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Acute pancreatitis pain

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https://www.readbyqxmd.com/read/28522785/infeasibility-of-endoscopic-transmural-drainage-due-to-pancreatic-pseudocyst-wall-calcifications-case-report
#1
Andrzej Krajewski, Gustaw Lech, Marcin Makiewicz, Andrzej Kluciński, Monika Wojtasik, Sławomir Kozieł, Maciej Słodkowski
Postinflammatory pancreatic pseudocysts are one of the most common complications of acute pancreatitis. In most cases, pseudocysts self-absorb in the course of treatment of pancreatitis. In some patients, pancreatic pseudocysts are symptomatic and cause pain, problems with gastrointestinal transit, and other complications. In such cases, drainage or resection should be performed. Among the invasive methods, mini invasive procedures like endoscopic transmural drainage through the wall of the stomach or duodenum play an important role...
February 28, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/28516251/-severe-hypertriglyceridemia-diagnostics-and-new-treatment-principles
#2
U Kassner, M Dippel, E Steinhagen-Thiessen
Severe hypertriglyceridemia is defined at a plasma triglyceride (TG) concentration of >885 mg/dl and may result - in particular when clinical symptoms appear before the age of 40 - from "large variant" mutations in genes which influence the function of the lipoprotein lipase (LPL). For diagnosis, secondary factors have to be excluded and treated before further genetic tests are considered. Typical symptoms in almost all patients are recurrent, sometimes severe abdominal pain attacks, which can result in acute pancreatitis, the most important, sometimes life-threatening complication...
May 17, 2017: Der Internist
https://www.readbyqxmd.com/read/28516111/transhiatal-herniation-of-the-pancreas-a-rare-cause-of-acute-pancreatitis
#3
Jeremy Wang, Adarsh M Thaker, Wael Noor El-Nachef, Rabindra R Watson
Transhiatal herniation of the pancreas is rare. Acute pancreatitis secondary to this phenomenon is particularly unusual. A 102-year-old woman presented with 1 day of severe chest pain, vomiting, dyspnea, and diaphoresis. Serum lipase was elevated, and computed tomography angiogram of the chest and magnetic resonance cholangiopancreatography revealed a hiatal hernia containing the pancreas, with associated findings of pancreatitis. Pancreatitis in this setting may be due to repetitive trauma or ischemia from sliding, intermittent folding of the pancreatic duct, or pancreatic incarceration...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28514287/concurrent-igg4-related-tubulointerstitial-nephritis-and-igg4-myeloperoxidase-anti-neutrophil-cytoplasmic-antibody-positive-crescentic-glomerulonephritis-a-case-report
#4
Tao Su, Li Yang, Zhao Cui, Su-Xia Wang, Ming-Hui Zhao
RATIONALE: IgG4-related disease (IgG4-RD) is a newly recognized systemic disease. The typical pathological finding in the kidney is abundant IgG4-positive plasma cell infiltration with characteristic storiform fibrosis in the interstitium. Antibodies of the IgG4 subclass have been linked to certain autoimmune diseases including antiproteinase 3 (PR3) anti-neutrophil cytoplasmic antibody (ANCA) of the IgG4 subclass. Here, we report a rare case of kidney injury with concurrent typical IgG4-related tubulointerstitial nephritis and IgG4 subclass of myeloperoxidase (MPO) ANCA-positive necrotizing crescentic glomerulonephritis...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28512098/a-rare-case-of-thrombotic-microangiopathy-triggered-by-acute-pancreatitis
#5
Kevin Singh, Ahmed Jamal Nadeem, Behzad Doratotaj
Thrombotic microangiopathy (TMA) occurring after acute pancreatitis is rarely described. Without prompt intervention, TMA can be, and often is, lethal, so prompt recognition is important. Here, we present a case of a 61-year-old woman with a history of alcohol misuse who presented with epigastric pain, nausea and vomiting after binge drinking. Elevated serum lipase and imaging were suggestive of acute-on-chronic pancreatitis. Although the patient's symptoms of acute pancreatitis subsided, her anaemia, thrombocytopenia and acute kidney injury worsened...
May 15, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28505667/early-versus-delayed-feeding-in-patients-with-acute-pancreatitis-a-systematic-review
#6
Valerie M Vaughn, Dmitry Shuster, Mary A M Rogers, Jason Mann, Marisa L Conte, Sanjay Saint, Vineet Chopra
Background: Acute pancreatitis is among the most common and costly reasons for hospitalization in the United States. Bowel rest, pain control, and intravenous fluids are the cornerstones of treatment, but early feeding might also be beneficial. Purpose: To compare length of hospital stay, mortality, and readmission in adults hospitalized with pancreatitis who received early versus delayed feeding. Data Sources: MEDLINE via Ovid, EMBASE, the Cochrane Library, CINAHL, and Web of Science through January 2017...
May 16, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28493932/safety-and-tolerability-of-high-dose-ulinastatin-after-2-hour-intravenous-infusion-in-adult-healthy-chinese-volunteers-a-randomized-double-blind-placebo-controlled-ascending-dose-study
#7
Qian Chen, Chaoying Hu, Ye Liu, Yun Liu, Wei Wang, Hongchao Zheng, Lianchen Rong, Jingying Jia, Shixuan Sun, Chen Yu, Yan Mei Liu
Ulinastatin, is a broad-spectrum protease inhibitor purified from human urine, inhibits endogenous proteases such as trypsin, α-chymotrypsin, hyaluronidase, and plasmin. It is widely being used at increasingly higher doses for the treatment of acute or chronic pancreatitis, severe infection, and acute organ failure. We aimed to evaluate the safety and tolerability of high-dose ulinastatin in healthy volunteers in our single center, randomized, double-blind, placebo-controlled, single-dose escalation study...
2017: PloS One
https://www.readbyqxmd.com/read/28482390/-clinical-analysis-of-11-children-with-pancreatic-cystic-fibrosis
#8
G L Wang, C N Zhao, J Zhou, F H Yu, H Q Shen, J Zhang, S Y Zhao, X W Xu
Objective: To increase the recognition of pancreatic cystic fibrosis (PCF) in children and facilitate diagnosing and treatment of this rare entity. Method: This is a retrospective analysis of children who presented to Beijing Children's Hospital affiliated to Capital Medical University from January 2010 to December 2015. We describe their clinical features, laboratory testing and management. Result: Eleven children were diagnosed with PCF by genetic testing or sweat chloride test during these 5 years, including 4 boys and 7 girls...
May 4, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/28480730/choledochocele-as-an-atypical-cause-of-relapsing-acute-pancreatitis-diagnosis-and-endoscopic-treatment
#9
Cristina Saldaña Dueñas, Juan José Vila Costa, Ignacio Fernández-Urién
The choledochocele is a cystic dilatation of the intraduodenal portion of the bile duct and corresponds to the type III biliary cysts in the Todani ´s classification. Eventhough the majority of patients remain asymptomatic they can be an atypical cause of abdominal pain or relapsing acute pancreatitis events. The risk of malignancy is lower than other choledochal cyst (<2,5%). The treatment is based on surgical or new endoscopic techniques of resection. In some of the cases an endoscopic sphincterotomy is the first approach...
May 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28471312/the-scandinavian-baltic-pancreatic-club-sbpc-database-design-rationale-and-characterisation-of-the-study-cohort
#10
Søren S Olesen, Jakob L Poulsen, Asbjørn M Drewes, Jens B Frøkjær, Johanna Laukkarinen, Mikael Parhiala, Iben Rix, Srdan Novovic, Björn Lindkvist, Louise Bexander, Georg Dimcevski, Trond Engjom, Friedemann Erchinger, Ingfrid S Haldorsen, Aldis Pukitis, Imanta Ozola-Zālīte, Stephan Haas, Miroslav Vujasinovic, J Matthias Löhr, Antanas Gulbinas, Nanna M Jensen, Maiken T Jørgensen, Camilla Nøjgaard
OBJECTIVES: Chronic pancreatitis (CP) is a multifaceted disease associated with several risk factors and a complex clinical presentation. We established the Scandinavian Baltic Pancreatic Club (SBPC) Database to characterise and study the natural history of CP in a Northern European cohort. Here, we describe the design of the database and characteristics of the study cohort. METHODS: Nine centres from six different countries in the Scandinavian-Baltic region joined the database...
May 4, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28462914/dynamic-measurement-of-disease-activity-in-acute-pancreatitis-the-pancreatitis-activity-scoring-system
#11
Bechien U Wu, Michael Batech, Michael Quezada, Daniel Lew, Kelly Fujikawa, Jonathan Kung, Laith H Jamil, Wansu Chen, Elham Afghani, Sonya Reicher, James Buxbaum, Stephen J Pandol
OBJECTIVES: Acute pancreatitis has a highly variable course. Currently there is no widely accepted method to measure disease activity in patients hospitalized for acute pancreatitis. We aimed to develop a clinical activity index that incorporates routine clinical parameters to assist in the measurement, study, and management of acute pancreatitis. METHODS: We used the UCLA/RAND appropriateness method to identify items for inclusion in the disease activity instrument...
May 2, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28458836/acute-pancreatitis-caused-by-pancreatic-ischemia-after-tevar-combined-with-intentional-celiac-artery-coverage-and-embolization-of-the-branches-of-the-celiac-artery
#12
Yohei Kawatani, Hirotsugu Kurobe, Yoshitsugu Nakamura, Yuji Suda, Yoshinori Okuma, Shinichiro Sato, Toru Hashimoto, Takaki Hori
Covering and embolizing the celiac artery has been reported to be a relatively safe procedure, owing to the rich collateral pathway between the celiac artery and superior mesenteric artery. A 69-year-old man presented with an aneurysm on the distal descending aorta. The proximity of the aneurysm to the celiac artery origin necessitated covering the artery with a stent graft. Additionally, the celiac trunk was short, increasing the risk for Type II endoleak. The origin of the celiac artery was covered after embolization of the branches of the celiac artery...
February 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28441856/-clinical-value-of-the-early-use-of-ulinastatin-in-patients-with-moderately-severe-or-severe-acute-pancreatitis
#13
J Wang, J Jin, J Huang, D R Li, Y Hao, J D Kong, Z Y Chu, J H Fu, F Huang
Objective: To observe the clinical efficacy and the effects on serum inflammatory factors of early use of ulinastatin in patients with moderately severe or severe acute pancreatitis (MSAP/SAP). Methods: This prospective, randomized, controlled trial was conducted in the First Affiliated Hospital of Soochow University from September 2013 to May 2016. A total of 42 cases were enrolled and assigned into either observation group or conventional treatment group (n=21 each). The conventional treatment group received somatostatin, while the observation group received somatostatin combined with ulinastatin...
April 25, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28438234/significant-radiologic-response-of-pancreatic-metastasis-after-targeted-therapy-of-ceritinib-ldk378-for-alk-rearranged-lung-adenocarcinoma-presenting-with-hyperglycemia
#14
Jing Zheng, Jianya Zhou, Yanping Zhu, Qian Shen, Jianying Zhou
Pancreatic metastasis from non-small cell lung cancer (NSCLC) is usually asymptomatic or presents with abdominal pain, acute pancreatitis, or jaundice. A lung primary is associated with worse survival compared to pancreatic metastases from other organs. Surgical treatment of solitary metastasis to the pancreas from NSCLC has been reviewed in several studies, one of which had a notable disease-free interval. To our knowledge, there are no prior reports of targeted therapy of pancreatic metastasis of NSCLC followed by a significant response...
April 14, 2017: Oncology Research
https://www.readbyqxmd.com/read/28436602/accuracy-of-circulating-histones-in-predicting-persistent-organ-failure-and-mortality-in-patients-with-acute-pancreatitis
#15
T Liu, W Huang, P Szatmary, S T Abrams, Y Alhamdi, Z Lin, W Greenhalf, G Wang, R Sutton, C H Toh
BACKGROUND: Early prediction of acute pancreatitis severity remains a challenge. Circulating levels of histones are raised early in mouse models and correlate with disease severity. It was hypothesized that circulating histones predict persistent organ failure in patients with acute pancreatitis. METHODS: Consecutive patients with acute pancreatitis fulfilling inclusion criteria admitted to Royal Liverpool University Hospital were enrolled prospectively between June 2010 and March 2014...
April 24, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28435316/subanesthetic-ketamine-for-pain-management-in-hospitalized-children-adolescents-and-young-adults-a-single-center-cohort-study
#16
Kathy A Sheehy, Caroline Lippold, Amy L Rice, Raissa Nobrega, Julia C Finkel, Zenaide Mn Quezado
BACKGROUND: Subanesthetic doses of ketamine, an N-methyl-d-aspartate receptor antagonist used as an adjuvant to opioid for the treatment of pain in adults with acute and chronic pain, have been shown, in some instances, to improve pain intensity and to decrease opioid intake. However, less is known about the role of ketamine in pain management in children, adolescents, and young adults. PURPOSE: We examined the effects of subanesthetic ketamine on pain intensity and opioid intake in children, adolescents, and young adults with acute and chronic pain syndromes treated in an inpatient setting...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28431198/serum-amylase-and-lipase-and-urinary-trypsinogen-and-amylase-for-diagnosis-of-acute-pancreatitis
#17
REVIEW
Gianluca Rompianesi, Angus Hann, Oluyemi Komolafe, Stephen P Pereira, Brian R Davidson, Kurinchi Selvan Gurusamy
BACKGROUND: The treatment of people with acute abdominal pain differs if they have acute pancreatitis. It is important to know the diagnostic accuracy of serum amylase, serum lipase, urinary trypsinogen-2, and urinary amylase for the diagnosis of acute pancreatitis, so that an informed decision can be made as to whether the person with abdominal pain has acute pancreatitis. There is currently no Cochrane review of the diagnostic test accuracy of serum amylase, serum lipase, urinary trypsinogen-2, and urinary amylase for the diagnosis of acute pancreatitis...
April 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28414683/recurrent-hypertriglyceridemic-pancreatitis-htgp-and-the-use-of-insulin-drip-as-treatment
#18
T Tran, N Lee
INTRODUCTION: Chronic pancreatitis by definition is a recurrent episode of acute pancreatitis and is commonly associated with alcoholism in the US. Another cause of chronic pancreatitis is hypertriglyceridemia (HTGP);, occurring in 1-5 percent of cases. The incidence of HTGP is higher in patients with diabetes and HIV, usually requiring triglyceride levels > 1000 mg/dL. CASE: A 33 year old man with uncontrolled type 1 diabetes and recurrent pancreatitis, first diagnosed 5 years prior, presented as a transfer from an outside hospital for a recurrent episode of HTGP...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28414668/autoimmune-diabetes-presented-with-diabetic-ketoacidosis-induced-by-immunotherapy-in-an-adult-with-melanoma
#19
A A Alzenaidi, J Dendy, L Rejjal
INTRODUCTION: Immunotherapy has been approved for treatment of melanoma. Autoimmune endocrinopathies have been reported in trials involving immunotherapy but autoimmune diabetes has not been definitively linked to them. Here we describe a case of autoimmune diabetes presenting with DKA after receiving combined immunotherapy with anti-CTLA4 and anti-PD1 monoclonal antibodies. CASE: A 47year old gentleman with metastatic melanoma presented to our institution with confusion, abdominal pain and decreased oral intake...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28408989/timing-of-oral-refeeding-in-acute-pancreatitis-a-systematic-review-and-meta-analysis
#20
Masayasu Horibe, Toshihiro Nishizawa, Hidekazu Suzuki, Kazuhiro Minami, Naohisa Yahagi, Eisuke Iwasaki, Takanori Kanai
BACKGROUND AND AIM: The optimal timing of oral refeeding in acute pancreatitis is unclear. This study aimed to perform a systematic review with meta-analysis of randomized controlled trials (RCTs) that compared early oral refeeding with standard oral refeeding in acute pancreatitis. METHODS: PubMed, the Cochrane library, and the Igaku-Chuo-Zasshi database were searched in order to identify RCTs eligible for inclusion in the systematic review. The weighted mean differences (WMDs) or odds ratios (ORs) with 95% confidence intervals (CIs) were calculated...
December 2016: United European Gastroenterology Journal
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