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

Between the years of 1970 and 1984, a total of 96 patients underwent biliary enteric bypass to alleviate distal common bile duct obstruction from benign and all malignant disease. Cholecystoenterostomy (CCE) was performed in 13 patients (chronic pancreatitis 7, carcinoma 6), choledochoduodenostomy (CDD) was performed in 35 patients (stones 9, chronic pancreatitis 17, carcinoma 8, and fistula 1), cholecystojejunostomy (CDJ) was performed on 48 patients (stones 1, pancreatitis 21, carcinoma 25 and stricture 1). Operative mortality was 7 per cent and morbidity occurred in 12 per cent of the patients. Symptomatic improvement was measured by relief of pain and sepsis and decrease of bilirubin and alkaline phosphatase to normal. Overall improvement was seen in 73 per cent of patients (CCE 50%, CDD 8%, CDJ 65%), 27 per cent of the patients did not improve (CCE 50%, CDD 12%, CDJ 35%), 83 per cent of the poor results were in patients with advanced malignancy. Thirty-one per cent of patients undergoing CCE required conversion to CDD or CDJ. Cholecystoduodenostomy was associated with failure in 50 per cent of patients. CCD and CDJ are safe and reliable means of relieving distal common duct obstruction due to biliary or pancreatic disease. Cholecystojejunostomy may be performed in the terminal patient with advanced carcinoma requiring a short-term biliary bypass.
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PMID:Biliary enteric bypass for benign and malignant disease. 360 59

A 68-year-old man without previous hepatobiliary or pancreatic disease was admitted after five attacks of nausea, vomiting, abdominal pain and high fever. Laboratory investigations indicated cholestatic liver disease and pancreatitis. For 1.5 years the patient had occasionally been taking a non-steroidal anti-inflammatory drug, sulindac (clinoril, MSD, New York), for osteoarthritis. On suspicion of a drug-associated disease, a rechallenge experiment was performed with sulindac. Five hours after drug administration symptoms recurred. There was a pronounced increase in serum alkaline phosphatase and amylase. A liver biopsy 3 d later showed portal tract inflammatory infiltration and abnormal interlobular bile ducts with degeneration and necrosis of the epithelium and neutrophilic infiltration of the ducts. Sulindac-induced cholangitis has not been described previously. The pathogenetic mechanism is considered to be an immunoallergic idiosyncratic reaction to the active metabolite of sulindac absorbed by the bile duct epithelium. The lesion is apparently reversible.
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PMID:Acute cholangitis and pancreatitis associated with sulindac (clinoril). 362 32

Twenty-eight patients underwent surgery for intractable pain, duodenal or extrahepatic biliary obstruction secondary to chronic pancreatitis. Eleven had pancreatic duct obstruction alone, six biliary obstruction alone, seven combined pancreatic and biliary, two combined biliary and duodenal, one combined pancreatic and duodenal, and one simultaneous pancreatic, biliary, and duodenal obstruction. Pancreatitis was secondary to alcohol in all but one case. The following operations were performed: longitudinal pancreatojejunostomy (20), choledochoduodenostomy (8), choledochojejunostomy (7), cholecystojejunostomy (1), and gastrojejunostomy (4). Of the 20 patients with pancreatic duct drainage, pain relief was complete in 11 and partial in six. Initial incomplete relief of pain, or recurrence, stimulated further diagnostic procedures, leading to improvement or correction of the problem in five patients. A significant (p less than 0.01) fall in alkaline phosphatase (935 +/- 228 to 219 +/- 61 U/L) occurred following surgery. One patient was subsequently found to have pancreatic carcinoma. Two patients were lost to follow-up and four patients died (one perioperative and three late). In conclusion, the possibility of pancreatic, biliary, and duodenal obstruction must be considered in symptomatic patients with chronic pancreatitis. Surgery must be individualized. Drainage procedures, either alone or in combination, are associated with a low morbidity and improved clinical condition and may be preferable to resection in the surgical management of these patients.
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PMID:Selective drainage for pancreatic, biliary, and duodenal obstruction secondary to chronic fibrosing pancreatitis. 370 34

Six small to medium-sized, middle-aged, female dogs with histories of acute pancreatitis developed clinical signs of extrahepatic biliary obstruction. Clinical findings were similar in the 6 dogs and included icterus. Serum biochemical analyses indicated high concentrations of total bilirubin and cholesterol and high alkaline phosphatase and alanine transaminase activities. Exploratory abdominal surgery was performed in each dog. Each dog had a firm mass involving the body of the pancreas, with obstruction of the distal portion of the common bile duct, marked peripancreatic inflammation, and omental adhesions. Cholecystoduodenostomy, using an open mucosal appositional technique for biliary redirection, was performed in each dog. Clinically, results of surgery were good to excellent (ie, lack of postoperative icterus, anorexia, lethargy, or weight loss and absence or infrequency of vomiting). The mean postoperative evaluation period for the 6 dogs was 35 months (range, 20 to 48 months); 5 dogs were alive and healthy at the end of the study. Histologic examination of tissue specimens of the pancreatic mass indicated chronic active fibrosing pancreatitis in the 6 dogs.
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PMID:Common bile duct obstruction secondary to chronic fibrosing pancreatitis: treatment by use of cholecystoduodenostomy in the dog. 380 35

Carcinoembryonic antigen (CEA) was measured in whole serum and in serum extracted with perchloric acid by microradioimmunoassay in patients with benign and malignant diseases of the liver and pancreas. The level of detectability was 5 ng per ml. This level or greater was present in the serum of 50% of patients with chronic diffuse liver disease, 64% with pancreatitis, 94% with cancer of the digestive system, and 3% of controls. The incidence of levels of CEA of 5 ng/ml or more differed for various categories of chronic liver disease: from 22% in active chronic hepatitis, 46% in primary biliary cirrhosis, 63% in hepatoma, 78% in cryptogenic cirrhosis, and 88% in alcoholic cirrhosis; levels of CEA correlated with degrees of impairment of liver function as judged by bromsulphalein retention and serum levels of alkaline phosphatase and transaminase. In pancreatitis, 64% of cases had levels of CEA ranging from 5 to 20 ng/ml and in cancer of the pancreas 94% had levels above 5 ng/ml and 50% above 20 ng/ml.
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PMID:Carcinoembryonic antigen in serum in diseases of the liver and pancreas. 472 56

Pancreatic juice gamma-glutamyltransferase (GGT, EC 2.3.2.2) has been proposed as a marker of pancreatic disease. We have collected pancreatic juice endoscopically from 24 control patients and 43 patients with a variety of hepatic, pancreatic, and biliary disorders. Pancreatic juice GGT, alanine transaminase (ALT, EC 2.6.1.2), and alkaline phosphatase (ALP, EC 3.1.3.1) were measured and found to be present in all samples. GGT was significantly higher in patients with pancreatic cancer (range 21-1175 IU/liter, P less than 0.005) compared with controls (range 2-52 IU/liter). Of 17 patients with pancreatic juice GGT concentrations greater than 52 IU/liter, eleven had definite pancreatic disease (seven pancreatic cancer, four chronic pancreatitis) and, in the remaining six, pancreatitis was possible although not proven. Pancreatic juice ALT and ALP provided no useful diagnostic criteria. GGT in pancreatic juice seems to be a nonspecific marker of pancreatic disease and merits further study.
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PMID:Pancreatic juice gamma-glutamyltransferase, alanine transaminase, and alkaline phosphatase in pancreatic disease. 610 99

Antemortem and postmortem sera from 60 dogs were evaluated for lipase, amylase, alkaline phosphatase, gamma-glutamyltransferase, and alanine aminotransferase (AAT); cerebrospinal fluid was examined for AAT and alkaline phosphatase. The postmortem intervals were 3, 6, 12, 24, and 48 h at temperatures of 4, 20, and 37 degrees C. Amylase levels remained stable at 4 and 20 degrees C and may be beneficial for diagnosing pancreatitis. Lipase levels may be useful as an adjunct to amylase values. Serum alkaline phosphatase values increased with postmortem interval; values were higher at 37 degrees C than at 4 degrees C. Other enzymes were of little value for diagnosis.
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PMID:Postmortem sera and cerebrospinal fluid enzymes. 615 26

In a model developed to study acute pancreatitis in the dog, the disease process was comparable with the spontaneously occurring disease. Infusion of oleic acid into the accessory pancreatic duct induced, grossly and microscopically, acute hemorrhagic pancreatitis with pancreatic atrophy, fibrosis, fat necrosis, and edema. Clinical changes included persistent fever and tachycardia in all dogs and abdominal pain, vomiting, and diarrhea in most. Serum amylase and lipase activities increased markedly as did activities of alkaline phosphatase, aspartate aminotransferase, and alanine aminotransferase. Hematologic alterations included hemoconcentration (despite intensive fluid therapy) and leukocytosis due primarily to neutrophilia and monocytosis. Neither corticosteroid nor anticholinergic therapy begun 24 to 32 hours after oleic acid infusion altered the course of the disease. Dogs survived 8 days and appeared clinically normal when the study was terminated.
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PMID:Effects of an anticholinergic and a corticosteroid on acute pancreatitis in experimental dogs. 617 2

Early differentiation of gallstone from nongallstone associated acute pancreatitis by imaging methods is often difficult. Timing of surgery in gallstone pancreatitis is controversial, but early surgery requires early demonstration of gallstones. This study assesses the value of easily available clinical and laboratory data in establishing gallstones as the etiology of pancreatitis. In 405 consecutive episodes of acute pancreatitis, data were collected prospectively on 14 clinical and laboratory variables. Gallstones caused 177 episodes and alcohol 135, 93 were due to other or unknown causes. Age, sex, and within 48 hours of admission, serum alkaline phosphatase, aminotransferases, amylase, and bilirubin were all significantly different (all p less than 0.001, chi square) in gallstone and alcohol groups. Multivariate analysis based on five of these variables enabled correct prediction of the presence or absence of gallstones in 50 of a further 56 episodes. This method may help in planning early interventional treatment of gallstone associated acute pancreatitis.
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PMID:The early identification of patients with gallstone associated pancreatitis using clinical and biochemical factors only. 619 78

Biochemical tests (serum glutamic pyruvic transaminase, serum glutamic oxaloacetic transaminase, alkaline phosphatase, gammaglutamyltranspeptidase, bilirubin, and serum amylase) were performed upon admission in 84 patients with suspected (36) or proven (48) acute pancreatitis at the time of the first episode of acute abdominal pain suspected clinically as acute pancreatitis. These parameters all increased significantly more in patients with gallstone pancreatitis. Among them, the SGPT was the most discriminant test between biliary and nonbiliary pancreatitis. The positive predictive value of SGPT was 92%, when the cutoff point was chosen at twice the upper limit of normal. In patients with increased SGPT, a SGOT-SGPT ratio less than 1 is the rule (88%) for those with gallstone pancreatitis. This enzymatic determination allowed us to select more accurately the patients suitable for morphological procedures to confirm the biliary origin of the pancreatitis.
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PMID:Early detection of biliary pancreatitis. 619 68


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