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

Four patients with pancreatic disease received glucagon intravenously. In two a definite decrease in the volume of pancreatic exocrine secretion was shown, and in one of these pancreatic juice protein and bicarbonate levels also fell. Two patients with acute pancreatitis had pronounced relief of epigastric pain associated with falls in plasma amylase after intravenous glucagon.Several mechanisms could account for the possible beneficial effect of glucagon in pancreatitis, and further studies of its use in this disease are justified.
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PMID:Possible use of glucagon in the treatment of pancreatitis. 557 5

The Cam/Ccr% has been suggested to be of value in the diagnosis of pancreatitis. The Cam/Ccr% was determined throughout gestation in normal pregnant and nonpregnant patients. The Cam/Ccr% was lower (p less than 0.05) throughout pregnancy and was a function of increased creatinine clearance. The Cam/Ccr% was increased in pregnant patients with pancreatitis. Two of four patients with the clinical diagnosis of hyperemesis gravidarum demonstrated elevations of the Cam/Ccr%. Toxemia with epigastric pain was noted to be associated with an elevated CamCcr% in all patients, whereas toxemia without epigastric pain was not routinely noted to be associated with an elevated ratio. The normal Cam/Ccr% in pregnancy is lower than the nonpregnant value, and this should be taken into consideration when evaluating a patient with suspected pancreatitis who is pregnant. Patients with the clinical diagnosis of hyperemesis gravidarum and toxemia should be screened with serial Cam/Ccr% for possible evolving pancreatitis.
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PMID:The amylase/creatinine clearance ratio in normal pregnancy and pregnancies complicated by pancreatitis, hyperemesis gravidarum, and toxemia. 615 8

Pancreas divisum was demonstrated in 22 of 500 consecutive ERCP (4.4%). Among patients with otherwise normal ERCP, pancreas divisum was found in 12.8%. In contrast, only 1.8% of patients with other pathology in the ERCP exhibited pancreas divisum (p less than 0.001). In relation to the clinical indication, pancreas divisum was found in 13.3% of patients with suspected or proven pancreatitis, in 1.9% of patients with suspicion of biliary tract disease (p less than 0.001), in 1.9% of patients with suspicion of pancreatic cancer (p less than 0,05) and in 4.4% of patients with epigastric pain of undetermined origin (p greater than 0.05). In 14 patients pancreas divisum was the only pathological finding in a thorough clinical and gastrointestinal workup; 6 of the 14 patients had had typical episodes of pancreatitis, in 6 other patients there was clinical and biochemical evidence of pancreatic disease (mainly pain and hyperenzymemia), and the last 2 cases had chronic epigastric pain without biochemical abnormalities. In 2 patients of this series the pancreas divisum was misinterpreted morphologically (sonography, autopsy) as tumor of the head of the pancreas. Based upon our experience and the literature, the following practical conclusions can be drawn: 1. Pancreas divisum may cause typical episodes of acute (relapsing) pancreatitis. 2. In patients with chronic epigastric pain associated with hyperenzymemia but without typical acute pancreatitis, pancreas divisum may be the cause. 3. Morphologically pancreas divisum may mimic a pancreatic tumor (sonography, computer-tomography, autopsy).
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PMID:[Clinical significance of pancreas divisum]. 618 82

A 40-year old man presented with pulmonary symptoms and a right-sided haemorrhagic pleural effusion. Tuberculosis and carcinoma, both primary and secondary, were excluded as a cause. Chronic pancreatitis was diagnosed on the basis of a 5-year history of repeated episodes of alcohol-induced epigastric pain and suggestive findings on endoscopic retrograde cholangiopancreatography. The chronic pancreatitis became acute during hospitalization. The disproportionate elevation of the pleural fluid amylase level in comparison with the serum amylase level provided definitive evidence that the pleural effusion was a complication of pancreatitis.
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PMID:Haemorrhagic right pleural effusion complicating acute-on-chronic pancreatitis. A case report. 620 79

Despite the rarity of chronic relapsing pancreatitis in children, in the last 15 years at Vanderbilt University Medical Center and its Children's Hospital we have used longitudinal pancreaticojejunostomy in treatment of eight patients whose symptoms began in childhood. Duration of symptoms ranged from 2 to 36 years. Seven of the eight patients had hereditary pancreatitis. Recurrent epigastric pain was characteristic and serum amylase was elevated in all patients on admission or shortly thereafter. Demonstration of an obstructed dilated pancreatic duct in all and stones in seven of eight patients by operative pancreatography in three early patients and by endoscopic retrograde cholangiopancreatography (ERCP) in five others established the therapeutic problem and facilitated treatment by removal of stones and longitudinal pancreaticojejunostomy. Results were uniformly excellent, both in the early postoperative period and in long-range follow-ups. Early diagnosis and early surgical drainage of the obstructed pancreatic duct by longitudinal pancreaticojejunostomy are desirable objectives in chronic relapsing pancreatitis with onset in childhood.
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PMID:Longitudinal pancreaticojejunostomy in chronic relapsing pancreatitis with onset in childhood. 672 10

The embryologic defect that results when the ventral and dorsal anlages of the pancreas do not fuse has been referred to as pancreas divisum. ERCP has made it possible to recognize this anomaly in patients undergoing investigation for otherwise unexplained abdominal pain. Of 70 patients in whom recurrent epigastric pain and pancreas divisum coexisted, sphincteroplasty of both papillae was carried out in 19 because of intractability of symptoms. In six patients, surgery was performed subsequent to failure of other biliary tract surgery. There was one postoperative death. In the remaining 18 patients, initial results were good to excellent in 13 and fair in 1. In four patients, however, recurrence of symptoms developed within periods that ranged from 1 to 6 months; therefore, reasonably permanent relief was limited to 10 patients. Of the remaining eight patients with recurrent or continuing symptoms, a variety of subsequent procedures led to satisfactory results in only three. In only seven patients was there even minimal chemical or microscopic evidence to suggest active pancreatitis. Similarly, pancreatograms in 17 patients with this anomaly revealed no abnormalities except for minor ones in 2 patients. Thus, if this is a syndrome that is due to relative stenosis of the lesser papilla and duct, the anomaly does not often result in documented pancreatitis. The definite but limited success rate from sphincteroplasty suggests that relative stenosis of the lesser papilla may be the cause of a syndrome but surgical refinements will be necessary to achieve a better operative success rate.
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PMID:Pancreas divisum. Results of surgical intervention. 683 84

Acute pancreatitis in a patient on oral contraceptive therapy is reported, and the relationship of estrogen administration to hyperlipemia and pancreatitis is discussed. A 23-year-old white woman was admitted to a hospital with epigastric pain, nausea, and vomiting. Three previous episodes of abdominal pain had been diagnosed as acute pancreatitis. On the present and previous admissions, she had just completed a cycle on her combination norethindrone 1 mg, mestranol 8 micrograms contraceptive. Laboratory results showed mild leukocytosis and elevated concentrations of blood glucose, alkaline phosphatase, serum amylase, and urine amylase. Serum cholesterol and triglycerides were elevated, and lipoprotein electrophoresis showed a type IV pattern. Abdominal sonogram revealed a normal pancreas, and all other test results were normal. The patient was treated with i.v. fluid replacement, dimenhydrinate, and meperidine hydrochloride. Within 72 hours she was asymptomatic, and serum amylase, triglyceride, and cholesterol concentrations had decreased. She was discharged with a diagnosis of acute pancreatitis secondary to oral-contraceptive-induced hyperlipidemia. Oral contraceptive therapy was not resumed. Predisposing factors, symptoms, and laboratory findings associated with estrogen-induced acute pancreatitis are presented, and the mechanisms through which serum lipid elevations and subsequent pancreatitis occur are discussed. Monitoring serum lipid concentrations before and during estrogen therapy is recommended. Research suggests that patients who are over 40 years old or have family histories of hyperlipemia are at particular risk, and that estrogen therapy should be discontinued if pancreatitis occurs.
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PMID:Estrogen-induced pancreatitis. 688 34

A 40-year-old woman presented with acute epigastric pain with vomiting. Within 24 hours, the pain spread to the right periumbilical region. Tc-99m disofenin hepatobiliary scan failed to demonstrate the gallbladder on a 60-minute view. The presumative diagnosis of acute cholecystitis was thought to be confirmed on this basis by the patient's physicians. However, a 75-minute view demonstrated filling of the gallbladder. In hepatobiliary scanning for acute abdominal pain, delayed views (2 to 24 hours) are recommended when the gallbladder is not visualized on the 60-minute view. If the gallbladder is visualized, cystic duct obstruction can be excluded and diagnoses such as pancreatitis, acalculous cholecystitis, and acute appendicitis should be investigated.
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PMID:Hepatobiliary scan with delayed gallbladder visualization in a case of acute appendicitis. 720 Aug 46

Seven cases of Crohn's disease of the duodenum are presented. They made up 2% of 350 cases of Crohn's disease seen over a period of 15 years. Mean age at onset of Crohn's disease was 22 years (range, 13--47). All patients had other, and most patients severe, lesions elsewhere in the alimentary tract. In three patients the duodenal lesion appeared simultaneously with or within a year of lesions elsewhere, in four cases not until 4 to 15 years later. The period of observation after detection of regional duodenitis was 2 to 14 years; mean, 8 years. The commonest complaint due to duodenitis was epigastric pain. It was present in everyone. Gastrointestinal bleeding rarely occurred. Complicating pancreatitis was not seen. Pathophysiologic abnormalities (decreased vitamin B12 and iron absorption, abnormal protein loss) depended more on the extraduodenal extension of Crohn's disease than on the duodenal lesion. In three patients duodenal obstruction required a bypass operation (gastrojejunostomy or duodenojejunostomy). The same three patients and three other of the series were subjected to other surgical treatment, including ileal resection and, in four cases, subtotal colectomy. Two patients died, one of pneumonia in his home and one in her home town of, probably, acute gastroenteritis complicating a severe short-bowel syndrome. The prognosis in this series seemed to be worse than in Crohn's disease in general, not because of the duodenal lesion but because of its association with severe lesions elsewhere in the gastrointestinal tract.
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PMID:Crohn's disease of the duodenum. 720 78

Twelve patients with biliary-enteric anastomoses were examined with transhepatic cholangiography to evaluate the etiology of epigastric pain, cholangitis, abnormal liver function tests, pancreatitis, or transient or persistent jaundice. Cholangiography was successful in all, and there were no significant complications. Four patients had reflux barium studies and one underwent endoscopic retrograde cholangiopancreatography. All five of these examinations failed to reveal diagnostic information relevant to patient management. Transhepatic cholangiography is easy to perform and relatively safe, especially in patients with unobstructed duct systems. In demonstrates biliary anatomy in great detail and can be used effectively regardless of the site of the anastomosis or prior gastric surgery. It is concluded that transhepatic cholangiography should be used as the primary means of evaluating the biliary-enteric anastomosis.
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PMID:Thin needle cholangiography as the primary method for the evaluation of the biliary-enteric anastomosis. 740 2


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