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

In a model developed to study acute pancreatitis in the dog, the disease process was comparable with the spontaneously occurring disease. Infusion of oleic acid into the accessory pancreatic duct induced, grossly and microscopically, acute hemorrhagic pancreatitis with pancreatic atrophy, fibrosis, fat necrosis, and edema. Clinical changes included persistent fever and tachycardia in all dogs and abdominal pain, vomiting, and diarrhea in most. Serum amylase and lipase activities increased markedly as did activities of alkaline phosphatase, aspartate aminotransferase, and alanine aminotransferase. Hematologic alterations included hemoconcentration (despite intensive fluid therapy) and leukocytosis due primarily to neutrophilia and monocytosis. Neither corticosteroid nor anticholinergic therapy begun 24 to 32 hours after oleic acid infusion altered the course of the disease. Dogs survived 8 days and appeared clinically normal when the study was terminated.
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PMID:Effects of an anticholinergic and a corticosteroid on acute pancreatitis in experimental dogs. 617 2

Between 1957 and 1977, 95 patients underwent transduodenal pancreatic sphincteroplasty (TPS) for a diagnosis of recurrent pancreatitis. Five to twenty-five year follow-up was obtained for 89 patients (94%) and was analyzed by life-table method. Short-term successful outcome was defined as relief of symptoms (e.g., pain) for one to three years; long-term successful outcome was defined as those patients who remained symptom-free at time of last follow-up. Operative mortality was 4.2% (4 patients). Fifty-six patients (66%) had a successful short-term outcome. Of these, 13 patients had recurrence of symptoms: 7 occurred at 4 years, 5 at 5 years and 1 at 6 years. Preoperative factors associated with poor short-term outcome were previous upper abdominal surgery (X2 = 5.67, p less than 0.05) and frequent diarrhea (X2 = 6.18, p less than 0.05). Preoperative factors associated with poor long-term outcome were previous upper abdominal surgery (X2 = 7.82, p less than 0.01), heavy alcohol intake (X2 = 4.71, p less than 0.05), narcotic use (X2 = 5.68, p less than 0.05) and frequent diarrhea (X2 = 4.8, p less than 0.05). Morphine Prostigmin Test (MPT) was performed preoperatively in 78 patients (82%). A significantly greater proportion of patients with a rise in serum pancreatic enzymes secondary to MPT (MPT+) had a successful long-term outcome compared with those without such a rise (MPT-) (61% v 41%, X2 = 5.13, p less than 0.05). Furthermore, of the patients with a successful short-term outcome, 88% with MPT+ remained long-term symptom-free compared to 38.5% with MPT- (X2 = 8.36, p less than 0.01). We conclude that TPS can be a successful operation for acute recurrent pancreatitis. Previous upper abdominal operations, signs of more advanced pancreatic disease, preoperative narcotic use and alcohol abuse, were associated with a worse outcome and probably associated with chronic recurrent pancreatitis. Preoperative use of MPT, coupled with accurate clinical history, defined groups with different short- and long-term prognosis after TPS.
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PMID:Transduodenal sphincteroplasty. 5-25 year follow-up of 89 patients. 662 16

A 12 year-old boy presented with duodenal hematoma in the hours following small bowel biopsy. Two years later, he presented with abdominal pain and diarrhea. Investigations allowed to find a chronic calcified pancreatitis, which is suggested to be the consequence of the previous duodenal hematoma.
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PMID:[Intramural hematoma of the duodenum and chronic pancreatitis after jejunal biopsy]. 672 62

The clinical picture and epidemiologic characteristics of infection due to Campylobacter fetus subspecies jejuni were studied in 188 patients hospitalized in Finland during a three-year period. All but two patients had diarrhea; 90% had abdominal pain, fever, and fatigue; half had vomiting and headache; one third experienced electrolyte disturbances; and one fifth of the patients had other complications, most commonly pancreatitis (6%) and arthritis (5%). All age groups were affected, most usually those who were 0 to 9 years old and 20 to 29 years old. The incidence of domestic cases increased during the summer months. With only three exceptions (1.3%), all jejuni strains were sensitive to erythromycin. Among Finns who visited ten popular tourist countries, the incidence of hospitalized C jejuni enteritis cases varied from 0 to 63 per 100,000 travelers.
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PMID:Campylobacter enteritis in 188 hospitalized patients. 682 88

Among 81 hospitalized patients with enteritis due to Campylobacter fetus ssp. jejuni, abdominal pain was found to be an outstanding symptom, being observed in half the patients on admission. In 16 patients pain was the main reason for admission and in 5 prompted laparotomy. In 4 cases appendicitis was suspected, but in only 2 was slight inflammation seen; in 1 of these, however, the inflammation could not be verified by microscopic examination. One patient was operated on because of intestinal occlusion, presumably due to Campylobacter enteritis. In 10 further cases a surgeon was consulted because the abdominal pains were at first suspected to be due to cholecystitis, pancreatitis or other abdominal emergencies. Thus, acute phase of Campylobacter infection may mimick acute abdominal emergency. The diagnosis is sometimes hampered by the late onset of diarrhoea or even by its total absence, as well as by the usual presence of abdominal tenderness and severe abdominal pains.
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PMID:Campylobacter enteritis mimicking acute abdominal emergency. 734 86

The toxic shock syndrome has only recently been described. Eleven female patients aged 13 to 43 years (median 17) with toxic shock syndrome have been seen at the Mayo Clinic since August 1975. One patient died. Seven patients had one or more recurrences. As previously described, the syndrome was often life-threatening, afflicted mostly menstruating females, and was characterized by a very brief prodromal illness consisting of high fever, vomiting, diarrhea, conjunctivitis, headache, irritability, sore throat, myalgias, abdominal tenderness, and erythematous rash. The disorder can progress to hypotension or prolonged refractory shock, adult respiratory distress syndrome, diffuse intravascular coagulation with severe thrombocytopenia, and renal failure. Pancreatitis was observed in two cases. During convalescence, pronounced desquamation and peeling of the skin occurred. Numerous laboratory abnormalities are observed. In 5 of the 11 patients, Staphylococcus aureus was isolated from conjunctiva, oral cavity or nares, vagina, or stool. A recently described pyrogenic exotoxin was identified in the isolates of three patients; its etiologic role remains speculative. Therapy is mainly supportive. Antistaphylococcal therapy for the acute illness and for prevention of recurrences has not yet proved to be of any benefit. The role of vaginal tampons, if any, in the pathogenesis of this disorder remains unclear.
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PMID:Toxic shock syndrome, a newly recognized disease entity. Report of 11 cases. 744 20

The patient was a 1-year-old infant with severe postencephalitis syndrome. Diarrhea and elevation of the pancreatic enzymes, except for serum amylase (elastase 1 > 1, 5000 ng/dl (100-400); lipase, 885 IU/I/37 degrees C (10-48); trypsin, > 900 ng/ml (110-460)), were observed starting 70 days after starting valproate (dose, 70 mg/kg; serum level, 83.8 micrograms/ml). These findings as well as those obtained by abdominal ultrasonography suggested a diagnosis of pancreatitis, which was thought to be caused by sodium valproate. Important signs of valproate-induced pancreatitis may be easily overlooked in patients with neurological impairment, such as in ours. Because the blood half-life of amylase is short, not only amylase but some other pancreatic enzymes should be promptly investigated when valproate-related pancreatitis is clinically suspected in physically or mentally handicapped children.
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PMID:Pancreatitis with normal serum amylase associated with sodium valproate: a case report. 757 66

A prospective randomized trial was undertaken to determine if selective peroperative cholangiography resulted in greater morbidity and mortality from missed common bile duct (CBD) stones. Five hundred and thirty-nine consecutive cholecystectomies were performed over a 3-year period. Two hundred and fifty-four had indications for mandatory peroperative cholangiography and were excluded from the trial. The remaining 285 patients, without a history of jaundice, pancreatitis or abnormal liver function tests, were randomized blindly into two groups. Group 1 underwent peroperative cholangiography (PC) and group 2 did not. If the surgeon found a dilated CBD at surgery then these patients were also excluded from the trial. Selective peroperative cholangiography revealed an unsuspected CBD calculus in 16 of the 132 patients (12%). Up to the time of review no patient from group 2 presented with symptoms or complications from retained CBD stones. One patient in group 1 had endoscopic removal of a retained CBD calculus 16 months after cholecystectomy. All patients were sent a questionnaire at least three years after surgery and 210 responded (74%). One hundred and thirty (62%) of the respondents had peroperative cholangiography. There were 11 deaths from unrelated causes. No difference between the two groups was found for postoperative dietary habit, dyspepsia, pain, flatulence, diarrhoea or signs of biliary obstruction. It seems from these results that a policy of selective cholangiography in our hands may miss a 12% incidence of unsuspected stones but, importantly, this does not appear to influence postoperative morbidity or mortality.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Does selective peroperative cholangiography result in missed common bile duct stones? 769 32

Gallbladder stones remain asymptomatic over a long period. The biliary colic is the typical pain caused by these stones. Dyspeptic symptoms seem to be unrelated to the presence of gallstones. Acute cholecystitis, a serious complication of gallstone disease, spans a wide spectrum of clinical findings. The typical signs are right upper abdominal pain and tenderness, fever, leucocytosis and Murphy's sign. 35% of patients experience gallbladder empyema or perforation. Localized gallbladder perforation, characterized by high fever, severe right upper abdominal pain and tenderness and a palpable mass is often difficult to distinguish from acute cholecystitis. Free perforation into the abdominal cavity causes diffuse peritonitis. Gallbladder perforation into the lumen of an adjacent organ produces fistulas, mostly with minimal symptoms or a pain relief after decompression of the inflamed gallbladder. Air in the bile ducts and on some occasions bile-acid-induced diarrhea may result. Rarely, the perforation of large stones leads to an occlusion of the GI tract and results in a gallstone ileus. Common bile duct stones may be asymptomatic or cause bile duct obstruction with biliary colics and jaundice. Acute bacterial cholangitis characterized by Charcot's triad (pain, jaundice and fever) and the acute biliary pancreatitis with its typical symptoms are the serious complications of common bile duct stones, associated with a high mortality rate. The clinical manifestations of a gallstone disease and its complications reveal important diagnostic features, but the most important diagnostic features, modalities are the imaging procedures. They are decisive for an accurate therapy.
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PMID:[Clinical manifestations of cholelithiasis and its complications]. 776 32

Medical emergencies involving the gastrointestinal tract include bleeding, abdominal pain, diarrhea, toxic megacolon, pancreatitis, and hepatic failure. Each can be a cause for admission to an intensive care unit or occur de novo in a patient hospitalized in such a unit. The clinical presentation, management, and consequences of these varied gastrointestinal problems seen in an intensive care unit are presented followed by a recommended course of action.
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PMID:Gastrointestinal problems experienced in an intensive care unit. 783 5


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