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https://www.readbyqxmd.com/read/28930953/proposed-clinical-pathway-for-nonoperative-management-of-high-grade-pediatric-pancreatic-injuries-based-on-a-multicenter-analysis-a-pediatric-trauma-society-collaborative
#1
Bindi J Naik-Mathuria, Eric H Rosenfeld, Ankush Gosain, Randall Burd, Richard A Falcone, Rajan Thakkar, Barbara Gaines, David Mooney, Mauricio Escobar, Mubeen Jafri, Anthony Stallion, Denise B Klinkner, Robert Russell, Brendan Campbell, Rita V Burke, Jeffrey Upperman, David Juang, Shawn St Peter, Stephon J Fenton, Marianne Beaudin, Hale Wills, Adam Vogel, Stephanie Polites, Adam Pattyn, Christine Leeper, Laura V Veras, Ilan Maizlin, Shefali Thaker, Alexis Smith, Megan Waddell, Joseph Drews, James Gilmore, Lindsey Armstrong, Alexis Sandler, Suzanne Moody, Brandon Behrens, Laurence Carmant
BACKGROUND: Guidelines for nonoperative management (NOM) of high-grade pancreatic injuries in children have not been established, and wide practice variability exists. The purpose of this study was to evaluate common clinical strategies across multiple pediatric trauma centers to develop a consensus-based standard clinical pathway. METHODS: A multicenter, retrospective review was conducted of children with high-grade (American Association of Surgeons for Trauma grade III-V) pancreatic injuries treated with NOM between 2010 and 2015...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28930867/pancreatic-neuroendocrine-tumors-computed-tomography-enhancement-but-not-histological-grade-correlates-with-tumor-aggression
#2
Motoyo Yano, Sunil Misra, Danielle H Carpenter, Amber Salter, Charles F Hildebolt
OBJECTIVES: The aims of this study were to assess computed tomography enhancement of pancreatic neuroendocrine tumors (NETs), determine correlation with histological vascularity and fibrosis, and identify a biomarker for tumor aggression. METHODS: The arterial and venous enhancement of NET was calculated on computed tomography for 56 patients. Tumor size and vascularity/fibrosis were assessed. Tumor aggression was grouped by World Health Organization and Hochwald grade and the presence of metastases...
September 19, 2017: Pancreas
https://www.readbyqxmd.com/read/28930825/acinar-cell-carcinoma-of-the-pancreas-presenting-as-diffuse-pancreatic-enlargement-two-case-reports-and-literature-review
#3
Yaping Luo, Guilan Hu, Yanru Ma, Ning Guo, Fang Li
RATIONALE: Pancreatic acinar cell carcinoma (ACC) is a rare malignant tumor of exocrine pancreas. It is typically a well-marginated large solid mass arising in a certain aspect of the pancreas. Diffuse involvement of ACC in the pancreas is very rare, and may simulate pancreatitis in radiological findings. We report 2 cases of ACC presenting as diffuse enlargement of the pancreas due to tumor involvement without formation of a distinct mass. PATIENT CONCERNS: The patients consisted of a 41-year-old man with weight loss and a 77-year-old man who was asymptomatic...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28929356/a-high-abdominal-aortic-calcification-score-on-ct-is-a-risk-factor-for-postoperative-pancreatic-fistula-in-elderly-patients-undergoing-pancreaticoduodenectomy
#4
Nao Kakizawa, Hiroshi Noda, Fumiaki Watanabe, Kosuke Ichida, Koichi Suzuki, Toshiki Rikiyama
BACKGROUND: To evaluate the clinical significance of a CT-based evaluation of abdominal aortic calcification (AAC) in the postoperative outcomes after pancreaticoduodenectomy (PD) in elderly patients. METHODS: Patients 70 years of age and older who were randomly assigned to Group A were compared with those younger than 70 who were assigned to Group B in terms of preoperative and intraoperative variables and postoperative outcomes. We compared the patients with clinically relevant postoperative pancreatic fistula (CR-POPF) (Group C) to those without CR-POPF (Group D), and especially Group A...
September 19, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28928103/pancreatic-metastasis-from-non-small-cell-lung-cancer-diagnosed-using-endoscopic-ultrasound-guided-fine-needle-aspiration-biopsy-a-case-report
#5
Nobuyasu Kurihara, Hajime Saito, Hiroshi Nanjo, Hayato Konno, Yoshihiro Minamiya
A 56-year-old man presented with a chest computed tomography (CT) finding of a right upper lobe nodule, which was diagnosed using brush cytology as adenocarcinoma stage IB (cT2aN0M0). Repeat CT scan for preoperative evaluation revealed a small, slightly hypodense spot in the pancreatic body, which was diagnosed as pancreatic metastasis from lung cancer using endoscopic ultrasound-guided fine needle aspiration biopsy (EUS-FNAB). Because of the presence of distant metastasis, surgical resection was deferred and chemotherapy was chosen instead...
September 19, 2017: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/28927802/synthesis-and-biological-evaluation-of-an-111-in-labeled-exendin-4-derivative-as-a-single-photon-emission-computed-tomography-probe-for-imaging-pancreatic-%C3%AE-cells
#6
Hiroyuki Kimura, Naotaka Fujita, Kaori Kanbe, Hirokazu Matsuda, Hiroyuki Watanabe, Kenji Arimitsu, Hiroyuki Fujimoto, Keita Hamamatsu, Yusuke Yagi, Masahiro Ono, Nobuya Inagaki, Hideo Saji
A non-invasive method of pancreatic β-cell mass measurement is needed to enhance our understanding of the pathogenesis of diabetes, facilitate the early diagnosis of this disease, and promote the development of novel therapeutics. Here, we described the synthesis of a novel indium-111 ((111)In) exendin-4 derivative, [Lys(12)(In-BnDTPA-Ahx)]exendin-4, through a process involving isothiocyanate-benzyl-DTPA (BnDTPA) and 6-aminohexanoic acid (Ahx) attached to an ɛ-amino group at the lysine-12 residue. We further evaluated the potential use of this derivative as a SPECT probe for pancreatic β-cell imaging...
September 7, 2017: Bioorganic & Medicinal Chemistry
https://www.readbyqxmd.com/read/28927353/recurrent-metastatic-medullary-thyroid-carcinoma-a-case-of-sustained-response-to-prolonged-treatment-with-somatostatin-analogues
#7
Juana María Cano, Rocío Galán, Rafael López
BACKGROUND: Medullary thyroid carcinoma (MTC) is a rare disease. Treatment options for recurrent disease are limited. Somatostatin analogues might have a role as anticancer agents agents in MTC, although the evidence is inconclusive. PATIENT FINDINGS: A 64-year old male was diagnosed with MTC in January 2010. Total thyroidectomy with neck dissection (stage IVA, pT2pN1bM0, R1) was performed, followed by adjuvant locoregional radiotherapy. Two years later, the patient developed recurrent metastatic disease evidenced by elevated carcinoembryonic antigen (CEA) and calcitonin levels, and a positive uptake (Octreoscan®) in the right adrenal gland and pancreatic head...
September 19, 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/28925490/multi-detector-spiral-ct-diagnosis-of-common-bile-duct-ampullary-carcinoma
#8
D-Z Zhao, Y Guo, Y-P Sun, H-M Liu, Z Zhang, Q-L Ma, Y-S Wang, C-L Chen
OBJECTIVE: The aim of this project was to study the imaging characteristics of multi-detector CT (MDCT) in different types of malignant tumor in the common bile duct ampulla. PATIENTS AND METHODS: We examined 30 cases of pancreatic head cancer, 35 of terminal cholangiocarcinoma, 26 of ampullary carcinoma, and 40 of benign lesions, all confirmed by pathology. We used 64-slice spiral CT plain scan and multi-phase enhanced scan with multi-planar reconstruction (MPR) and curved planar reconstruction (CPR) post-processing to obtain three-dimensional images...
August 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28924486/expression-of-transcription-factors-in-men1-associated-pancreatic-neuroendocrine-tumors
#9
Yasutaka Takeda, Yukihiro Fujita, Kentaro Sakai, Tomoe Abe, Tomonobu Nakamura, Tsuyoshi Yanagimachi, Hidemitsu Sakagami, Jun Honjo, Atsuko Abiko, Yuichi Makino, Masakazu Haneda
MEN1-associated pancreatic neuroendocrine tumors (pNETs) may potentially express distinct hormones, but the mechanism has not been elucidated. Transcription factors such as MafA and Pdx1 have been identified to lead to beta cell differentiation, while Arx and Brn4 to alpha cell differentiation in developing pancreas. We hypothesized those transcription factors are important to produce specific hormones in pNETs, similarly to developing pancreas, and examined the expression of transcription factors in a case of MEN1 who showed immunohistological coexistence of several hormone-producing pNETs including insulinoma...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28921102/pancreatic-acinar-cell-carcinoma-with-extensive-tumor-embolism-at-the-trunk-of-portal-vein-and-pancreatic-intraductal-infiltration
#10
Akihiko Kida, Koichiro Matsuda, Kai Takegoshi, Mitsuru Matsuda, Akito Sakai, Yatsugi Noda
A 59-year-old man was admitted to the hospital with acute pancreatitis. The cause was suggested to be a pancreatic tumor based on computed tomography (CT). The pancreatic tumor was 45 mm with an extensive tumor embolism at the trunk of the portal vein and intraductal infiltration of the main pancreatic duct (MPD). The pancreatic tumor was diagnosed as acinar cell carcinoma (ACC) by endoscopic ultrasound guided fine needle aspiration. Therefore, the cause of acute pancreatitis was diagnosed to be intraductal infiltration of ACC in the MPD...
September 18, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28921009/radiation-overexposure-from-repeated-ct-scans-in-young-adults-with-acute-abdominal-pain
#11
Massimo Tonolini, Elena Valconi, Angelo Vanzulli, Roberto Bianco
PURPOSE: The purpose of this study is to assess the dose of ionizing radiation caused by repeated CT scans performed to investigate non-traumatic acute abdominal conditions in young adults. METHODS: Over 26 months, we collected a cohort of patients aged 18 to 45 years who were subject to at least one urgent contrast-enhanced abdomen/pelvis CT. Patients affected with urolithiasis, HIV infection, tumors, and vascular and chronic inflammatory bowel diseases were excluded...
September 18, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28919629/acinar-cell-carcinoma-of-the-pancreas-a-case-report
#12
S Mohammed, M M Chowdhury, A A Ullah, S M Towhid, S A Sobhan, I J Zeba, M M Haque, M T Islam, M Hussain, T K Roy, S R Russel, A M Chowdhury, M K Alam
Acinar cell carcinoma (ACC) of the pancreas is a very rare neoplasm. We report a case of pancreatic acinar cell carcinoma involving the uncinate process of the pancreas. A 45 year old man presented with a painful upper abdominal mass without any jaundice or weight loss. Computed Tomography (CT) and Magnetic Resonance Cholangio-Pancreatography (MRCP) indicated a mass lesion in the uncinate process of the pancreas. He underwent Whipple's procedure (Pancreaticoduodenectomy). Histological slides revealed features of Acinar cell carcinoma (ACC) in the uncinate process of the pancreas and a lymph node...
July 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28919282/impact-of-pancreaticoduodenal-arcade-dilation-on-postoperative-outcomes-after-pancreaticoduodenectomy
#13
Yusuke Nakayama, Motokazu Sugimoto, Tatsushi Kobayashi, Naoto Gotohda, Shinichiro Takahashi, Masahiko Kusumoto, Masaru Konishi
BACKGROUND: The aim of this study was to investigate the impact of pancreaticoduodenal arcade (PDA) dilation on postoperative outcomes after pancreaticoduodenectomy. METHODS: Consecutive patients submitted to pancreaticoduodenectomy between 2008 and 2016 underwent preoperative multi-detector computed tomography, the images of which were re-reviewed. The patients were categorized according to the grade of PDA dilation into 3 groups (remarkably-dilated, slightly-dilated, and non-dilated)...
September 14, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28912819/large-subcapsular-splenic-hematoma-with-a-large-pancreatic-pseudocyst-was-successfully-treated-with-splenic-arterial-embolization-and-ultrasound-guided-percutaneous-drainage-of-pancreatic-pseudocyst
#14
Song Zhang, Fei Liu, Heena Buch, Guifang Xu, Lei Wang
Subcapsular splenic hematoma is a rare complication of pancreatitis. The management for subcapsular splenic hematoma remains controversial. We herein report a case of a large subcapsular splenic hematoma with a large pancreatic pseudocyst, which was successfully treated with splenic arterial embolization and ultrasound- (US-) guided percutaneous drainage of pancreatic pseudocyst, for the first time. A 44-year-old male suffered from recurrent abdominal pain for more than two years. He had previous 3 episodes of pancreatitis...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28906385/percutaneous-intratumoral-injection-of-gemcitabine-plus-cisplatin-mixed-with-fibrin-glue-for-advanced-pancreatic-carcinoma-case-report
#15
Biao Yang, Jian-Ping He, Min-Lan Yuan, Wei Li, He Jiao, Xin You, Xing-Rong Liu, Jian Zhao, Chun-Lin Li, Xiao-Bo Fu, Zheng-Yin Liao, Cheng Yi
RATIONALE: The aim of this study was to determine the effectiveness of intratumoral injection of chemotherapeutics in improving the quality of life and survival of patients with pancreatic carcinoma. PATIENT CONCERNS: We present a case series of 5 patients with unresectable pancreatic adenocarcinoma. DIAGNOSES: Patients diagnosed with unresectable poorly differentiated pancreatic ductal adenocarcinoma by intraoperative frozen biopsyor percutaneous biopsy...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28905804/large-pancreatic-pseudocyst-penetrating-into-posterior-mediastinum
#16
Adam Roman Markowski, Elżbieta Brodalka, Katarzyna Guzinska-Ustymowicz, Konrad Zaręba, Dariusz Cepowicz, Bogusław Kędra
We report a rare case of a large mediastinal pancreatic pseudocyst compressing the left atrium and the esophagus and causing dyspnea, palpitations, and emesis. Chest radiograph was non-diagnostic, esophagogastroduodenoscopy showed diffuse extrinsic compression of the distal esophagus and gastric corpus, but a definitive diagnosis was confirmed by computed tomography. We decided to perform surgery due to the recurrence of the pancreatic pseudocyst, a history of unsuccessful radiologically guided external drainage a few years earlier, and a very large diameter of the pseudocyst causing acute cardio-pulmonary distress syndrome...
August 31, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/28902791/initial-features-of-hepatic-metastases-from-pancreatic-cancer-histological-and-radiolographical-appraisal-of-hepatic-micrometastases-detected-by-real-time-fluorescent-imaging
#17
Tomohiro Katada, Hideki Hashidate, Naoyuki Yokoyama, Natsuru Sudo, Koko Mitsuma, Tetsuya Otani
OBJECTIVE: The pathophysiology of primary-stage hepatic metastases from gastrointestinal cancers may provide clues to their formation. We investigated initial features of hepatic metastases from pancreatic cancer by examining the histologies of radiographically occult hepatic micrometastases. METHODS: We examined 133 consecutive pancreatic cancer patients with no evident hepatic metastases on preoperative imaging. An indocyanine green near-infrared camera system was used to detect hepatic metastases during surgery; preoperatively acquired images of patients were then retrospectively reviewed...
October 2017: Pancreas
https://www.readbyqxmd.com/read/28902738/false-positive-pancreatic-uptake-detected-on-68ga-psma-pet-ct-a-priority-changing-incidental-finding-while-assessing-the-need-for-a-prostate-biopsy
#18
Mehmet Onur Demirkol, Murat Can Kiremit, Omer Acar, Alan Alper Sag, Yersu Kapran
A 72-year-old man underwent Ga-PSMA PET/CT because of an elevated prostate-specific antigen level despite prior prostatectomy. Besides low-intensity prostatic PSMA reactivities, a faintly PSMA-positive lesion in the pancreatic corpus drew attention, which seemed suggestive of a primary pancreatic cancer on the subsequent MRI and therefore had to be excised. The final diagnosis was pT3 low-grade neuroendocrine tumor. PSMA-positive incidentalomas, detected on Ga-PSMA PET/CT, can reveal more clinically significant extraprostatic disorders...
September 11, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28900703/utility-of-18-f-fdg-pet-ct-and-cect-in-conjunction-with-serum-ca-19-9-for-detecting-recurrent-pancreatic-adenocarcinoma
#19
Sampanna Rayamajhi, Aparna Balachandran, Mathew Katz, Arun Reddy, Eric Rohren, Priya Bhosale
PURPOSE: The roles of different cross-sectional imaging in evaluating the recurrence of pancreatic adenocarcinoma are not well established. We evaluated the utility of (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) and contrast-enhanced computed tomography (CECT) in the diagnosis of recurrent pancreatic adenocarcinoma in conjunction with the tumor marker CA 19-9. METHODS: We retrospectively reviewed the records of patients who underwent CECT and FDG PET/CT along with serum CA 19-9 measurement as a follow-up or on a clinical suspicion of recurrent disease after initial surgery for pancreatic adenocarcinoma...
September 12, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28898198/appropriate-interval-for-imaging-follow-up-of-small-simple-pancreatic-cysts
#20
Jordan Menda, Maile E Yoon, Hyo-Chun Yoon
CONTEXT: The frequency at which patients should undergo follow-up imaging of small pancreatic cysts is problematic because different medical societies have different follow-up guidelines. OBJECTIVE: To determine whether short-term follow-up of small pancreatic cysts is necessary to detect pancreatic cancer or cystic neoplasia. DESIGN: We retrospectively reviewed all abdominal magnetic resonance imaging (MRI) studies obtained in a geographically isolated health maintenance organization between January 1, 2012, and December 31, 2014, looking for pancreatic cysts...
2017: Permanente Journal
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