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

Fifty children and adolescents were found to have gallstones at Children's Hospital of Buffalo (NY) during a period of 10 years. The mean (+/- SD) age was 12.2 +/- 6.2 years, with 21 boys and 29 girls. The majority of patients could be categorized into four groups: hemolytic disease (18 patients), parenteral nutrition (eight patients), adolescent pregnancy (seven patients), and idiopathic (10 patients), while seven patients had a variety of other etiologies. Right upper quadrant pain was the most common symptom (32 patients), followed by jaundice (15 patients), vomiting (13 patients), and nonspecific abdominal complaints (13 patients). Ten patients presented with jaundice and underlying hemolytic disease; seven patients were asymptomatic. Clinical presentation was found to vary with age and factors associated with the development of gallstones. Ultrasonography was the mode of diagnosis in 48 patients. Cholecystectomy was performed in 36 patients. In contrast to gallstones in adults, after exclusion of the patients with adolescent pregnancy, there was no female predominance. Pancreatitis was the most common complication, occurring in 8% of the patients; cholecystitis and cholangitis were absent.
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PMID:Gallstones in children. Characterization by age, etiology, and outcome. 173 34

Plasma immunoreactive cationic trypsin (ICT), which is a specific and highly sensitive indicator of pancreatic injury, was measured in 14 children with signs of systemic envenomation following a sting by the scorpion Leiurus quinquestriatus. High ICT levels were found in 13 children (93%), indicating that acute pancreatitis is a common complication of envenomation by this scorpion. The pancreatitis may account for the abdominal pain and vomiting commonly seen in scorpion envenomation and may also contribute to the agitation and discomfort noted in young children.
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PMID:Acute pancreatitis in children following envenomation by the yellow scorpion Leiurus quinquestriatus. 202 71

Among 24,498 laparotomies performed for diseases and traumas of the abdominal organs 72 were complicated by postoperative pancreatitis. The most frequently encountered symptoms of postoperative pancreatitis were pain in the upper abdomen, marked intestinal paresis, tachycardia, hyperthermia, and vomiting. Treatment was started with conservative measures, including controlled hemodilution and forced diuresis. If these measures failed, operation was undertaken. Operations were carried out on 21 patients: pancreatic blockade (n = 8), abdomenization (n = 8), cryodestruction (n = 5). The omental bursa was drained through a lumbar approach. Intra-aortic infusions and immunostimulation therapy were conducted in the postoperative period. Nine patients died (2 of them were not operated on). Death was caused by pancreonecrosis.
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PMID:[Diagnosis and treatment of postoperative pancreatitis]. 204 32

This paper describes the clinical course of a young diabetic primigravida who presented to her physician with vomiting and abdominal pain. Despite the conventional doses of intravenous fluid and insulin that were used to treat her suspected diabetic ketoacidosis, she remained severely acidotic and developed increasing abdominal pain. Two hundred twenty units of regular insulin over a 5-hour period were required to reverse the lipolysis, acidemia, and abdominal pain, which characterized her severe episode of diabetic ketoacidosis. This discussion emphasizes the importance of insulin in the reversal of the hyperglycemia and acidosis that accompany a diabetic crisis. The roles of bicarbonate, phosphorous, magnesium, insulin, potassium, and fluids are discussed along with conditions such as pregnancy, infection, pancreatitis, and abdominal pain, which can complicate the management of diabetic ketoacidosis.
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PMID:Diabetic ketoacidosis and pregnancy. 216 29

A 48-year-old woman complained of right-sided upper abdominal pain and recurrent vomiting, and had lost 10 kg in 4 months. Ultrasound and computed tomography showed a solid, space-occupying lesion in the head of the pancreas, not separable from the duodenum. Despite thorough investigation the nature of the lesion remained obscure. Operation revealed a divided pancreas with stenosis of the accessory duct at the papilla. Histological examination showed pseudosarcomatous myofibroblastic proliferation within the duodenal wall in the vicinity of a duodenal wall cyst which had been destroyed by inflammation. In cases of divided pancreas it is the accessory duct which drains the main bulk of the pancreas, while the main duct carries little or no secretion; the stenosis of the accessory duct in this patient had therefore led to low-grade pancreatitis involving the head of the pancreas.
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PMID:[An unusual "tumor-like finding" between the head of the pancreas and the duodenal wall]. 218 Jun 71

A case of spontaneous oesophageal rupture or Boerhaave syndrome is described. The absence of the typical initial vomiting together with a clinical picture that successively indicated repeated myocardial infarction, pancreatitis and pulmonary abscess delayed diagnosis by 4 days, after which emergency thoracotomy, performed on the identification of extravisceral overflow by contrast radiography using a water-soluble medium, revealed necrotic inflammation of the oesophagus, mediastinum and left lung that was so severe that only thoracic drainage was possible. After an initial improvement the patient died of septic shock on the 16th postoperative day.
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PMID:[Spontaneous esophageal rupture or Boerhaave's syndrome. Presentation of a case]. 233 50

A 25-year-old man, who was admitted for evaluation of arthralgia and fever of 2-weeks duration, complained of a 10 kg weight loss during the previous weeks. Systemic lupus erythematosus (SLE) was diagnosed on the basis of leukopenia, LE cells, antinuclear antibodies, antibodies to double-stranded DNA, and arthritis, Malabsorption was diagnosed because of the finding of hypoalbuminemia, fat droplets in the feces, a pathological D-xylose test, and an appropriate X-ray image. Approximately half the patients with SLE develop minor expressions of gastrointestinal tract involvement, such as nausea, vomiting, and diarrhea. Major manifestations, such as intestinal obstruction or perforation, ascites, peritonitis and pancreatitis have been reported with varying frequency. Despite the frequent association of SLE with gastrointestinal manifestations, malabsorption, as in this case, has rarely been reported.
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PMID:[Malabsorption in systemic lupus erythematosus]. 235 16

A previously healthy 35-year-old woman was seen at 37 weeks' gestation with a 10-day history of fever, vomiting, diarrhea and malaise. Serum laboratory findings included elevation of serum bilirubin and AST, prolongation of serum prothrombin time and a positive monospot. A tentative diagnosis of acute fatty liver of pregnancy was made, and a healthy male infant was delivered by emergency cesarean section because of fetal distress. Over the subsequent 3 days, acute progressive oliguric renal failure, disseminated intravascular coagulation, hypoglycemia requiring intravenous dextrose infusion and pancreatitis developed; her mental status progressed to stage III encephalopathy. Quantitative computed tomography estimated the liver volume to be 770 cm3. The decision to proceed with orthotopic liver transplantation was made on the basis of progressive clinical deterioration despite aggressive support and because of her small liver size. After transplant, the patient's multisystem failure rapidly reversed. Histopathological examination of the native liver demonstrated predominantly zone 3 microvesicular steatosis with characteristic ultrastructural changes consistent with acute fatty liver of pregnancy. Southern blot analysis for Epstein-Barr virus DNA was negative. We conclude that orthotopic liver transplantation should be considered for the small group of patients with fulminant hepatic failure associated with acute fatty liver of pregnancy who manifest signs of irreversible liver failure despite delivery of the fetus and aggresive supportive care.
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PMID:Fulminant hepatic failure caused by acute fatty liver of pregnancy treated by orthotopic liver transplantation. 240 63

Acute alcoholic pancreatitis is a clinical diagnosis made in patients who have acute upper abdominal pain, emesis, and hyperamylasemia soon after ingesting alcohol. We sought to determine whether the clinical diagnosis of pancreatitis was supported by elevated serum levels of pancreatic isoamylase, currently the most specific test for pancreatitis. Serum lipase levels and urinary amylase/creatinine clearance ratios were examined for comparison with pancreatic isoamylase concentrations. Potential sources for salivary isoamylasemia were explored with technetium scans of the parotid glands. Of 19 patients with a clinical diagnosis of alcoholic pancreatitis, 16 had elevated levels of pancreatic isoamylase, and 17 had salivary hyperamylasemia. The diagnostic specificity of the serum lipase level or the urinary amylase/creatinine clearance ratio was excellent compared to that of the pancreatic isoamylase level. Three patients had elevated levels of salivary isoamylase only. Scans of the parotid glands in the study group revealed significantly higher uptake values than scans in nonalcoholic control subjects, suggesting one possible source of elevated levels of salivary isoamylase.
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PMID:Alcoholic pancreatitis and parotitis: utility of lipase and urinary amylase clearance determinations. 242 37

Two children with Kawasaki disease presented with vomiting, back and abdominal pain, elevated serum amylase values, and ultrasonographic findings consistent with pancreatitis. In both patients, pancreatitis appeared after approximately two weeks of illness, and both patients underwent extensive evaluations, which yielded negative results, for other disorders associated with pancreatitis. We suggest that in the absence of acute infection, and in the presence of appropriate diagnostic criteria, pancreatitis should be considered in all patients with Kawasaki disease who have severe abdominal pain.
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PMID:Pancreatitis in Kawasaki disease. 243 39


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