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)

The authors report a series of 30 cases of acute pancreatitis associated with cholelithiasis. There were 9 cases of necrotizing pancreatitis and the latter group included the 4 deaths observed in this series. Clinical, radiological and laboratory data were in favor of this association in 24 out of the 30 cases. Cholelithiasis appeared to be directly responsible for initiating the pancreatitis in 1/3 of cases. In another 1/3 of cases the mecanism was thought to be related to scarring of the sphincter of Oddi. In the remaining 1/3 of cases no direct relationship could be found. On the basis of these findings, the authors recommend that emergency surgery be reserved for these cases in which cholelithiasis appears to be the etiology. (The biliary syndrome overshadowing the pancreatic syndrome) and to postpone treatment of pancreatic lesions. In all other cases, the authors suggest to keep elective surgery, for after a period of initial conservative treatment with the hope of then treating together biliary and pancreatic lesions.
 ...
PMID:[Acute pancreatitis and cholelithiasis. A study of thirty cases (author's transl)]. 23 83

Stenosing odditis represents only 4.5 p. cent of all benign lesions of the extrahepatic bile ducts. Their diagnosis is made by peroperative radiomanometry, but clinically they are suggested by a past history and serious clinical signs. The pancreatic involvement is rarely macroscopic (10 p. cent of cases of which 5 p. cent are severe) and acute pancreatitis due to stricture of the sphincter without gall stones is exceptional. Associated biliary lesions are frequent; in 50 p. cent of cases, of lithiasis of the common bile duct or pancreatitis, in 66 p. cent of cases of residual odditis. The treatment is surgical. Sphincterotomy should be reserved for young subjects with a slightly dilated common bile duct, or when necessary to extract a gall stone from the lower end of the bile duct. Biliary by pass operations are all the more indicated when the patient is elderly or the common bile duct more dilated. Local complications are the most frequent and the most serious after sphincterotomy; the local complications of biliary by pass operations are usually very simple. The late results of biliary by-pass operations are better than those of sphincterotomy, which confirms that the pancreatic complications of odditis are rare or well tolerated. The presence of chronic pancreatitis in association is not an aggravating factor.
 ...
PMID:[Stenosing odditis: diagnosis and treatment. Report of 109 cases (author's transl)]. 59 95

We studied the relationship between pregnancy and pancreatitis together with reviewing the bibliography after having had 4 cases. As far as the aetiology is concerned there does not seem to be a mechanical factor associated with the pregnant uterus but a vesicular factor (gall bladder) of stasis and hypersecretion, with hyperlipidaemia of pregnancy and pancreatic oversecretion in pregnancy, all of which are finally associated with a neuro-vegetative lack of tone and with the part played by certain drugs that are often prescribed in pregnancy. The fetal prognosis is relatively good except for the risks of premature delivery. Management of a case of acute severe pancreatitis is difficult to work out. All the same, the treatment should be above all conservative, which means medical. Surgery should be reserved for those cases with definite indications such as progressive deterioration in spite of medical treatment with the knowledge beforehand that it will not make much difference to the final prognosis.
 ...
PMID:[Pregnancy and severe pancreatitis (author's transl)]. 64 18

Grey-scale ultrasound scanning (US), computed tomography (CT), and endoscopic retrograde cholangiopancreatography (ERCP) were performed in a series of 50 patients with known or suspected pancreatic disease. The impact of the individual tests were assessed in the relevant clinical context. With a maximum of 100, the overall clinical impact score of ERCP (75) exceeded that of CT(63) and US (36). In patients with obscure pain, and in those with relapsing pancreatitis, a combination of US and ERCP provides good clinical guidance. Computed tomography scanning can currently be reserved for documentation of patients with a major mass lesion. None of the techniques can detect early pancreatic cancer, except of the papilla of Vater, where ERCP is diagnostic. Recommendations for future diagnostic strategies may alter as grey-scale ultrasonography and computed tomography develop, and, in any case, depend on many factors including local expertise, availability, and cost.
 ...
PMID:Comparative clinical impact of endoscopic pancreatography, grey-scale ultrasonography, and computed tomography (EMI scanning) in pancreatic disease: preliminary report. 68 May 99

The authors analyze the surgical indications and procedures for cases of chronic pancreatites. There were but few cases and the procedures were chosen for minimal harm ; there were : 4 external marsupialisations, 1 resection of a true cyst, 5 cystoanastomoses, 2 biliary bypasses, 4 left pancreatectomies. Postoperative courses were normal in 12 patients; 2 had recurrent pancreatitis because of alcoholism. Our attitude towards chronic pancreatic lesions is thus as follows: 1. Cautions and reserved indications. 2. Ad minima procedures.
 ...
PMID:[Surgery for chronic non neoplastic diseases of the pancreas (author's transl)]. 101 76

A prospective study of 397 patients with primary biliary operations performed for benign disease included a perioperative culture of the bile. Two main groups of patients in whom bacteria in the bile and, thus, probably increased risk postoperative infection was common, are patients undergoing emergency operation (60 per cent bacteria in the bile, as compared with 22 per cent in those with elective operations) and patients with a history of acute cholecystitis or pancreatitis, or both, or jaundice (49 per cent bacteria in the bile with a positive history as compared with 11 per cent without). The rate of infection was 2.8 per cent in high-risk groups, as compared with 0.6 per cent in patients undergoing elective operative procedures with no history of acute cholecystitis, pancreatitis or jaundice. Thus, antibiotics can probably be reserved for those patients who had emergency surgical treatment and for those with elective operations and a history of acute cholecystitis, pancreatitis or jaundice. In addition, antibiotic prophylaxis might be indicated for all patients who are 75 years of age or older, as bacteria in the bile seems to be common in this age group even without a history of the aforementioned complications.
 ...
PMID:Selective antibiotic prophylaxis in biliary tract operations. 186 65

Azathioprine sodium has been reported to be effective therapy for chronic cutaneous lupus erythematosus (LE) but rarely for chronic cutaneous leukocytoclastic vasculitis (LV). We used azathioprine in the treatment of six patients with cutaneous LE, four of whom had subacute cutaneous (nonscarring) LE and two of whom had chronic cutaneous (scarring, discoid) LE, and six patients with chronic cutaneous LV. The conditions of all patients had been resistant to conventional therapy, and they required long-term oral corticosteroid therapy for control of their disease. Two of the patients with LE had prominent palmar and/or plantar involvement. Three patients with LE had an excellent response to azathioprine, with near complete clearing of the skin lesions, allowing a decrease in prednisone dosage. One patient with LE initially demonstrated significant improvement, but azathioprine therapy had to be discontinued because of pancreatitis. The treatment failed in two patients with LE; one had nausea and the other repeatedly developed a drug-induced fever. Five of the six patients with LV had improved conditions, with complete control of the disease occurring in two patients and partial control in three patients. Azathioprine is effective for some patients with cutaneous LE and chronic cutaneous LV, but it should be reserved for patients with severe disease in whom more conventional treatment fails.
 ...
PMID:Azathioprine. An effective, corticosteroid-sparing therapy for patients with recalcitrant cutaneous lupus erythematosus or with recalcitrant cutaneous leukocytoclastic vasculitis. 200 76

The relative merits of various serum pancreatic enzymes, ultrasonography (US), and computerized tomography (CT) have been evaluated. In practice, the diagnosis of acute pancreatitis (AP) remains hinged on the clinical picture and elevated serum amylase. The advantages of total serum amylase are its technical simplicity, ready availability, and sensitivity. Within 24 h of onset of symptoms, elevation of amylase is as sensitive as that of lipase, pancreatic isoamylase, immunoreactive trypsin, or elastase. However, after the first hospital day, it is the least sensitive of the enzymatic tests. Its greatest disadvantage is its overall low specificity. Lipase assays are now fast, reliable, practical, more specific, almost as sensitive, and not more expensive than amylase assays. The current feeling is that lipase assays should be used more often or even should replace amylase assays. However, comparative studies using objective criteria for AP are required to evaluate the utility of lipase estimations over that of amylase. Other enzymes such as P-isoamylase, immunoreactive trypsin, chymotrypsin, or elastase are more cumbersome, expensive, and not better than lipase. They should be reserved for cases of doubtful diagnoses. The levels of these pancreatic enzymes neither correlate with the severity of the disease nor can they accurately predict the subsequent clinical course of the patients. The main role of ultrasonography remains in the evaluation of the biliary tract in AP. The contrast-enhanced computed tomography (CECT) is useful for estimating the presence and extent of pancreatic necrosis. Thereby, it enables prompt recognition of patients at high risk for systemic and local complications. Routine use of CECT may aid in the identification of pancreatitis when enzyme elevations are modest, but the utility of the procedure in all clinically mild cases is questionable. Patients who are seriously ill or who present a diagnostic problem should have a CECT. A normal CT under such circumstances excludes clinically severe AP. Serial CT should be done in patients demonstrating phlegmonous extrapancreatic spread.
 ...
PMID:Evaluating tests for acute pancreatitis. 218 90

Serum elastase-1, amylase, lipase, and trypsin-like immunoreactivity were measured in a group of 17 consecutive patients with acute pancreatitis. When assayed within 24 h of the onset of symptoms, all enzymes were found to be elevated, thus showing similar sensitivity. Elastase-1 did not improve the diagnostic score of the other enzymes studied. Owing to their much quicker and less expensive determinations, amylase and lipase should be considered the best initial markers of pancreatic injury. However, during the course of pancreatitis, amylase and in a lesser degree lipase returned to normal in more cases than elastase or trypsin; both were still elevated in 90% of the patients 10 days after the onset of the symptoms. Thus, trypsin and/or elastase-1 should be reserved for cases of doubtful or delayed diagnosis. The specificity and the positive predictive value of these enzymes need to be evaluated.
 ...
PMID:Comparison of elastase-1 with amylase, lipase, and trypsin-like immunoreactivity in the diagnosis of acute pancreatitis. 243 92

Chronic pancreatitis of biliary origin, frequently located in the cephalic portion of the organ, etiopathogenically dependent on biliary lithiasis, the anatomoclinical evolution of which is complicated by their presence, have a better prognosis, and are usually reversible following therapy of the biliary affections. Persistent chronic pancreatitis proper, usually of the recurrent type, associated with calcification and the development of pancreatic stones, and with pseudocysts, although rare in our country, raise diagnostic difficulties from the standpoint of surgery, and have a reserved prognosis. The authors have evaluated a total of 321 cases hospitalized between 1960 and 1987 with chronic pancreatitis of biliary origin (252 cases--78.5%), and chronic pancreatitis proper, not associated to biliary affections (69 cases--21.5%). Male patients totalled 33.6% of all cases. The authors stress the high frequency of chronic pancreatitis associated to biliary lithiasis (181 cases), in contrast with pancreatitis associated to nonlithiasic cholecystopathies (38 cases), or to postoperative cholecystic disturbances (33 cases). Chronic pancreatitis non-associated to biliary affections totalled 69 cases, of which 24 were of the persistent type, 13 were of the recurrent type, one had calcifications, two had pancreatic stones, four followed acute pancreatitis, six were complicated by pancreatic abscesses, and 9 were complicated by pseudocysts. The duration of biliary and pancreatic disturbances was between 3 and 5 years in 43.9% of the cases, and between 6 and 10 years in 21.3%. Chronic pancreatitis achieves a complex clinical syndrome, the dominant feature being the painful biliopancreatic syndrome associated to obstructive jaundice (42.4%), angiocholitis (47.6%), weight loss (46%), hepatic and renal failure (10.9%), diabetes (8.4%), and a tumoral mass (15.7%). Indirect surgical interventions aimed at suppressing the biliary factor were carried out in 291 patients, with very good results in 56% of the cases, good results in 32%, mediocre in 7%. In 2.4% of the cases surgery failed to improve the condition of the patients. Direct interventions on the pancreas, which consisted either in pancreatic decompression or in exeresis of the gland have been performed in 30 patients. Drainage of pancreatic abscesses was done in 6 patients (2 deaths), cystic-digestive anastomoses were performed in 8 patients, Wirsung-jejunostomy in 3 patients (1 death), cystostomy in one patient, distal pancreatectomy in one patient (deceased), viscerolysis and novocaine infiltration in 11 patients. In the 321 cases of chronic pancreatitis operated by direct and indirect procedures very good
 ...
PMID:[Chronic pancreatitis: anatomico-clinical and surgical therapy characteristics. Our experience with 321 cases]. 252 82


1 2 3 4 5 6 7 8 Next >>