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

Sequential changes in pancreatic secretion were evaluated during a 2- to 3-year follow-up study in 8 dogs provided with Thomas gastric and duodenal fistulas. Four animals were given intragastric ethanol (2 g kg-1) daily for 3 years; 4 others served as controls. In alcohol-fed animals: (1) Flow rate and bicarbonate output in response to 1 clinical unit kg-1 hr-1 of secretin were increased at the end of 2 years but not after 1 year of alcohol feeding. (2) At the end of 2 years, the dose-response curve of pancreatic secretion to cholecystokinin was unchanged but the maximal bicarbonate and water secretion in response to high doses of secretin were increased. Modifications (1) and (2) are explained by reduplication of pancreatic ducts secondary to the development of chronic pancreatitis, verified by biopsy. (3) The previous report by our group of an increased cholecystokinin release in the course of chronic alcohol consumption in dogs seems to be attributable to an artefact. This work shows that the pancreatic response to intraduodenal oleic acid is not significantly modifed by 3 years of alcohol feeding.
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PMID:Chronic alcoholism and canine exocrine pancreas secretion. A long term follow-up study. 55 9

In 90 patients pressure measurements in the pancreatic duct (50 cases) and in the common bile duct (20 cases) were performed endoscopically. In the normal pancreas an averaged basis pressure in Wirsung's duct of 22.2 cm H2O was found with a range of 9.6 to 37.0 cm H2O. In two cases of marked chronic pancreatitis and in one case of pancreatic carcinoma the secretion pressure was considerably diminished. The mean basic pressure of the common bile duct amounted to 12.0 cm H2O with a range of 7.3 to 17.0 cm H2O. The pressure values in the duodenum were found to be considerably lower than in the pancreatic duct and the bile duct; they amounted to 5.3 cm H20 with a range of 0.6 to 10.9 cm H20. In both ducts two different patterns of ondulations were found: tracings of slight ondulations, i.e. slow pressure changes with a constant average pressure and tracings of coarse ondulations with quick increase and drop in pressure. It will be discussed, how these findings can be related to physiology and pathophysiology of the pancreatic and biliary duct system. The clinical relevance for detection of excretory insufficiency of the pancreas and of pathologic changes leading to stenosis of the duct system are considered.
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PMID:[Basic pressure in the pancreatic duct and in the bile duct: results from 50 standardized duodenoscopic transpapillary pressure measurements (author's transl)]. 84 Jan 26

A variety of receptors on pancreatic acinar and duct cells regulate both pancreatic exocrine secretion and intracellular processes. These receptors are potential sites of action for therapeutic agents in the treatment of pancreatitis. Cholecystokinin (CCK) receptor antagonists, which may reduce the level of metabolic "stress" on acinar cells, have been shown to mitigate the severity of acute pancreatitis in a number of models. Not all studies have shown a benefit, however, and differences may exist between different structural classes of antagonists. Because increased pancreatic stimulation due to loss of feedback inhibition of CCK has been proposed to contribute to the pain of some patients with chronic pancreatitis, CCK receptor antagonists could also be of benefit in this setting. Somatostatin and its analogs diminish pancreatic secretion of water and electrolytes and have been effective in treating pancreatic fistulas and pseudocysts. These agents are also being evaluated for their ability to reduce pain in chronic pancreatitis (perhaps by reducing ductal pressure by diminishing secretory volume) and mitigating the severity of acute pancreatitis (possibly by reducing the metabolic load on acinar cells). Recently described secretin receptor antagonists may also have therapeutic value as a means of selectively inhibiting pancreatic secretion of water and electrolytes.
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PMID:Receptor strategies in pancreatitis. 134 60

In this study, the effects of chronic water immersion stress on the pancreas were investigated in four groups of rats (each group, n = 9): stress + cerulein group, stress group, cerulein group, and control group. Stress + cerulein rats were treated with water immersion stress for 5 h and two intraperitoneal injections of 20 micrograms/kg body wt of cerulein once a week for 16 weeks. In the macroscopic findings of the pancreas, all rats in the stress+cerulein group exhibited moderate or distinctive congestion of blood vessels, gland atrophy, and fatty changes, while some of them showed bleeding. Microscopically, they all exhibited moderate or severe fibrosis, inflammatory cell infiltration, fatty changes, destruction of lobular architecture, and hemosiderin deposits, while some of them also showed bleeding. The stress group without treatment with cerulein injections showed slight fibrosis, hemosiderin deposits, and bleeding. The cerulein group without stress treatment showed fatty changes, but no inflammatory cell infiltration or fibrosis. In the stress + cerulein group only, the contents of digestive enzymes and protein in the pancreas were approximately 55% lower than those of the control group, whereas those in other groups did not show significant reduction. These findings suggest that stress plays some role in the development of chronic pancreatitis, perhaps by causing circulatory disturbance and blood vessel injury.
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PMID:Effects of stress on the development of chronic pancreatitis. 138 Oct 97

The exocrine pancreas is a gland which secretes water, enzymes and electrolytes into the intestinal lunar. These enzymes for the normal digestion of food and a deficit, whether due to a seduced secretion (chronic pancreatitis, cystic fibrosis), or dysfunction in the chronology of their secretion (following truncal vagotomy) will cause malabsorption which often develops, in clinical terms, into malnutrition sometimes this functional deficit is secondary to other pathologies or surgical operations which alter the digestive tract physiology, preventing the correct combination of nutrients and pancreatic enzymes together with the biliary salts. The outcome is malabsorption, mainly of fast and fat soluble vitamins. As the onset is slow and forms part of a chronic, pathology, diagnosis is difficult, for which reason it is included in the general group of malabsorption due to pancreatic insufficiency or surgical sequelae, finally resulting in pancreatic failure or problems following surgery. The purpose of this publication is to review one by one all the situations in which there is an alteration in the function of the pancreatic enzymes, with emphasis on cases in which a defined malabsorption syndrome will result, and in which the prescription of exogenous pancreatic enzymes will imposiue the picture.
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PMID:[Exocrine pancreatic insufficiency. Organic and functional deficiencies]. 157 5

The ability of the pancreas to regenerate and the effects of trophic hormones on regeneration of the pancreas after partial pancreatectomy are not completely understood. We investigated the effects of the trypsin inhibitor FOY-305 (an agent that stimulates endogenous cholecystokinin) on pancreatic regeneration after partial pancreatectomy in rats. FOY-305 or water was administered for either 13 days or 27 days by gavage feeding, after sham operation or partial pancreatectomy (n = 6 to 8 animals per group). FOY-305 stimulated hypertrophy of the pancreatic remnant at 13 days; prolonged treatment for 27 days produced both hypertrophy and hyperplasia. The magnitude of pancreatic growth after FOY-305 administration was significantly greater at 27 days in the pancreatic remnant than growth of the equivalent pancreatic segment (duodenal and parabiliary) in sham-operated rats treated with FOY-305. Our results suggest that endogenous cholecystokinin released by FOY-305 stimulates regeneration after partial pancreatectomy. The pancreatic remnant is more sensitive to trophic stimulation in comparison to the normal pancreas. FOY-305 may be a useful agent in the treatment of pancreatic insufficiency after extensive subtotal pancreatectomy or chronic pancreatitis.
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PMID:Pancreatic regeneration after partial pancreatectomy. 170 41

The effect of local instillation of alcohol on sphincter of Oddi motor activity was determined by endoscopic manometry. Sphincter of Oddi pressures and motor function were compared in eight cholecystectomized subjects with normal sphincter of Oddi motor function and in four patients with chronic alcoholic pancreatitis. The effect of local instillation of 3 ml of 40% alcohol was compared with water instillation. In cholecystectomized subjects, alcohol produced a significant increase of basal sphincter of Oddi pressure from 21.0 +/- 2.8 mm Hg to 95.8 +/- 83 mm Hg (p less than 0.01) without significant changes in the amplitude, duration, and frequency of phasic contractions. In patients with alcoholic chronic pancreatitis, alcohol instillation resulted in a significant increase of basal sphincter of Oddi pressure from 32.5 +/- 4.8 mm Hg to 225.1 +/- 105 mm Hg without changes in amplitude, duration, and frequency of phasic contractions. Two patients with chronic alcoholic pancreatitis had a tonic contraction of the sphincter of Oddi with transitory and mild epigastric pain. Local instillation of alcohol increases sphincter of Oddi motor activity which may play a role in the pathogenesis of alcoholic pancreatitis.
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PMID:Effect of local instillation of alcohol on sphincter of Oddi motor activity: combined ERCP and manometry study. 191 79

Urinary excretion of lactulose, mannitol, and 3-0-methylglucose, following oral administration (5 g, 5 g, and 2 g, respectively, in 100 ml H2O; 80 ml/m2), has been measured in subjects with cystic fibrosis (CF) (22), Shwachman syndrome (3), chronic pancreatitis (3), and normal controls (46). Mean lactulose excretion was increased 10-fold in CF (p less than 0.001), and two-fold in other disorders associated with pancreatic insufficiency (PI) (p less than 0.05). Mean mannitol excretion was 1.6 times greater in CF (p less than 0.001), compared with controls, but was reduced in other forms of PI (p less than 0.03). The mean lactulose/mannitol excretion ratio was increased in all types of PI (p less than 0.001). There were no significant differences in 3-0-methylglucose excretion. This study confirms the large increase in lactulose absorption recently reported in CF and also demonstrates increased absorption of mannitol; these changes are different than those in other forms of PI. This study provides further evidence for a specific abnormality of the mucosal barrier to the absorption of passively absorbed, water soluble molecules in CF.
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PMID:Active and passive sugar absorption in pancreatic insufficiency. 249 12

Pancreatic function was determined (using the secretin-pancreozymin test) before the use of gluten-free diet in 22 patients with endemic (celiac) sprue. Water and bicarbonate secretion were within normal limits, if anything there was a trend to high-normal values. Remarkable and apparently characteristic for celiac sprue was the only slight contraction of the gallbladder after intravenous injection of submaximal doses of cholecystokinin-pancreozymin (CCK). Secretion of the 3 enzymes amylase, lipase and trypsin was decreased in about one third of cases, the difference relating both to the concentrations and the amount secreted, compared with normal control values was significant (P greater than 0.01). But in no case was the reduced enzyme secretion so marked that one would expect maldigestion. Multivariate non-linear discriminance analysis demonstrated that pancreatic secretion in sprue is quite distinct from that in healthy subjects and those with chronic pancreatitis. It is assumed that there is a pattern of exocrine pancreatic secretion typical for sprue.
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PMID:[Pancreatic secretion in domestic sprue]. 257 24

The term "hemosuccus pancreaticus" was coined by Sandblom in 1970, to describe a syndrome manifested by massive gastrointestinal hemorrhage through the pancreatic duct and the ampulla of water. A case of hemosuccus pancreaticus which had no hematemesis and melena is reported in comparison with two previously experienced cases. A 68-year-old alcoholic man was referred to Eiju General Hospital for poor appetite and occasional colicky pain in left epigastrium. Abdominal angiography and computed tomography revealed an aneurysm at the tail of the pancreas and hemosuccus pancreaticus caused by true aneurysm was strongly suspected. Laparotomy revealed chronic pancreatitis and a pancreatic pseudocyst at the tail of the pancreas that was considered to be the cause of the pain. Resection of pancreatic tail and splenectomy was performed without complication. Histopathological diagnosis of the resected pancreas was chronic pancreatitis. He has complained no abdominal pain and melena for 6 months after operation.
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PMID:[A case of hemosuccus pancreaticus associated with chronic pancreatitis]. 259 8


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