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

Radiologic findings and medical records of 27 patients with angiographic documentation of splenic vein occlusion were reviewed. The most common causes were pancreatic carcinoma, pancreatitis, and malignant lymphoma. Radiographic findings which suggest splenic vein occlusion are gastric varices without esophageal varices and collateral veins in the left upper abdomen during the vascular phase of rapid sequence pyelography. Additional features may be associated with the underlying disease, such as pancreatic calcification and upper abdominal mass lesions. The diagnosis is usually confirmed by high dose celiac or splenic angiography. Examination of the stomach with barium for the detection of gastric varices is more sensitive than has been previusly recognized; features which suggest them are described. Isolated gastric varices may be a clue to isolated splenic vein occlusion and its underlying causes.
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PMID:Recognition of splenic vein occlusion. 9 86

Intrapancreatic cysts were demonstrated by endoscopic retrograde pancreatography (E.R.P.) in nine patients with a clinical diagnosis of relapsing pancreatitis. The cysts ranged in diameter from 0.6 cm to 5 cm and were frequently associated with a prolonged elevation of the serum amylase level. The complication of intracystic haemorrhage with obstructive jaundice developed in one patient requiring early surgical decompression and drainage. In four patients laparotomy was performed because of continuing abdominal pain. One patient was treated by cystogastrostomy and another by cyst aspiration, but in two patients the cyst could not be visualized or palpated. Four patients were observed without operation for periods of four to 24 months, and all showed improvement or resolution of symptoms. E.R.P. was repeated in one patient and the cyst could not be outlined, while in another an abnormal barium meal X-ray examination result reverted to normal. Intrapancreatic cysts can be managed non-operatively, since complications appear infrequent and spontaneous resolution may occur.
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PMID:Intrapancreatic cysts associated with relapsing pancreatitis. 28 28

The authors present a case of intramural hematoma of the small intestines during anticoagulant treatment. With reference to this case, they study the frequency, etiopathogenesis and anatomy of this hematoma and particularly look at the radiological manifestations. In this respect they distinguish three stages in the evolution. The first, when the straight X-ray of the abdomen and barium followthrough demonstrate an axial stenosis of the small intestines with dilation of the proximal loops; the second (between the 7th and 20th days) when the loop affected by the hematoma takes on a characteristic "palissade" or "spring" -like sausage appearance; finally the third (after the 3rd week), when only thickening of the haustrations persists with progressive return to normal. The radiological diagnosis is discussed, not only with intramural hematomas of the small intestines of other etiologies (traumatic, during pancreatitis, during disorders in hemostatis), but also with conditions giving rise to similar radiological pictures: malabsorption, inflammatory conditions, etc.
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PMID:[An intramural hematoma of the small intestine, during anticoagulant therapy: radiological course. Concerning one case]. 30 Aug 5

Visceral artery erosion is an uncommon but disasterous complication of pancreatitis. When gastrointestinal bleeding or severe intra-abdominal hemorrhage is associated with pancreatitis and the usual sources of bleeding are not detected by endoscopy or barium studies, erosion of a visceral vessel should be suspected. We present nine cases and an additional 44 cases from previous reports are reviewed. A palpable abdominal mass was present in 59% of the patients; however, a pseudocyst was present in 78%. Arteriography was performed in 15 patients and the source of bleeding was evident in 14. The splenic artery was the most common site of bleeding, although the other branches of the celiac axis and the middle colic artery have been involved. Successful treatment consisted of ligation of the bleeding vessel and, if present, drainage of the pseudocyst. Depending on the location of the vessel and the pseudocyst, major resections may be necessary. When bleeding and the pancreatic inflammatory process involved the colon, ligation of the bleeding site, drainage of the area, and colostomy was the most successful form of treatment.
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PMID:Visceral vessel erosion associated with pancreatitis. Case reports and a review of the literature. 31 Jun 67

Four patients with intraluminal diverticulum of the duodenum are presented and compared with those reported previously. This lesion is a rare congenital disorder that usually becomes symptomatic in adult life. It is located in the second portion of the duodenum within the lumen, extending distally. It has the appearance of a "thumb of a glove" and it is lined by mucosa on both surfaces. It develops betweeen the fourth and eighth week of the embryo's life, but it increases in size during adult life. It usually presents with typical or atypical symptoms of peptic ulcer disease, but sometimes manifestations such as gastrointestinal bleeding, duodenal obstructions or pancreatitis may predominate and may be severe and life-threatening. The diagnosis is best made with hypotonic duodenography, which demonstrates the lesion as a barium coated pouch within the air filled duodenal lumen. The treatment of choice is duodenotomy and excision of the lesion. Proper identification of the papilla of the ampulla of Vater is important since this structure is often adjacent to the diverticulum. No recurrences have been noted in the three patients operated upon.
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PMID:Intraluminal duodenal diverticulum in the adult. 40 22

Endoscopic retrograde choledochopancreatography (ERCP) was employed in 52 patients symptomatic after cholecystectomy in whom barium meal studies and intravenous cholangiography had failed to yield a diagnosis. Cannulation of the papilla of Vater was carried out in 50 of the patients in a mean time of 10 min. Diagnostic information demonstrating a pathological lesion or a normal biliary and pancreatic ductal system was obtained by means of endoscopy and ERCP in 48 cases. There were no serious complications. A pathological lesion was demonstrated in all but one of the patients presenting with jaundice, cholangitis or pancreatitis but the diagnostic yield was not as high in patients with vague upper abdominal symptoms. Endoscopy and ERCP are the investigative procedures of first choice in complex post-cholecystectomy cases in whom intravenous cholangiography fails, gives incomplete information or suggests normality in the face of continuing symptoms or clinical evidence of residual biliary disease.
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PMID:Diagnosis and management of post-cholecystectomy symptoms: the place of endoscopy and retrograde choledochopancreatography. 58 78

42 cases of pancreatic cyst in acute (22 cases) pr chronic (20 cases) pancreatitis were seen between 1962 and 1976. Analysis of the case data revealed the following: (1) exact assignment of the cyst to acute or chronic pancreatitis is often possible only by long-term observation; (2) the cysts of chronic pancreatitis are not a uniform group: some (8 cases) apparently occurred in acute pancreatitis through necrotic episodes (pseudocysts), others (12 cases) by a retention mechanism; these "retention cysts" develop later in the course of chronic pancreatitis than the pseudocysts and produce a different clinical picture with better prognosis; (3) barium meal and retrograde cholangiopancreatography proved of diagnostic value' (4) if the cysts persist for more than six weeks operation is indicated because of the high incidence of complications.
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PMID:[Pseudocysts and retention cysts in acute and chronic pancreatitis (author's transl)]. 75 56

Diverticula rarely occur within the lumen of the duodenum. They arise near the papilla of Vater and extend distally. The diverticulum is lined on both sides with duodenal mucosa, and its eccentric opening is usually proximal in the sac. The diverticulum results from incomplete recanalization of the intestinal lumen after the proliferative epithelial stage in the 7-week embryo and represents either a remnant of one of two channels formed during recanalization or a distal ballooning of a congenital duodenal diaphragm. Although the patient with a diverticulum may be asymptomatic, most patients present with abdominal pain and obstructive symptoms; pancreatitis and gastrointestinal bleeding may be associated with the diverticulum. Barium study shows a characteristic radiolucent halo that represents the wall of the diverticulum. Surgery should be approached with caution because injury to the papilla is a hazard, and in children, coexisting congenital anomalies may be present.
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PMID:Intraluminal duodenal diverticulum. Report of two cases and review of the literature. 80 22

In 5 out of 35 patients with acute, acute relapsing and chronic pancreatitis, barium enema revealed partial colonic stenosis at the splenic flexure. In 3 patients laparotomy disclosed colonic perforation with abscess, adhesions between colon and pancreas or a marked pancreatic edema. In two patients barium enema follow-up 3-6 months later showed spontaneous resolution of the stenosis. Comparison with 35 cases in the literature shows that colonic stenosis after pancreatitis is usually incomplete, located at the splenic flexure and due to adhesions between the colon and the pancreas. Spasmodic pains in the upper abdomen, increasing constipation and often rectal bleeding or positive guaiac test of the stool may indicate colonic stenosis. Spontaneous resolution is possible, but if operation is indicated the adhesions should be carefully dissected in order to obviate resections of the colon or the pancreas.
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PMID:[Colonic stenosis after pancreatitis]. 100 43

Four renal allograft recipients with evidence of ischemic damage to the colon are presented and compared with 11 cases from 5 major series. Similarities in the patients included: deterioration of renal function, multiple immunosuppressive and antibiotic regimens, the use of cadaver renal allografts, and diagnostic and therapeutic measures requiring frequent enemas with barium and ion-exchange resins. Two of our patients underwent surgery for the removal of segments of necrotic colon after several weeks of fever and abdominal pain initially attributed to either acute rejection, viral infection, or pancreatitis. One patient had three days of melena and responded to non-operative therapy. The fourth patient developed ischemic colonic changes 10 weeks after allograft nephrectomy and was receiving no immunosuppression at the time. Broad spectrum antibiotics were used at various times in all patients. Early aggressive evaluation of gastrointestinal complaints--including barium enema, upper gastrointestinal series with small bowel follow-through, proctosigmoidoscopy or colonoscopy, and arteriography--is indicated, in view of the lethality of the complication of colonic ulceration. The clinical pictures presented emphasize the fact that recipients of renal allografts are commonly heir to many complications which may be considered rare in the normal population.
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PMID:Acute colitis in the renal allograft recipient. 110 14


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