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Query: UMLS:C0149521 (chronic pancreatitis)
 7,199 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Features of 75 abnormal pancreatograms are analysed. Radiomorphology is conferred with surgical or postmortem findings in all cases. None of the anatomical alterations was found to be specific for any given diseases entity, some consistency was verified however. Solitary stenosis suggests cancer. Diffuse alterations point to chronic pancreatitis. Cave filling is a likely sign of cyst or pseudocyst. Since, however, these features are nonspecific, the diagnosis must be based on clinical data as well.
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PMID:[Diagnostic features of the abnormal endoscopic pancreatogram (author's transl)]. 62 63

In a prospective study of 112 patients suspected of periampullary cancer endoscopic retrograde cholangiopancreatography (ERCP) was successfully performed in 87 patients (78%). Technical failures were due to gastric outlet obstruction in four patients and inability to cannulate the ampulla of Vater in 21 patients. Successfully performed ERCP had both a high sensitivity (92%) and specificity (90%) for periampullary cancer. The few errors in pancreatogram interpretation were due to juxta-ductal cancers and difficulty in differentiating duct changes of cancer from those of chronic pancreatitis. Pancreatic cytology, performed in 21 patients, was reliable, diagnosed two pancreatic cancers when the pancreatogram failed and, if used routinely, assists interpretation of the pancreatogram. Retrograde cholangiography provided a correct diagnosis in six jaundiced patients with normal pancreatograms. Three complications of ERCP occurred in this series.
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PMID:Prospective evaluation of endoscopic retrograde cholangiopancreatography in the diagnosis of periampullary cancers. 63 90

By contract with the National Cancer Institute, the accuracy of diagnostic techniques was assessed in 184 patients suspected of having pancreas cancer. Of 138 patients who were operated upon, 89 were found to have pancreas duct cancer, 30 had cancer of a different site of origin in the head of the pancreas region and in 19 there was no evidence of cancer at operation. All of the 46 patients who were not operated upon, 13 proven to have cancer and 33 patients discharged as free of cancer, were followed in our clinic. The majority of our patients presented with signs and symptoms of biliary obstruction. Computerized transaxial tomography (CTT) gave a "correct" diagnosis in 31 of 33 patients (94%) with proven cancer, there were 2 patients with a false negative report and a false positive diagnosis occurred in 8 of 20 patients (40%) without cancer. Celiac angiography (CA) gave a correct diagnosis in 78 of 94 patients (83%) with cancer, a false negative in 17%, and a false positive in 32%. 76Selenomethionine pancreas scan correctly diagnosed 27 of 36 patients (75%) with cancer, gave a false negative in 25% and a false positive in 31%. Ultrasonography gave a correct diagnosis in 18 of 27 patients with cancer (67%), a false negative in 33% and a false positive in 28%. Endoscopic retrograde cholangiopancreatography diagnosed correctly 8 of 11 cases (73%) of cancer, there were false negative diagnoses in 3 cases (27%) and false positives in 3 of 14 patients (21%). Duodenal aspiration techniques gave a very low percentage of correct diagnoses. Chronic pancreatitis most commonly gave rise to a false positive diagnosis. Serum alkaline phosphatase was elevated in 82% of patients, gave 18% false negatives and 33% false positives. Carcinoembryonic antigen (CEA) was elevated (greater than 2.5 ng/ml) in most of the pancreas cancer patients but also in patients with other cancers and with non-cancerous diseases. In our hands, CTT, CA, alkaline phosphatase, 75Se-methionine and ultrasonography, in descending order, have given the highest percentage of correct diagnoses but false positive and false negative diagnoses prevented any single test from being conclusive.
Cancer 1978 Mar
PMID:The value of diagnostic aids in detecting pancreas cancer. 63 74

Endoscopic retrograde cholangiopancreatography (ERCP) is essential in the diagnosis of pancreatic disease, jaundice and in post-cholecystectomy syndromes, as well as in cases where cholecystography and i.v. cholangiography fail to explain disturbances that strongly suggest bile duct involvement. Its confirmation of clinically established pancreatic disease is much more positive than that given by scintiscanning and multiple superselective arteriography. Unlike the latter, it also permits the differential diagnosis of chronic pancreatitis, cancer of the pancreas, pseudocysts, etc. and distinguishes medical and surgical pancreatitis (stenosis, proteinaceous calculi, and obstructing pseudocysts). Differential diagnosis of progressive jaundice on clinical grounds or with the aid of ordinary means of examination is sometimes unsatisfactory. ERCP clearly distinguishes medical and surgical forms, so that exploratory laparotomy is not needed in subjects with liver-cell forms. It also shows the nature, site and extent of extrahepatic obstruction, and points to the organic cause in 79% of cases of postcholecystectomy syndrome. Right hypochondrial pain or intermittent jaundice and negative cholecystography and i.v. cholangiography is a further indication, since ERCP will reveal disease of the pancreas or bile ducts (cholelithiasis, choledocholithiasis, sclerosing cholangitis, etc). It is also useful in the diagnosis of cirrhosis, abscess, echinococcus cyst and primary or secondary cancer in cases where needle biopsy and-or arteriography are either contra-indicated or inconclusive.
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PMID:[Diagnostic value of retrograde cholangiopancreatography by transendoscopic route]. 66 74

The radiological findings in ERCP in 49 patients (ERP 49 patients and ERC 24 patients) with pancreatic diseases were evaluated blindly (24 patients with chronic pancreatitis and 25 patients with pancreatic cancer as a final diagnosis). Obstructions of the main pancreatic duct were found in 16 out of 24 patients with chronic pancreatitis and in 24 out of 25 patients with pancreatic cancer. Irregularity of obstructions was seen significantly more often in patients with cancer. Cholangiography demonstrated obstructions of the distal part of the common bile duct in both groups of patients, but irregularity of obstructions was exclusively seen in the cancer group. Though characteristic radiological features were demonstrated, a safe diagnosis must probably still rely on biopsy.
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PMID:Endoscopic retrograde cholangio-pancreatography in pancreatic cancer and chronic pancreatitis. Differences in morphologic changes in the pancreatic duct and the bile duct. 70 45

Circulating CEA levels were determined in 102 patients wtih histologically proven pancreatic carcinoma and 26 patients with chronic pancreatitis. In the group with pancreatic carcinoma eleven patients had resectable tumors, the mean CEA in the nonjaundiced patients was 10 +/- 5 ng/ml while the mean value in jaundiced patients in this group was 27 +/- 40. Thirty-four patients with nonmetastatic locally unresectable disease had a mean serum CEA of 25 +/- 52 with a range of 1 to 250 ng/ml. Twenty-one percent had values of 5 ng/ml or less. The mean value in 57 patients with metastatic disease was 97 +/- 194 with a range of 0.05 to 1000 ng/ml and 19 percent had values of 5 ng/ml or less. Survival of patients with locally unresectable or metastatic carcinoma was significantly longer in those patients who had a normal CEA at the time of diagnosis. Circulating CEA in the metastatic group was much lower in patients with nonhepatic metastases as well as in those with well differentiated adenocarcinoma histology. Twenty-three patients with chronic pancreatitis and normal serum bilirubin had a mean CEA value of 5.3 +/- 4 ng/ml with 65% of values being 5 ng/ml or less but the CEA ranged from 4.6 to 27 in three who were jaundiced.
Cancer 1978 Sep
PMID:Circulating carcinoembryonic antigen in pancreatic carcinoma. 70 16

We have analysed retrospectively the pancreatic ultrasound scans (using a bistable machine) in 138 consecutive patients, and have related the results to the clinical status and the final diagnosis in each case. The scans were read without knowledge of the patient's clinical state. When technically unsatisfactory scans were excluded from consideration, the overall diagnostic accuracy of ultrasonography proved to be 82%, with a false positive rate of 8%. The scan was abnormal in all 10 patients with cancer of the pancreas: a positive diagnosis of cancer was made in six. All patients with chronic pancreatitis in relapse had abnormal scans, but in 53% the scans were normal in patients in whom the disease was in clinical remission. In seven patients with chronic pancreatitis who suffered relentless pain, the head of the pancreas was swollen and contained cystic areas or emitted abnormal echoes. In acute pancreatitis ultrasonic scanning proved useful in following the progression of the disease to final resolution, or to development of complicating pseudocyst, abscess, or ascites. Random echoes in the early stages of acute pancreatitis are features of haemorrhagic necrosis. In alcoholic relapsing pancreatitis the persistence of abnormal echoes, disposed linearly along the axis of major ducts, suggests the presence of chronic pancreatitis.
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PMID:Ultrasonic scanning in pancreatic disease. 73 69

In a prospective study of 46 patients with suspected pancreatic disease the provisional diagnoses arrived at independently by isotope scanning (IS), ultrasonography (USS) and computed tomography (CT) have been compared. In the control group, IS and CT were associated with a higher false positive rate than USS; The isotope scan was abnormal in most patients with proven chronic pancreatitis and cancer. The results from USS and CT were similar when structural changes were present. USS was superior in diagnosing pancreatic carcinoma and was a convenient means to follow the progression of acute pancreatitis to final resolution or the development of a pseudocyst. CT proved especially useful in accurately delineating cysts, pseudocysts and calculi prior to planning surgery and in assessing disease in contiguous viscera.
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PMID:A clinical evaluation of isotope scanning, ultrasonography and computed tomography in pancreatic disease. 73 53

A critical "blind" evaluation of 129 randomly selected angiographic examinations was carried out including 37 control patients, 58 patients affected by proven chronic relapsing pancreatitis and 34 patients with cancer of the pancreas. In 48.5% of the control patients a completely normal angiographic picture was found. The false positives were found in 10.8% of chronic pancreatitis and in pancreatic carcinoma in 5.5% of the cases. Equivocal signs were found in 35.2%. The percentage of the false negative results in chronic pancreatitis was 34.4% (of which 8.6% were suggestive of pancreatic cancer). In pancreatic cancer positive results were seen in 70.6% of the cases. The percentage of the false negatives was 26.5% (suggestive of chronic pancreatitis); equivocal signs were found in 2.9% of these patients. Notwithstanding the not-negligible percentage of errors, angiography can be usefully employed in diagnosis of pancreatic disorders.
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PMID:Angiography in chronic pancreatitis and pancreatic cancer. A critical evaluation. 74 14

Pure pancreatic juice was collected from 8 control subjects, 12 patients with chronic pancreatitis and 4 patients with cancer of the pancreas by endoscopic retrograde cannulation of the papilla. Samples were collected at 1 minute intervals for 20 minutes after rapid intravenous injection of secretin (Eisai, 1 U/kg) and for 10 minutes after rapid intravenous injection of CCK-PZ (Boots, 1 U/kg). Determinations of volume, bicarbonate concentration and three hydrolases (amylase, chymotrypsinogen and lipase) were made. Our tentative conclusions are (1) pancreatic enzymes are likely to be affected one after another, not in parallel fashing, in chronic pancreatitis and in cancer of the pancreas, (2) bicarbonate concentration and chymotrypsinogen or lipase are most susceptible in chronic pancreatitis and lipase secretion seems to be more susceptible than other parameters in cancer of the pancreas. Amylase is the least affected enzyme in both pancreatic diseases, and (3) determinations of chymotrypsinogen and/or lipase should be preferably performed among hydrolytic enzymes in the evaluation of exocrine pancreatic function in chronic pancreatitis and cancer of the pancreas.
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PMID:Analysis of human pure pancreatic juice in chronic pancreatitis and cancer of the pancreas. 74 91


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