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

One hundred patients with acute pancreatitis are studied. The results in 90 cases were "favorable or very favorable", in ten cases "unfavorable or death". Various different characterisitics were analyzed statistically in relationship to the two types of outcome: sex, clinical histories, and results of physical examination. Furthermore, the individual relationships between age, main initial analytic parameters, and later development were determined. In our experience neither age nor sex, considered individually, showed a significant relationship to the seriousness of the disease. Having had pancreatitis previously proved to be a favorable factor (p less than 0.005). None of the other factors in the case histories showed any bearing of the later course of the condition. Findings in physical examination which were signs of unfavorable prognosis included jaundice (p less than 0.001), low blood pressure (p less than 0.001), tachycardia (p less than 0.005), intestinal paresia (p less than 0.001), pain following decompression (p less than 0.025), and abdominal tenderness (p less than 0.05). Abnormalities in ECG (p less than 0.005), marked leukocytosis (p less than 0.0005), hyperglycemia (p less than 0.02), hypocalcemia (p less than 0.05), and high values for the coefficient of amilase/creatinine clearance (p less than 0.01) also suggested an unfavorable course.
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PMID:[Early prognosis of acute pancreatitis (author's transl)]. 45 91

A successful pancreatogram was obtained at endoscopic retrograde cholangiopancreatography (ERCP) in 53 patients with calculous biliary disease. Twenty-eight patients presented with jaundice and 25 with pain. In both groups there was a high incidence of pancreatogram abnormalities (47 and 48 per cent respectively). These findings demonstrate that the pancreas is often abnormal in the presence of complicated calculous biliary disease even though there may be no recent clinical evidence of pancreatitis and suggest that asymptomatic chronic pancreatitis may be common. The clinical significance of the abnormalities is discussed.
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PMID:Pancreatogram changes in patients with calculous biliary disease. 46 38

A collected series of 64 cases of chronic relapsing pancreatitis is reported. Analysis of this material reveals several points of interest. There is a difference in the aetiological spectrum in Britain when compared with reports from France and the United States. In particular, nearly half the British cases were idiopathic. The clinical presentation and the age and sex ratios also varied with aetiology. Endoscopic retrograde cannulation of the pancreatic duct was of little value in confirming a diagnosis of pancreatitis in the problem case. This investigation did, however, demonstrate that a widespread dilatation of the pancreatic duct was a minority finding. In those patients with alcoholic pancreatitis follow-up studies have shown that, if the addiction can be broken, there is a 75 per cent chance that pain will diminish or disappear with the passage of time. The main indication for surgical intervention was severe pain and this study has shown that if strict criteria are observed, a worthwhile relief of symptoms can be achieved. In particular, subtotal pancreatectomy produced good results in up to 85 per cent of cases, although with an appreciable short term postoperative morbidity.
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PMID:Chronic relapsing pancreatitis: a review of 64 cases. 46 39

Seventy-four patients underwent operation for chronic pancreatitis during a 22 year period at UCLA Hospital. Follow-up data obtained for 60% of these patients an average of 3.2 years postoperation were analyzed by computer for statistically significant benefit between paired operation combinations and the variables of pain relief, stool habits, alcohol use, readmission for pancreatitis, and narcotic use. The combined group of total and cephalic pancreaticoduodenectomy proved more effective with respect to pain relief and readmission (p less than 0.05) than the group that had pseudocyst drainage. The comparison of groups that underwent resection or ductal drainage showed no statistical differences for the above variables. Regardless of type of operation, if the patient had evidence of pancreatic calcifications and had abstained from alcohol postoperatively, the likelihood of a return to normal activity was more favorable (p less than 0.05).
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PMID:Surgical treatment of chronic pancreatitis. Twenty-two years' experience. 48 5

Although it is widely known that patients with severe hyperlipemia may have pancreatitis, it is not generally appreciated that such patients may have recurrent abdominal pain of variable character and intensity not due to pancreatitis. Review of 35 patients followed in our clinic for 1--11 years showed that 54% had recurrent abdominal pain, while only 29% had pancreatitis. Although mild pain occurred frequently with plasma triglycerides in the 2000--5000 mg/dl range, triglycerides over 6000 mg/dl were often associated with severe pain and physical findings which necessitated hospitalization, often led to the misdiagnosis of pancreatitis and other intra-abdominal catastrophes and resulted in multiple unnecessary diagnostic studies and operations. When recognized, the pain subsided within 48 hours upon cessation of oral intake and treatment with intravenous electrolyte solutions. Furthermore, effective treatment of the hyperlipemia prevented both the attacks of severe pain and the pancreatitis which otherwise occurred (or recurred) in a significant fraction of the patients. These data confirm the existence of hyperlipemic abdominal crisis as a distinct entity and testify to the importance of recognizing this syndrome in order to avoid the occurrence of acute pancreatitis and the performance of unnecessary and potentially harmful surgery.
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PMID:The natural history and surgical significance of hyperlipemic abdominal crisis. 48 15

A case of traumatic pancreatitis with a radiopaque calculus producing pain by obstructing the distal pancreatic duct is presented. Preoperative ductal anatomy was defined by a percutaneous pancreatogram that established the presence of mechanical duct obstruction as the cause of pain, and the potential for operative relief of duct obstruction. A remission from pain resulted from pancreatic duct decompression by a lateral pancreaticojejunostomy. The potential value of percutaneous pancreatography is discussed.
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PMID:Percutaneous pancreatography: case report and presentation of technique. 48 36

The authors used paranephric, vagosympathetic and vagoganglionic blockade in 253 patients with acute cholecystitis, cholecystopancreatitis and pancreatitis. The universally adopted methods were used for the estimation of the results with the recording of electrogastrogram before the blockade, immediately after novocaine injection and on hour later. The arrest or subsiding of pain syndrome occurred after paranephric blockade in 78.8% of patients, after vagosympathetic blockade in 95.2% and after vagoganglionic blockade in 92.6%. 20 patients were operated upon.
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PMID:[Novocaine blocks in the overall treatment of acute cholecystitis, cholecystopancreatitis and pancreatitis]. 52 80

Two Swedish kindreds with hereditary pancreatitis are reported. The onset of symptoms was in early childhood. Otherwise the clinical course did not differ from the non-hereditary form. In no patients were found signs of alcohol-overconsumption, hyperparathyreoidism, hyperlipidemia or mucoviscoidosis. Three patients with intractable pain and frequent hospitalization were operated on with pancreatico-jejunostomy as described by Puestow-Gillesby, with excellent results. Although the observation periods are short (0.5, 2 and 4 years, respectively) it seems legitimate to recommend the operation also for the hereditary form of pancreatitis if intractable pain or frequent exacerbations are present.
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PMID:Hereditary pancreatitis-a report on two kindreds. 65 33

A review of abdominal radiographs of 50 patients with the clinical diagnosis of chronic pancreatitis showed calcific pancreatitis in 27 patients. Ten patients had severe pain associated with weight loss. Five had obstruction of the duct of Wirsung: one by a pseudocyst and four by large stones near the ampulla of Vater. The radiologic workup presented emphasizes the need to study the duct of Wirsung in patients with chronic pancreatitis to guide the surgical approach for relief of intractavle pain. Theories regarding the pathophysiology of calcium deposition and stone formation and migration are reviewed.
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PMID:Calcifications within the duct of Wirsung in calcific pancreatitis. 66 83

An analysis of 89 cases with chronic pancreatitis revealed 56% of chronic alcoholic pancreatitis (AP). The sex ratio was 47 males to 3 females and the mean age at onset was 42.4 years in AP and 49.3 years in chronic non-alcoholic pancreatitis (NAP). The 'total amount' of alcohol consumption was correlated to the onset. In AP, the abdominal pain was apt to relapse and severe in nature, furthermore painless pancreatitis was seen in 6%. The association with diabetes or calcification (38%) were more frequently seen in AP. The calcifications in AP appeared to be smaller in size and distributed diffusely or localized in cephalic portion. A striking frequency of liver dysfunctions (39 cases) were demonstrated, however, cirrhosis was rare in AP. The P-S test dysunctions in NAP were frequently reversible in the follow up study, while even some of chronic asymptomatic alcoholics developed clinical signs of pancreatitis during the observed period and proceeded to definite AP, of whom pancreatic dysfunctions showed fluctuation and eventual progression. In other words, even pain free intervals the pancreatic inflammation in susceptible persons may proceed to ultimated destruction of the pancreas. The fatality from chronic pancreatitis was rare (12.3%), which was related diabetes mellitus.
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PMID:A clinical investigation of chronic pancreatitis--comparative study between alcoholic pancreatitis and non-alcoholic pancreatitis--. 66 97


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