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

Autosomal-dominant polycystic kidney disease is an inherited disorder characterized by multiple cysts in kidneys and other organs. A 63-year-old man was evaluated for the etiology of recurrent pancreatitis and chronic renal failure. Multiple cysts of kidneys, liver, and pancreas and pancreas divisum was diagnosed. Pancreatitis should be included in the differential diagnosis of abdominal pain in patients with ADPKD. Pancreas divisum may be a predisposing factor for acute pancreatitis in these patients.
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PMID:Recurrent pancreatitis in a patient with autosomal-dominant polycystic kidney disease. 1635 65

An 81-year-old man, with chronic renal failure due to chronic glomerulonephritis on maintenance hemodialysis (HD) for 4.5 years, was admitted to our hospital because of rapidly developing hyperglycemia and hypertension. He had been under good control on HD with no history of hyperglycemia. One month prior to admission he felt thirsty and generally fatigued, but did not inform medical staff of his symptoms. We diagnosed him as suffering from autoimmune pancreatitis (AIMP) associated with secondary diabetes mellitus, according to the typical feature of AIMP on endoscopic retrograde cholangiopancreatography and an elevated level of serum immunoglobulin G4 (IgG4). He was treated with insulin and a corticosteroid, following which, the diffuse narrowing of the main pancreatic duct improved and his serum IgG4 level reduced. AIMP is a rare but important complication in HD patients that requires prompt diagnosis and treatment; we are therefore reporting on a unique complication in a chronic HD patient.
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PMID:A case report of autoimmune pancreatitis accompanied with rapidly developing hyperglycemia and hypertension in a chronic hemodialysis patient. 1738 37

Fungal infections after kidney transplantation are a major cause of morbidity and mortality, and Candida infection of the pancreas is considered an infrequent but important agent in necrotizing pancreatitis. We report the case of a 43-year-old Caucasian patient who underwent simultaneous pancreas-kidney transplantation because of diabetes type I, and chronic renal failure with peritoneal dialysis. The postoperative course was complicated by acute pancreatitis due to the thrombosis of the splenic artery of the graft, the subsequent acute rupture of the external iliac artery caused by fungal arteritis (Candida glabrata), and peritonitis a few days later caused by sigmoid perforation with detection of Candida glabrata infection of the resected intestinal tract. The present case remarks that awareness and prevention of fungal infection are major issues in the transplant field. Important information can be added by systematic culture of conservation perfusates but, probably, the best way for early recognition of a critical level of infectious risk remains the routine application of the colonization index screening. In cases of positive results, preemptive antifungal therapy could be warranted.
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PMID:Disseminate fungal infection after acute pancreatitis in a simultaneous pancreas-kidney recipient. 2062 6

A 77-year-old man with an infrarenal abdominal aortic aneurysm was referred with a complex medical history including pancreatitis, chronic renal failure, atrial fibrillation, and a cerebral infarction. He also had a history of atherosclerosis obliterans, treated with a vascular bypass using an 8-mm prosthetic graft 9 years previously. His complicated anatomy, including a small access route and a large common iliac artery, suggested usage of Powerlink, a bifurcated stent graft through the previously placed graft, as an access route. The patient was discharged from the hospital with a type III endoleak, which was completely resolved 5 months after discharge.
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PMID:Successful treatment of an abdominal aortic aneurysm by endovascular graft placement through a previously placed prosthetic graft: Report of a case. 2111 Jan 63

Acute pancreatitis is often complicated by acute renal failure, either isolated or part of multiple organ failure. Preexisting chronic kidney disease worsens the prognosis, especially when the pancreatitis is severe and/or other major comorbidities are present. In case of acute-on-chronic renal failure secondary to acute pancreatitis, an early application of renal replacement therapy has improved the prognosis of patients included in the present clinical study.
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PMID:[Acute-on-chronic renal disease caused by pancreatitis--impact of renal replacement therapy]. 2152 61

A 70-year-old lady with a past medical history of light chain myeloma, chronic renal failure and a left breast plasmacytoma treated with radiotherapy was admitted for drainage of a subsequent left pleural effusion. She was given high dose steroids for her myeloma, following which she developed abdominal pain suspicious of pancreatitis. Results revealed a raised serum amylase of 5117, a modified Glasgow score of 3 and normal calcium levels. The working diagnosis was drug-induced pancreatitis and steroids were stopped. She remained well and her abdominal pain settled, but amylase remained markedly raised despite no findings of pancreatic pathology. A subsequent isoenzyme test on the amylase found it to be salivary amylase secreted from the plasmacytoma. The patient had her steroid therapy restarted and was allowed to be discharged from hospital.
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PMID:A case report of a salivary amylase secreting plasmacytoma in a patient with multiple myeloma. 2168 9

Endoscopic necrosectomy (EN) for walled-off pancreatic necrosis (WOPN) is less invasive than surgical treatment and has become the first choice for pancreatic abscess. EN is usually carried out with several devices including snares, baskets, and grasping forceps. Occasionally, we have encountered cases in which EN has not been satisfactorily carried out, and there is pressure for further innovation in EN. Here, we describe a case of a large area of WOPN that was successfully treated by EN with endoscopic submucosal dissection and associated techniques, which facilitated removal of necrotic tissues. A 60-year-old man was referred to our hospital for WOPN as a complication of necrotizing pancreatitis. As a result of his complicating conditions including ischemic heart disease, uncontrollable arrhythmia, chronic renal failure, and persistent pleural effusion, he was deemed a poor surgical candidate. Although EN with conventional devices was carried out for five sessions, we could not remove the dense and massive necrotic tissues. At the sixth EN session, the Clutch Cutter device (Fujifilm, Tokyo, Japan) was used to remove the necrotic tissues, without major complications. This is believed to be the first report of EN using the Clutch Cutter for successful treatment of WOPN.
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PMID:Large area of walled-off pancreatic necrosis successfully treated by endoscopic necrosectomy using a grasping-type scissors forceps. 2374 85

There is a definitive association between valproate therapy and acute pancreatitis. More than 50 cases have been reported. Most of the reported cases were mild yet there were a few more cases with higher morbidity and mortality. The risk is higher in patients under 20 years of age, during the first year of therapy, on the patient having encephalopathy or chronic renal failure and on patients with anti-epileptic drug polytherapy. The treatment of pancreatitis is supportive, laparotomy should be avoided. Re-challenge is hazardous and should be avoided.
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PMID:Valproate associated acute pancreatitis. 2427 3

Cigarette smoking is a major factor for pancreatic dysfunction in patients with chronic pancreatitis (CP). In the course of acute pancreatitis may lead to organ damage resulting in their failure. The chronic renal failure can cause disturbances in the exocrine pancreas. The study population consisted of 51 patients with chronic pancreatitis and 29 healthy subjects classified as the control group. The study population was divided into smokers and non-smokers on the basis of determining the concentration of cotinine (ELISA). It has been shown that the concentration of creatinine in the groups was in the range of reference values, but in non-smoking and smoking control group that is higher in comparison with patients (respectively 0.97 +/- 0.17 and 0.79 +/- 0.14 [mg/dl] , p = 0.0004; 1.00 +/- 0.14 and 0.78 +/- 0.23 [mg/dl], p = 0.0416). It has been shown 1.5 times higher uric acid concentration in the serum of smoking patients with chronic pancreatitis (245.67 +/- 79.73 micromol/l) compared to non-smoking control group (173.67 +/- 50.08 [micromol/l]). There was a significant difference between the mean value of urea nitrogen (BUN) in terms of the concentration of creatinine (index of BUN/creatinine) in the group of non-smoking healthy persons (13.38 +/- 4.53) and the average index of BUN/creatinine ratio in a group of nonsmoking and smoking patients with pancreatitis (respectively, 2.73 +/- 0.56, p < 0.0001 and 2.40 +/- 0.77, p < 0.0001). The results show that cigarette smoking may be an important factor in potential changes in uric acid levels in patients with chronic pancreatitis. In addition, reduced protein catabolism is the result of progressing exocrine pancreatic dysfunction in both smoking and non-smoking patients with chronic pancreatitis.
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PMID:[Assessment of concentrations of creatinine, uric acid and urea in non-smoking and smoking patients with chronic pancreatitis]. 2450 1

Pancreatitis in children can result from metabolic and toxic risk factors, but the evidence linking these factors is sparse. We review the evidence for association or causality of these risk factors in pancreatitis, discuss management strategies, and their rationale. We conducted a review of the pediatric pancreatitis literature with respect to the following risk factors: hyperlipidemia, hypercalcemia, chronic renal failure, smoking exposure, alcohol, and medications. Areas of additional research were identified. Hypertriglyceridemia of 1000 mg/dL or greater poses an absolute risk for pancreatitis; persistent elevations of calcium are predisposing. Further research is necessary to determine whether end-stage renal disease leads to increased pancreatitis in children similar to adults. It is unknown whether cigarette smoking exposure, which clearly increases risk in adults, also increases risk in children. The role of alcohol in pediatric pancreatitis, whether direct or modifying, needs to be elucidated. The evidence supporting most cases of medication-induced pancreatitis is poor. Drug structure, improper handling of drug by host, and bystander status may be implicated. Other pancreatitis risk factors must be sought in all cases. The quality of evidence supporting causative role of various toxic and metabolic factors in pediatric pancreatitis is variable. Careful phenotyping is essential, including search for other etiologic risk factors. Directed therapy includes correction/removal of any agent identified, and general supportive measures. Further research is necessary to improve our understanding of these pancreatitis risk factors in children.
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PMID:Toxic-metabolic Risk Factors in Pediatric Pancreatitis: Recommendations for Diagnosis, Management, and Future Research. 2721 50


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