Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0030305 (pancreatitis)
 16,014 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Bronchobiliary fistulas are rare. One aetiological cause is biliary obstruction with secondary suppuration and subsequent hepatic and subphrenic abscesses. Only a few cases of bronchobiliary fistulas in patients with chronic pancreatitis have been reported and we record another case. A 47-year-old white male, with chronic alcohol-induced pancreatitis who had earlier undergone several laparotomies related to this disease, was admitted with a hepatic abscess. Drainage was not successful. The patient developed bilioptysis and a bronchobiliary fistula was diagnosed. The fistulous tract was demonstrated using PTC as well as bronchography. Laparotomy was performed and the fistulous tract was excised. The hepaticoduodenal ligament was completely obstructed by the inflamed pancreatic gland. An earlier but now obstructed cholecystojejunostomy was revised. This case was complicated by episodes of severe gastrointestinal bleeding probably caused by thrombosis of the portal vein and local varices around the gallbladder and common duct.
 ...
PMID:Bronchobiliary fistula in chronic pancreatitis. Case report. 367 59

Using case reports, attention is drawn to rare causes of cholestasis the clarification of which by ERC/PTC and by endoscopic therapy, if necessary, will clearly shown the usefulness of this method. The picture of an unusual choledocholith, the extraction of a "suture stone", the case of a Mirizzi syndrome, a cholecystocolic fistula, a cystic dilatation of the choledochus with Caroli's syndrome and status after choledochojejunostomy, the extraction of an ascarid from the papilla at biliary pancreatitis as well as the detection of a biliobronchial fistula resulting from an unsound hepaticojejunostomy are examples to underline the diagnostic usefulness of the ERC/PCT including its therapeutic capabilities and consequences in contrast to other methods, such as x-ray, ultrasound or computertomography.
 ...
PMID:[Rare causes of cholestasis in ERC/PTC]. 748 14

We report a case of a 30-year old female with congenital lithiasic choledochal dilatation which was not diagnosed at the ultrasonographic examination. Congenital biliary dilatation abnormalities are rare and may clinically present with episodic biliary colics or more rarely with recurrent pancreatis. Ultrasound, CT-scanning and ERCP usually make these anatomic alterations evident but in some cases there may be some doubt despite the vast range of radiological techniques available (PTC, Tc99m-Isida scinti-scan). The best results from a diagnostic point of view are obtained from the ERCP that may in fact visualize an anomalous pancreatico-biliary junction, rule out carcinoma, accurately define the cyst dimensions or show the intrahepatic ductal radicals. Furthermore, the extraction of intracystic stones or the treatment of choledochocele through a papillostomy may be performed. However the ERCP may cause traumatic pancreatitis, above all in youngster as was verified in our patient. During surgical exploration, the definitive diagnosis can be achieved via intraoperative cholangiography. We emphasize that in patients with congenital choledochal dilatation, the dilated choledochus should be excised even in young children to avoid the risk of malignancy which may occur also following cyso-duodeno- or cystojejunostomy treatment. In our patient an hepatiocojejunostomy on a Roux-en-Y limb was performed. This single case has been oresented along with a review of the literature to recall such anomalies in differential diagnosis of biliary colics and to stress that the choice treatment is surgical resection.
 ...
PMID:[Lithiasic, congenital, choledochal dilatation: problems of diagnosis and therapy]. 957 43

The goal of this study was to determine the prevalence, epidemiology and clinical-therapeutical evolution of hepatolithiasis (HL) in Argentina. With this purpose a survey was conducted sending a questionnaire to ten referencial and interventional radiology centers in the country. Seven centers answered on time. In the last five years a total of 8,736 consecutive patients were examined for cholangiography (endoscopic retrograde cholangiography, PTC). A total of 5,920 (68%) were biliary lithiasis and 53 (0.9%, range 0.5-2.6%) of these were HL. In case of HL the diagnostic procedure was the ERCP in 68% of the cases, and the PTC in the remainder 32%. The patients with HL (53% females, mean age 52, range 23-85) clinically presented cholangitis (79%); pancreatitis (6%) and five (9.4%) showed evolution to a biliary cirrhosis. Associated diseases or abnormalities of the biliary tree were: biliary postsurgical strictures (BPS), 28%; Caroli's Syndrome, 20%; and choledocholithiasis, 28%. While a 9.4% presented a "biliary history" (that was defined as two or more episodes of biliary surgery) and a 5.7% lacked associated or predisposing diseases. Follow-up was lost in 23% of the cases and in 77% a follow up of 38 months (range 8-60) was observed with 4.8% mortality rate. The treatment was hepatobiliary surgery in 58% of the cases; endoscopic papillotomy in 17% and combined treatments that included extracorporeal shock wave lithotripsy and ursodeoxycholic acid (UDCA) in 15%. Four out of 53 cases (7.5%) received UDCA as the only successful therapy. HL is an entity with high biliary morbidity in 85% of the cases and development in to cirrhosis in 9.4%. When the diagnosis is made in the western world both BPS and Caroli must be discarded first. Combined treatments or only UDCA are new therapeutical alternative in the western world.
 ...
PMID:[Hepatolithiasis and Caroli's disease in Argentina: results of a multicenter study]. 1043 88

This is the first article of a series of papers reviewing "new findings" on animal diseases. The articles are arranged in order of animal species. This article reviews seven publications on new findings on or directly related to dog diseases. The following seven cases are discussed: Canine sarcocystosis in Central America. Copper accumulation in a Skye terrier: Antemortem diagnosis and cytoprotective bile acid therapy. Keratinocyte culture and use of a cultured epidermal autograft. Line 1 insertion mutation in Factor IX of dogs with hemophilia B. Not previously described localization of the lesions in stifle osteochondritis dissecans. Panniculitis associated with pancreatitis: Antemortem diagnosis. Primary polydipsia associated with (and induced by?) gastrointestinal disease. After a short introduction, the bibliographical data, the abstract of the author(s) and some additional information derived from the article are given.
 ...
PMID:New findings on animal diseases published since 2003. 1. Dogs. 1507 38

Choledochal cysts are rare congenital disorders first described by Vater and Ezler in 1723. Their exact etiology remains incompletely understood; however, an anomalous pancreaticobiliary union (APBDU) and subsequent reflux of biliary contents into the biliary tree are thought to play a role. Accordingly, APBDU-associated choledochal cyst patients are significantly more likely to have evidence of hepatitis, cholangitis or pancreatitis and pathologically confirmed inflammation. In 1977, Todani and colleagues modified the original Alonso-Lej classification to include five types of CC. Type I and IV are the most common and most likely to be associated with malignancy. The majority of choledochal cysts are diagnosed in childhood. Clinical presentation varies and most often consists of nonspecific abdominal pain. Diagnosis is typically accomplished using multimodality imaging techniques including computed tomography, magnetic resonance imaging, ultrasound and MRCP. The use of diagnostic PTC and ERCP in CC has been largely replaced by MRCP. Appropriate management consists of prompt, complete cyst excision followed by restoration of biliary enteric continuity when necessary. Minimally invasive CC resection in the pediatric population has demonstrated acceptable outcomes. Prognosis is generally excellent; however, malignancy risk remains higher than the general population even after complete surgical excision.
 ...
PMID:Pediatric choledochal cysts: diagnosis and current management. 2913 95