edema formation is the first manifestation of acute pancreatitis. Microcirculatory derangements like leukocyte-endothelial cell interaction and perfusion failure result in enhancement of microvascular permeability to large molecules playing a pivotal role in the progression of the acutely altered pancreatic tissue. Due to the lack of suitable methods the crucial mechanisms of enhanced permeability in vivo are not very well investigated. Sprague-Dawley rats were randomly assigned to three groups: (a) sham operated animals with normal pancreas, (b) the pancreatitis group induced by 60 min temporary occlusion of the arterial supply followed by reperfusion and (c) the histamine group in which the pancreas was superfused with 10(-5)M histamine. The pharmacokinetics of tetramethylrhodamine-labelled BSA in the intravital microscopic images of a capillary network of the pancreas were densitometrically quantified over 20 min. From these data the effective microvascular permeability was calculated taking also into account morphology of microvessels, elimination rate of the tracer from the intravascular space and capillary microhematocrit. In addition macromolecular leakage of gold-labelled BSA was investigated by electron microscopy. Microvascular permeability was 0.10 +/- 0.02 x 10(-7) cm/s, 0.49 +/- 0.04 x 10(-7) cm/s and 1.21 +/- 0.29 x 10(-7) cm/s for control, ischemia and histamine group, respectively (P < 0.05 ischemia, histamine vs. control and ischemia vs. histamine). Electron microscopy revealed albumin extravasation in the last two groups. We established a technique allowing to quantify microvascular permeability in pancreatic tissue by dynamic intravital microscopy being independent of the investigator. This technique enabling accurate pathophysiologic characterisation in terms of edema formation can form the basis for evaluating in the future novel treatment strategies directed against acute pancreatitis.
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PMID:Dynamic intravital fluorescence microscopy--a novel method for the assessment of microvascular permeability in acute pancreatitis. 1470 3

The aim of this study was to investigate the influence of a small amount of enteral nutrition along with parenteral nutrition on acute necrotizing pancreatitis (ANP) induced by glycodeoxycholic acid in rats in the early phase of disease. The induction of ANP resulted in a significant increase in mortality rate, intestinal permeability, bacterial infection in the pancreas and extrapancreatic organs, pancreatic necrosis and serum activity of urea and amylase, and a significant decrease in concentrations of calcium, protein and albumin. But no difference was observed between the pancreatitis groups. Significant hyperglycemia and increased liver transaminase activity were observed in rats treated with combined nutritional therapy (CNT). CNT did not improve the course of acute pancreatitis, intestinal permeability, bacterial translocation, or reduce the extent of acinar cell injury in ANP and is therefore unlikely to be of benefit in patients with pancreatitis in the early period.
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PMID:Effects of combined nutritional therapy on acute necrotizing pancreatitis in rats in the early phase of the disease. 1473 Feb 21

It is well established that damage to the outer membrane of cells is a common phenomenon allowing abnormal transmission of substances into the cytosol. Penetration of albumin into acinar cells has been detected in experimental acute pancreatitis, raising the possibility that membrane damage is a very early event, potentially representing the first changes leading to pancreatitis. To determine if direct damage to the cell membrane is a key factor during induction of acute pancreatitis, thus altering the balance of extra- and intracellular substances, fluorescein-dextran was administered with supramaximal doses of caerulein via the jugular vein or by injection directly into the pancreas. This tracer rapidly penetrates into cells. Two patterns of tracer penetration are observed: cytosolic and vesicular/vacuolar. Fluorescein-dextran administered intravenously with caerulein penetrates into the cytosol of acinar cells within 10 min. Strong cytoplasmic fluorescence occurs within 5 min after direct injection. It may be concluded that supramaximal caerulein, administered in vivo, damages the cell membrane of acinar cells, allowing large molecules to enter the cytosol. Thus Ca(2+) and other substances may enter the cells in abnormally high concentrations, initiating the cellular changes characteristic of pancreatitis. The results raise the question whether membrane wounding may play a role in the initiation of human pancreatitis.
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PMID:Cell wounding in early experimental acute pancreatitis. 1476 92

In a patient with an undiagnosed pleural effusion, the first question to answer is whether the fluid is an exudate or a transudate. This is usually determined by means of Light's criteria, which differentiate transudative effusions from exudative effusions by measuring the levels of total protein and lactate dehydrogenase in the pleural fluid (PF) and serum. In patients under diuretic treatment, Light's criteria misclassify transudates as exudates, but the serum to pleural fluid albumin gradient usually remains above 12 g/L. When tests are done only in PF, protein concentration >30 g/L performs at least as well as the other individual markers. To diagnose tuberculous pleuritis among exudates, PF adenosine deaminase and PF interferon-g exhibit high diagnostic accuracy. When malignancy is suspected the addition of tumour markers to the results of cytologic analysis increases the rate of detection. Other biochemical markers are useful in specific circumstances involving pleural effusion, such as amylase in effusions due to pancreatitis, or oesophageal rupture, and triglycerides in chylothorax. Several PF markers are associated with complicated parapneumonic effusion - e.g. low PF pH and glucose, and high PF LDH activity -- although PF pH appears to be the best biochemical aid in decisions regarding chest tube drainage. Recent reports suggest that neutrophil-derived enzymes (polymorphonuclear elastase and myeloperoxidase) can be useful as early indicators of the need of chest tube insertion; however these findings must be confirmed in large series. This review discusses the clinical usefulness of biochemical markers in the diagnosis and management of pleural effusions. The vast majority of prospective studies in this field have been conducted in adults and, although the mechanisms of pleural effusion production do not differ in children and adults, the prevalence of each etiologic cause does. Therefore it seems advisable to confirm or recalculate the predictive values of each marker in the paediatric population.
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PMID:Useful clinical biological markers in diagnosis of pleural effusions in children. 1498 Feb 72

Clinical investigations of 120 patients have shown that Dimephosphon included in complex treatment of acute edematous pancreatitis facilitates more rapid arrest of the symptoms. An important effect of the drug is its ability to decrease the level of endogenous intoxication by both the hydrophilic and hydrophobic components. It was established that one of the mechanisms of favorable action of the drug is its ability to inhibit LPO, to decrease activity of phospholipase A2. The drug possessing the cytoprotecting effect promotes rapid restoration of the functional state of the liver, in particular its detoxicating, albumin synthesizing ability that is not least of the factors of optimization of the complex therapy.
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PMID:[Dimephosphon in complex therapy of acute edematous pancreatitis]. 1499 24

Ascites is a poorly understood postoperative complication of orthotopic liver transplantation (OLT). It is associated with additional morbidity and can prolong hospitalization considerably. The incidence, the factors predictive of occurrence and the etiology of this complication are not known. The charts of 118 patients with 138 OLT were analyzed according to the following criteria: ascites lasting longer than the first 10 postoperative days, assessed by loss of ascitic fluid through drainage tubes, surgical wounds or paracentesis, with a peak volume of > or =10 mL/kg/day. Patients were divided into three groups: Group 1, no ascites; Group 2, ascites associated with postoperative complications, including chylus ascites; and Group 3, ascites not associated with postoperative complications. Postoperative ascites occurred in 43 of 138 OLT (31.2%). Patients with biliary atresia, preoperative portal hypertension, postoperative pleural effusion or at retransplantation had ascites significantly more often. In 32 of 138 (23.2%) OLT, ascites was associated with postoperative complications, including thrombosis, abdominal infections, intestinal perforation, biliary leak, pancreatitis, and chylus ascites. In 11 of 138 (7.9%) OLT, ascites was the only postoperative complication (group 3). Group three patients were significantly older, and had lower preoperative platelet counts and preoperative ascites more often than group 1 patients. The primary liver diseases were mainly cystic fibrosis of the pancreas, congenital hepatic fibrosis, and North American Indian childhood cirrhosis. The serum-ascites albumin gradient suggested a hepatic origin of ascites. Postoperative ascites is associated with the duration and degree of preoperative portal hypertension. We speculate that the mechanism involved includes a disproportion between venous blood volume and liver uptake capacity of the donor organ.
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PMID:Ascites after orthotopic liver transplantation in children. 1566 4

In Mexican traditional medicine the plant species Bouvardia ternifolia is used as remedy to treat patients who have been stung by scorpions. In the preceding study, the methanol extract from the roots of this plant was capable of reducing the poisonous effect of Centruroides limpidus limpidus on mice. The poisoning from scorpion C. limpidus limpidus includes manifestations associated with the pancreatitis. This study evaluated the effect produced by the hexane and methanol extract from the root of B. ternifolia upon the acutely inflamed pancreas induced by the venom of C. limpidus limpidus on rats, and the release of amylase in the isolated pancreas of mice. The intravenous administration of venom induced the extravasation of labelled albumin, in a dose dependant manner. The pre-administration of both extracts of Bouvardia ternifolia reduced significantly (p < 0.05) the extravasation by 60%. Upon measuring the secretagogue effect of the venom in the isolated pancreas of mice, the EC50 of the venom was 3.76 x 10(-3) mg ml(-1), whilst in the presence of the methanol and hexane extracts, this EC50 was 9.13 x 10(-3) mg ml(-1) and 0.01629 mg ml(-1). In conclusion, the C. limpidus limpidus venom possesses a secretagogue effect of amylase on the pancreas of mice and produces an inflamed pancreas which is effectively antagonised by the hexane and methanol extracts from the roots of B. ternifolia.
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PMID:The secretagogue effect of the poison from Centruroides limpidus limpidus on the pancreas of mice and the antagonistic action of the Bouvardia ternifolia extract. 1569 10

Results of treatment of patients with necrotic acute pancreatitis taking into account a risk of an unfavorable course of the disease are analyzed. The risk is determined according to the level of albumin measured with fluorescent test. This approach to choice of policy of treatment which doesn't correspond to clinical picture and treatment may be regarded as preventive permits to improve results of treatment in all variants of the disease. Decreased number of severe complications, lethality and time of hospitalization in necrotic pancreatitis an demonstrated.
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PMID:[Treatment of patients with pancreonecrosis]. 1569 53


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