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

Of one hundred and forty-nine patients (101 male and 48 female) 4-67 years of age, 117 were alcoholics and underwent pancreatectomy because of episodic or continuous abdominal pain or complications or chronic pancreatitis. Nineteen patients underwent pancreaticoduodenectomy, seventy-seven 80-95% distal resection, anf fifty-three 40-80% distal pancreatic resection. There were 3 operative death and 30 late deaths 6 months to 11 years post pancreatectomy. Twenty-one patients were lost to followup, 1 to 11 years post pancreatectomy. Ninety-five patients are known to be alive, 4 of whom are institutionalized. Indications for pancreatectomy in addition to abdominal pain include recurrent or multiple pseudocysts, failure to relieve pain after decompression of a pseudocyst, pseudoaneurysm of the visceral arteries associated with a pseudocyst, recurrent attacks of pancreatitis unrelived by non-resective operations, duodenal stenosis and left side portal hypertension. The choice between pancreaticoduodenectomy or distal resection of 40-80% or 80-95% of the pancreas should be based on the principle site of inflammation whether proximal or distal in the gland, the size of the common bile duct, the ability to rule out carcinoma, and the anticipated deficits in exocrine and endocrine function. The risk of diabetes is very significant after 80-95% distal resection and of steatorrhea after pancreaticoduodenectomy. When the disease process can be encompassed by 40-80% distal pancreatectomy this is the procedure of choice.
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PMID:Pancreatectomy for chronic pancreatitis. 101 87

A family with hereditary pancreatitis is described. Nine family members definitely have had pancreatitis, whilst 15 more are suspected of having the disease. The condition presents as recurrent attacks of epigastric or central abdominal pain, sometimes radiating to the back, often associated with vomiting. The attacks of pain usually last three to four days. The inheritance fits well with an autosomal dominant pattern with limited penetrance, as it does in other families described in the literature. There is no aminoaciduria as has been described in some previously reported families. The attacks of pain start in childhood or young adult life (mean age of onset inthis family is 12-6 years) and appear to cease in this family by the age of 40 years. The diagnosis of pancreatitis in members of the family who have had confirmed pancreatitis was made by finding a raised serum amylase concentration in four cases, at laparotomy in four cases, and by pancreatic calcification seen on radiography in one case, The literature on the condition is reviewed, and it is speculated that the condition may have been underdiagnosed in Britain.
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PMID:A British family with herediatary pancreatitis. 107 96

Dorsal column stimulators (DCS) have been implanted in 130 patients with various chronic pain syndromes at the University of California, San Francisco, between 1969 and 1973. Preoperative psychiatric evaluation and percutaneous dorsal column stimulation testing were of value in rejecting those patients most likely to have unsatisfactory long-term results with DCS. Best results occurred in patients with phantom limb or peripheral nerve pain and worst results in patients with paraplegic pain, documented arachnoiditis, pancreatitis and arthritis. The need is stressed for careful preoperative selection and for close, prolonged postoperative care in a situation permitting access to multidisciplinary facilities for patient care.
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PMID:Experience with dorsal column stimulation for relief of chronic intractable pain: 1968-1973. 108 Aug 99

The effect of insulin treatment in acute pancreatitis was studied in a double-blind investigation. Fifteen patients with clinical signs of acute pancreatitis were treated with intravenous infusion of glucose and insulin only. Twelve patients were free from pain within four hours of commencement of treatment. Within eight hours all fifteen were free from abdominal pain. Fourteen patients with pancreatitis established by the same criteria were treated with glucose infusions without insulin. Only four of the patients in this group became free from pain within four hours. The role of intravenously infused insulin with respect to the more beneficial effect in the first group is discussed.
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PMID:Role of intravenously infused insulin in treatment of acute pancreatitis. A double-blind study. 109 32

Pain typical of that from the diseased reno-ureteral unit can emanate from any adjacent organ or any organ with the same innervation. It may also be the result of, or be exacerbated by, mental illness. Case examples of herniated thoracic disk, T12 neuralgia and short leg syndrome, costovertebral joint arthritis, metastatic carcinoma, myofascial syndrome and pancreatitis demonstrated the need for an orderly approach to the problem. Currently, patient screening with the Cornell medical index and the urology questionnaire allows direction of the physical examination, special radiographic and laboratory studies and psychiatric evaluations. An orderly evaluation of flank pain will prove rewarding and may prevent unnecessary urologic operations.
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PMID:Non-urologic flank pain: a diagnostic approach. 112 8

Five patients with cystadenoma of the pancreas were seen during a period of 22 years at this institute. This rare benign tumor occurred predominantly in middle age women, with the presenting symptoms of pain and an epigastric mass, but without a history suggestive of pancreatitis or abdominal trauma. Selective celiac and superior mesenteric antiography is helpful in establishing the diagnosis. If this cystic tumor is not recognized and adequately treated, the surgeon may miss the opportunity for cure. Cystadenoma should be suspected when a cystic mass arising from the body or tail of the pancreas is encountered without evidence of metastases. Although surgical extirpation is the preferable treatment, undue risks should not be undertaken because of the slow growth rate of this benign tumor. Due to the known association of this tumor with other malignant lesions, diabetes mellitus as well as multicystic tumors of the liver and kidneys, these patients should be thoroughtly investigated.
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PMID:Cystadenoma of the pancreas. 112 84

The anatomic pattern seen in the three patients with contiguous gastric duplications associated with pancreatic ducts evidently predisposes the patient to pancreatitis. In the previous patient reported upon from this institution, the correlation of severe bleeding episodes with attacks of pancreatitis strongly supports the concept of blood blocking the pancreatic ductal system, thereby producing pancreatitis. Passage of viscous mucoid secretions from the aberrant gastric mucosa into the pancreatic ductal system also might retard the normal flow of pancreatic juice, producing elevation of the serum amylase level and pain. Overdistention of the gastric duplication also might be considered as a source of pain, but such mechanisms can be considered only speculation at present. Diagnosis is usually made after more than one exploratory laparotomy. Hemorrhage may result, should the gastric duplication contain parietal cells, leading to hemoductal pancreatitis, hematemesis or melena and anemia. At least one in five patients with a gastric duplication possesses another intestinal duplication. Developmental defects commonly are associated with gastric cysts. Almost identical anatomy was present in the patients with contiguous duplications. That two such rare pancreatic disorders were documented in the same institution within two years suggests that this pattern of developmental defect is more common that had previously been expected.
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PMID:Pancreatitis of unusual origin. 116 66

Case reports of 2 patients who developed pancreatitis and hyperlipidemia while using oral contraceptives are presented. The 1st patient had been taking Ovulen for 2 years when severe abdominal pain suddenly developed. Initially cholecystitis was diagnosed. Symptoms subsided within 1 week but recurred 2 months later, when the white blood count was increased to 16,400/cubic mm. Serum was grossly lipemic with a triglyceride level of 3500 mg% and serum cholesterol 560 mg%. 3 days later triglycerides had fallen to 400 mg% and cholesterol to 270 mg%. Cholecystography was normal. The pain had subsided. Symptoms have not recurred since stopping use of Ovulen. The 2nd patient was admitted with severe abdominal pain of 48 hours duration. Similar attacks of pain had occurred previously but had been of short duration. She had been taking Ovulen for 3 years. White blood count was increased to 18,000. Serum was grossly lipemic. Serum glyceride concentration was 7000 mg% and cholesterol 1200 mg%. Afer 3 days triglycerides were 500 mg% and cholesterol 475 mg%. Pancreatitis was diagnosed. Therapy was Ryles tube suction, atropine, intravenous saline, and a broad spectrum antibiotic. Symptoms subsided in 10 days. The hyperlipidemia is thought to have been a primary condition causing the pancreatitis. [Patients known to have such a condition should avoid use of oral contraceptives.
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PMID:Hyperlipidaemia and pancreatitis associated with oral contraceptive therapy. 118 40

Jaundice occurring in patients with pancreatitis is usually due to hepatocellular injury or to associated biliary tract disease. Common duct obstruction is occasionally caused by pancreatic fibrosis, edema or pseudocyst in patients who have neither hepatocellular injury nor biliary tract disease. We have studied 7 patients with obstructive jaundice due to pancreatitis who demonstrated no other known cause for jaundice. The difficulty in making the differential diagnosis between benign and malignant disease in these patients, particularly when no pain is associated with obstructive jaundice, is discussed. In view of the fact that the terminal common duct traverses the pancreas, it is uncertain why obstructive jaundice associated with chronic pancreatitis does not occur more often unless the condition is sometimes transient and overlooked. Operative intervention is required in those patients in whom jaundice is persistent. Operation is intended to decompress the biliary tract and the pancreas. The approach used will be dictated by the operative findings in each patient.
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PMID:Obstructive jaundice in patients with pancreatitis without associated biliary tract disease. 121 86

The authors report five cases of an association between osteomalacia and chronic calcifying pancreatitis. The pancreatic involvement, which was pain-free in four patients, resulted in all cases in enzyme insufficiency with steatorrhoea. The deficiency-type osteopathy was highly vitamin sensitive. Aetiological study of these cases of osteomalacia revealed the constant presence of factors aggravating the vitamin deficiency, playing a role by increasing deficient intake or malabsorption, or by increasing Vitamin D requirements. It thus appears that hypovitaminosis D alone, of particular severity, was sufficient to result in the appearance of clinically evident osteomalacia. Such a vitamin deficiency, necessary when the intestinal mucosa is intact, is only rarely encountered, which accounts for the extreme rarity of osteomalacia in association with chronic pancreatic disorders.
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PMID:[Osteomalcaia and chronic pancreatis. 5 cases]. 121 65


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