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

The physiology and pathophysiology of the sphincter of Oddi are poorly understood. The relationships of functional disorders of the sphincter to biliary and pancreatic disease and of organic lesions of the papilla to pancreatic inflammatory disease are subjudice to say the least. The efficacy of sphincter section in the treatment of chronic pancreatitis is unproved. Section of the sphincter may be necessary to treat biliary tract pathology but its use should not be routine or indiscriminative since, there is morbidity as well as mortality. Finally, the price of sphincterotomy is: 1. hemorrhage; 2. duodenal perforation; 3. pancreatic duct damage--a. acute pancreatitis; b. chronic pancreatitis; 4. sphincter incompetence--a. common duct regurgitation--cholangitis; b. pancreatic duct regurgitation--pancreatitis; 5. sphincter stenosis--obstructive jaundice; 6. stasis cholecystitis; 7. diarrhea; 8. morbidity 10%; 9. mortality 1.9%.
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PMID:The sphincter of Oddi, sphincterotomy and biliopancreatic disease. 39 44

In a group of 48 patients with chronic pancreatitis the authors investigated the variations of blood insulin content after stimulation with starch and maltose, and compared these changes with the correspondind glycemia values. The two curves, practically matching in normal subjects, tend to diverge considerably in patients with chronic pancreatitis. According to the authors, since the assessment of exocrine pancreas function by common laboratory methods is none too satisfactory, this method may yield better appreciation of extant damage to the pancreas.
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PMID:[Nuclear insulin assay after a starch and maltose load in chronic diseases of the pancreas: a preliminary note (author's transl)]. 39 48

The possibilities for nuclear medical investigation in the retroperitoneal space were extended by the introduction of the scintillation camera with an evaluation system. The diagnostic aid in diseases of the kidney (unilateral and bilateral nephropathies, shock kidney, stenosis of the renal arteries, aortic occlusion), suprarenals (Conn syndrome) and the skeleton of the entire body (diagnosis of metastases and non-malignant bone diseases) are reviewed. Scanning scintigraphy can be used in the identification of lymphnode metastases in negative (198 Au colloid) and positive (67 Ga) tumor contrast and in double radionuclide substraction techniques in pancreatic tumor and chronic pancreatitis. Clinical examples are demonstrated.
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PMID:[Possibilities for nuclear medical investigation in the retroperitoneal space: (author's transl)]. 40 33

A 69-years-old male with a juxtaminorpapillary diverticulum of Santorini in the duodenum and chronic pancreatitis is described. The patient had suffered from attacks of epigastric pain during the last 35 years. At recent admission to hospital he had also an elevated urinary amylase activity and a juxtaminorpapillary diverticulum, demonstrated by duodenoscopy and X-ray examination after administration of a contrast medium. Endoscopic retrograde cholangio-pancreatography (ERCP) showed changes of the pancreatic duct system compatible with chronic pancreatitis, a diagnosis which was confirmed by explorative laparotomy.
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PMID:Juxtaminorpapillary diverticulum associated with chronic pancreatitis. 40 8

The late results of 18 splanchnectomies-principally in chronic pancreatitis-are reported. One patient died during the clinical follow-up treatment. Four patients died later. In the 13 survivors, the observations extended over 5 to 10 years with an average of 7 years after the operation. 11 of them are free from pain.
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PMID:[Resection procedure or splanchnecotomy in chronic pancreatitis. Indications and comparative results (author's transl)]. 41 62

In order to assess the efficiency of ultrasonic diagnosis of the pancreas, echographic findings in 481 patients were compared with the final diagnosis in the case sheets. Agreement between the echographic results and the final diagnosis was found in 94.6% with normal findings, in 77% of patients with pancreatic carcinoma and in 85% of patients with chronic pancreatitis. Altogether we have found agreement between the echographic results and the final diagnosis in 86.6% of all cases referred for diagnosis of the pancreas. The results correspond to the fiqures given by Rettenmaier. With adequate experience ultrasonic diagnosis should therefore be used as early as possible with a broad indication for all diseases of the pancreas.
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PMID:[Echographic diagnosis of the pancreas. Catamnesis of 481 cases (author's transl)]. 41 90

Grey-scale ultrasonography was used in 212 unselected patients in whom the presence or absence of pancreatic disease was subsequently confirmed by other means. Ultrasonographic criteria were established in the first 92 patients and by reference to previous experience. The remaining 120 patients were studied prospectively. The accuracy and clinical impact of the ultrasonographic diagnosis were judged alongside a standard clinical assessment. Clinical diagnoses were tentative and inaccurate. Ultrasound failed in three cases; otherwise it detected all the 33 patients with chronic pancreatic disease and correctly distinguished cancer from chronic pancreatitis. The ultrasonographic diagnosis of a normal pancreas was always correct, but four false-positive diagnoses were made in patients subsequently judged to have no pancreatic disease. Ultrasonography gave more accurate or more confident and accurate information than the clinical assessment in 57 of the 98 patients studied as problems in diagnosis. With this degree of accuracy ultrasonography should be the first imaging investigation in patients suspected of suffering from pancreatic disease. In our gastrointestinal unit the combination of grey-scale ultrasonography with techniques designed to outline the duct systems (such as endoscopic pancreatography) provides precise diagnosis and documentation of pancreatic disease.
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PMID:Prospective study of ultrasonography in chronic pancreatic disease. 42 Sep 99

Anomalous junction of the pancreaticobiliary ductal system (AJPBDS) was found not only in 6 of 28 children with congenital dilatation of the bile duct, but in 3 of 57 children with congenital biliary atresia, in 2 of 17 children with infantile hepatitis and in one child with chronic pancreatitis during the past 17 yr at the Kagoshima University Hospital. A new technique of selective choledochopancreatography has been developed in which the mid-choledochus is clamped and dye is selectively injected into the distal choledochus to demonstrate the pathology of the bile duct. This technique has been successful even in small children when other cholangiographic techniques have failed to show AJPBDS. AJPBDS can be divided into two main types: (1) with biliary tract dilatation and (2) without biliary tract dilatation. The preferred treatment for type 1 is considered to be Roux-en-Y limb hepaticojejunostomy with primary excision of the choledochal cyst in order to prevent reflux of pancreatic juice flow into the choledochus, postoperative gall stone formation, or cancer from arising in the remaining choledochal cyst. Hepatic portocholecystostomy for biliary atresia with patency between gall bladder and papilla duodeni associated with AJPBDS can not be recommended since it may cause dilatation or obstruction of the bile duct postoperatively. Further studies concerning the etiology or therapy for AJPBDS are necessary.
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PMID:Congenital biliary tract dilatation and anomalous junction of the pancreatico-biliary ductal system. 42 74

All confirmed cases of pancreatic carcinoma in bona fida residents of Olmsted County, Minnesota, from 1935 through 1974 were identified and reviewed. The average annual age-adjusted incidence rates were 7.4 for males and 3.5 for females per 100,000 population. Rates increased with age for both sexes and increased slightly over the 40-year period of study, with lower incidence rates observed for rural inhabitants in the first 2 decades. At the time of diagnosis, almost 75% of patients were 60 years of age or older and adenocarcinoma was histologically identified in 92% of the cases. One-year survival was 11%, and all patients died within 3 years of the initial diagnosis. An association between pancreatic carcinoma and diabetes was noted. There does not appear to be a clear association with cholelithiasis or chronic pancreatitis. There was a high percentage (20%) of multiple primary carcinomas and an overrepresentation of metal workers observed among patients with pancreatic carcinoma.
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PMID:Cancer of the pancreas in Olmsted County, Minnesota, 1935-1974. 42 4

Ultrasonically visualized pancreatic ducts seen in patients over two and a half years were reviewed. Pancreatic ducts ranging from 2 to 16 mm were identified in 41 patients. All proved to have pancreatic disease. Of these, 25 had inflammatory disease, including acute pancreatitis, chronic pancreatitis, and pancreatolithiasis, and 16 had ampullary or pancreatic head tumors. There was no correlation between the pancreatic duct diameter and the underlying pathology. A careful search for tumor must be made in all patients in whom the pancreatic duct is demonstrated, using current gray-scale instrumentation.
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PMID:Ultrasonic demonstration of the pancreatic duct: an analysis of 41 cases. 42 48


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