Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0149521 (chronic pancreatitis)
 7,199 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Five cases that illustrate the spectrum of biliary complications of pancreatitis and pancreatic pseudocyst are discussed. Obstructive jaundice, hemobilia, and bilious ascites were the major problems in these five patients. Sonography, transhepatic cholangiogram, endoscopic retrograde cholangiopancreatography, operative cholangiography, and arteriography are important in establishing the diagnosis and planning the treatment. Three patients had biliary obstruction caused by chronic pancreatitis, a pancreatic pseudocyst, or both. Two patients had a fistula between the common duct and the pseudocyst. Simple decompression of the pseudocyst was curative for only one patient. Three patients required decompression of the biliary tract, which emphasizes the need for intraoperative cholangiography. One patient required a Whipple operation to control hemorrhage but died in the immediate postoperative period. The operative findings determine the specific procedures for biliary tract decompression and pseudocyst drainage.
 ...
PMID:Common bile duct complications of pancreatitis evaluation and treatment. 660 May 27

We report 10 children with chronic relapsing pancreatitis. These patients can be divided into three groups, based on their clinical history, manifestations, and radiographic findings. Group 1 includes four patients with hereditary pancreatitis; these patients have had recurrent abdominal pain since early childhood, and have a positive family history for pancreatitis. Group 2 includes two patients with clinical and radiographic findings similar to those in patients with hereditary pancreatitis but without a family history of pancreatitis. Group 3 includes four patients with fibrosing pancreatitis who had symptoms and signs of obstructive jaundice. Our report emphasizes three points: (1) that chronic pancreatitis does occur in young children and is most commonly caused by hereditary pancreatitis or fibrosing pancreatitis; (2) that endoscopic retrograde cholangiopancreatiography is a safe and valuable tool for the study of pancreatic and common bile ducts; and (3) that surgical intervention is indicated to drain the pancreatic duct in patients with hereditary pancreatitis, and sphincterotomy is an effective therapy for patients with fibrosing pancreatitis.
 ...
PMID:Chronic relapsing pancreatitis in childhood. 683 84

Major advances in gastroenterology are due in part to the rapid development of fiberendoscopes. Originally intended to improve gastroenterological diagnostics, the field of application was broadened by a variety of therapeutic procedures which now concur with the corresponding surgical approach. Endoscopic electro- and photocoagulation has considerably improved the outcome of acute gastrointestinal hemorrhage: endoscopic polypectomy is the procedure of choice today in benign and occasionally in malignant bowel tumors. Biliary tract surgery was revolutionized by endoscopic sphincterotomy, offering a low-risk procedure in high-risk patients with common bile duct stones. Endoscopic treatment of chronic pancreatitis by duct occlusion is just the beginning, and the old dream of dissolving gallstones rapidly by perfusing the biliary system with litholytic agents is now reality. Finally, the transhepatic or internal drainage in obstructive jaundice leads to transitory preoperative or permanent relief in malignant blockade of bile flow.
 ...
PMID:New methods in gastroenterology. 700 38

Thirteen patients with resectable pancreatic carcinoma were examined by computed tomography (CT). Nine had a mass, 2 had dilatation of the main pancreatic duct, 1 appeared to have ductal dilatation, and 1 had no sign of abnormality. Resectable carcinoma was diagnosed retrospectively in 8 cases, based on the following criteria: a mass with a distinct contour, frequently containing a tiny or irregular low-density area and accompanied by dilatation of the caudal portion of the main pancreatic duct without involvement of the large vessels, liver, or lymph nodes. Including unresectable cancer, chronic pancreatitis, and obstructive jaundice from causes other than cancer, the false-positive rate was less than 6%. However, a small cancer without change in pancreatic contour is difficult to detect with CT.
 ...
PMID:Computed tomographic appearance of resectable pancreatic carcinoma. 707 99

Fibrosis of chronic pancreatitis can cause obstructive jaundice by compressing the intrapancreatic portion of the common bile duct. The frequency and clinical manifestations of common bile duct stricture from symptomatic chronic pancreatitis have been evaluated in 26 patients undergoing lateral pancreaticojejunostomy for intractable pain between 1974 and 1980. Four patients (15%) had a stricture with partial obstruction of the common duct in addition to pancreatic duct obstruction. Three of the four strictures were identified prior to operation by ERCP. The fourth developed biliary obstruction six months after pancreaticojejunostomy. Slight elevation of alkaline phosphatase was common and occurred in 12 of 22 patients with chronic pancreatitis without biliary obstruction. Alkaline phosphatase was elevated greater than four times normal in three of the four patients with a biliary stricture. Elevation of total and direct serum bilirubin occurred only in patients with stricture of the distal common duct. A waxing and waning picture of jaundice was seen in these four patients. When a fixed smooth stricture of the common duct is demonstrated in a patient with symptomatic chronic pancreatitis, drainage of the biliary tree should be combined with pancreatic duct drainage in order to prevent cholangitis, biliary cirrhosis, diagnostic confusion with pancreatic carcinoma, and persistence of pain.
 ...
PMID:common duct obstruction in patients with intractable pain of chronic pancreatitis. 711 5

Surgical experience with 9 patients with chronic pancreatitis is reviewed. Vague, atypical abdominal pain and obstructive jaundice were the most common form of presentation. Serum amylase was elevated in less than half the patients. Ultrasound, ERCP, and operative cholangiopancreatography were the most helpful studies. Ampullary or intrapancreatic obstruction were the main indications for operation, and, when relieved, resulted in resolution of symptoms for an average followup of 4.4 yr. Patients with familial and recurrent bouts of pancreatitis should be studied with ERCP to determine if an anatomic lesion is present.
 ...
PMID:Surgical implications of chronic pancreatitis. 716 80

Although obstructive jaundice in pancreatic inflammatory disease is being recognized with increased frequency, duodenal obstruction is thought to be unusual. The occurrence of both duodenal and biliary obstruction suggests pancreatic cancer, and has seldom been described in pancreatitis. We report three patients with combined duodenal and biliary obstruction occurring as a complication of chronic pancreatitis. Distinction from carcinoma by barium study or laboratory results alone was not possible; instead, it depended on studies of the common bile duct, exploratory laparotomy in two patients, and follow-up in all three.
 ...
PMID:Duodenal and common bile duct obstruction in pancreatitis simulating carcinoma. 727 92

The serum levels of a poly-[C]-specific acid ribonuclease (RNase) found in the pancreas was measured in 40 normal persons and 137 patients with pancreatic cancer, other cancers, obstructive jaundice, acute pancreatitis or chronic pancreatitis. Serum RNase increased by as much as 800 percent above normal in 69 percent of patients with pancreatic cancer. Analysis of the serum isoenzymes of RNase by isoelectric focusing did not reveal any unique RNases produced by the tumours. In contrast, serum RNase rose in only 8 percent of patients with other cancers, 11 percent of other patients with obstructive jaundice and in no patients with chronic pancreatitis. These data suggest that the finding of increased serum RNase is of adjunctive value inthe diagnosis of pancreatic carcinoma and may be particularly helpful in distinguishing it from other causes of biliary obstruction and from chronic pancreatitis.
 ...
PMID:Sensitivity and specificity of serum ribonuclease in the diagnosis of pancreatic cancer. 735 Aug 42

Common bile duct stricture secondary to chronic pancreatitis is difficult to detect clinically. Surgical bypass is necessary if complications from biliary obstruction develop. In 21 patients operated on between 1968 and 1979, the earliest typical biochemical finding was a persistently elevated serum alkaline phosphatase level. The SGOT level was minimally elevated in seven patients, but did not correlate with changes in the stricture. An increased bilirubin level was noted either during an acute exacerbation of pancreatitis or late in the course of the stricture development, when obstruction was almost complete. Operative cholangiograms taken in 12 of these patients and transhepatic cholangiograms taken in nine demonstrated a stricture of the intrapancreatic bile duct more than 2 cm long. Operations were performed for treatment of obstructive jaundice (11), ascending cholangitis (three), suspected pancreatic cancer (three), and progressive biliary cirrhosis (two). Sphincteroplasty, initially attempted in four patients, uniformly failed to relieve the obstruction due to the length of strictured duct. Satisfactory drainage was obtained for up to ten years with choledochoduodenostomy (12), choledochojejunostomy (three), and cholecystojejunostomy (six).
 ...
PMID:Common duct stricture from chronic pancreatitis. 737 60

Pancreatitis and pancreatic insufficiency have not previously been associated with mucinous cystadenoma of the pancreas. This report describes a patient with a long history of chronic pancreatitis whose course was complicated by obstructive jaundice and cholangitis and pancreatic insufficiency. Endoscopy with retrograde cholangiopancreatography provided the correct diagnosis, and the findings are described.
 ...
PMID:Mucinous cystadenoma of the pancreas. Endoscopy as an aid to diagnosis. 741 18


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>