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Acute pancreatitis pain

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https://www.readbyqxmd.com/read/28921009/radiation-overexposure-from-repeated-ct-scans-in-young-adults-with-acute-abdominal-pain
#1
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/28912191/high-versus-low-energy-administration-in-the-early-phase-of-acute-pancreatitis-goulash-trial-protocol-of-a-multicentre-randomised-double-blind-clinical-trial
#2
Katalin Márta, Anikó N Szabó, Dániel Pécsi, Péter Varjú, Judit Bajor, Szilárd Gódi, Patrícia Sarlós, Alexandra Mikó, Kata Szemes, Mária Papp, Tamás Tornai, Áron Vincze, Zsolt Márton, Patrícia A Vincze, Erzsébet Lankó, Andrea Szentesi, Tímea Molnár, Roland Hágendorn, Nándor Faluhelyi, István Battyáni, Dezső Kelemen, Róbert Papp, Attila Miseta, Zsófia Verzár, Markus M Lerch, John P Neoptolemos, Miklós Sahin-Tóth, Ole H Petersen, Péter Hegyi
INTRODUCTION: Acute pancreatitis (AP) is an inflammatory disease with no specific treatment. Mitochondrial injury followed by ATP depletion in both acinar and ductal cells is a recently discovered early event in its pathogenesis. Importantly, preclinical research has shown that intracellular ATP delivery restores the physiological function of the cells and protects from cell injury, suggesting that restoration of energy levels in the pancreas is therapeutically beneficial. Despite several high quality experimental observations in this area, no randomised trials have been conducted to date to address the requirements for energy intake in the early phase of AP...
September 14, 2017: BMJ Open
https://www.readbyqxmd.com/read/28902786/diagnosing-chronic-pancreatitis-comparison-and-evaluation-of-different-diagnostic-tools
#3
Yama Issa, Hjalmar C van Santvoort, Susan van Dieren, Marc G Besselink, Marja A Boermeester, Usama Ahmed Ali
OBJECTIVES: This study aims to compare the M-ANNHEIM, Büchler, and Lüneburg diagnostic tools for chronic pancreatitis (CP). METHODS: A cross-sectional analysis of the development of CP was performed in a prospectively collected multicenter cohort including 669 patients after a first episode of acute pancreatitis. We compared the individual components of the M-ANNHEIM, Büchler, and Lüneburg tools, the agreement between tools, and estimated diagnostic accuracy using Bayesian latent-class analysis...
October 2017: Pancreas
https://www.readbyqxmd.com/read/28895017/total-pancreatectomy-with-islet-autotransplantation-for-acute-recurrent-and-chronic-pancreatitis
#4
REVIEW
Varvara A Kirchner, Ty B Dunn, Gregory J Beilman, Srinath Chinnakotla, Timothy L Pruett, Joshua J Wilhelm, Sarah J Schwarzenberg, Martin L Freeman, Melena D Bellin
PURPOSE OF REVIEW: The first total pancreatectomy and islet autotransplantation (TP-IAT) was performed for chronic pancreatitis in 1977 with the goal to ameliorate the pain and simultaneously preserve islet function. We reviewed the recent medical literature regarding indications, patient suitability, current outcomes, and challenges in TP-IAT. RECENT FINDINGS: Current indications for TP-IAT include intractable pain secondary to chronic pancreatitis (CP) or acute recurrent pancreatitis (ARP) with failed medical and endoscopic/surgical management...
September 11, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28887258/case-report-severe-acute-type-b-aortic-dissection-complicated-by-acute-pancreatitis
#5
Jin Jie, Wu Yongfa, Wang Yuxin, Liao Mingfang, Qu Lefeng
A 52 year-old man presented with sudden abdominal pain and intermittent vomiting. The patient underwent contrast-enhanced computed tomography scan (CT) and was diagnosed with an acute type B aortic dissection (ABAD) involving the celiac trunk superior mesenteric artery (SMA), and extending to the renal artery. The patient was treated with thoracic endovascular aortic repair (TEVAR). After the procedure, the patient still complained of left upper abdomen abdominal pain, and an abdominal mass was detected on physical examination...
September 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28883232/severe-hypertriglyceridemia-possibly-masked-acute-pancreatitis-and-led-to-a-difficult-diagnosis-in-an-obese-patient-with-ketoacidosis-onset-type-2-diabetes
#6
Midori Fujishiro, Akiko Horita, Hiroshi Nakagawara, Takayuki Mawatari, Yoshifusa Kishigami, Yoshiteru Tominaga, Mitsuhiko Moriyama, Hisamitsu Ishihara
A young obese man with ketoacidosis-onset type 2 diabetes mellitus, associated with severe hypertriglyceridemia, was admitted to a local hospital complaining of abdominal pain. Although the abdominal pain worsened, his serum amylase level remained normal with persistent severe hypertriglyceridemia until the second day of hospitalization. The next day, computed tomography showed severe acute pancreatitis (AP) with serum amylase elevation, while the patient's triglyceride level decreased to 558 mg/dL. He was transferred to our hospital and recovered after intensive care...
September 6, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28877730/pancreas-herniation-into-the-mediastinum-a-case-report
#7
Muhammad Shafiq, Moaviz B Badshah, Maaz B Badshah, Mashood B Badshah, James Watkins
BACKGROUND: Pancreatic tissue found in the mediastinum (both true ectopic and herniated pancreas) is rare. It becomes even more challenging when there are complications associated with this entity. CASE PRESENTATION: We report an unusual case of pancreatic herniation into the mediastinum in a 90-year-old Caucasian female. This patient initially presented with nausea and vomiting associated with abdominal pain. Serum lipase and amylase both were elevated. Computed tomography scan of the chest, abdomen and pelvis revealed a large hiatal hernia with pancreas herniation into the mediastinum, with superimposed acute pancreatitis likely due to gallstone...
September 6, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28851510/early-discharge-in-mild-acute-pancreatitis-is-it-possible-observational-prospective-study-in-a-tertiary-level-hospital
#8
Sheila Serra Pla, Neus Garcia Monforte, Francisco Javier García Borobia, Pere Rebasa Cladera, Juan Carlos García Pacheco, Andreu Romaguera Monzonís, Natalia Bejarano González, Salvador Navarro Soto
BACKGROUND AND AIMS: In acute pancreatitis (AP), first 24 h are crucial as this is the period in which the greatest amount of patients presents an organ failure. This suggests patients with Mild AP (MAP) could be early identified and discharged. This is an observational prospective trial with the aim to demonstrate the safety of early discharge in Mild Acute Pancreatitis (MAP). METHODS: Observational prospective study in a third level single centre. Consecutive patients with AP from March 2012 to March 2014 were collected...
August 5, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28844095/pancreatic-panniculitis-and-polyarthritis
#9
REVIEW
Sebastian Zundler, Deike Strobel, Bernhard Manger, Markus F Neurath, Dane Wildner
PURPOSE OF REVIEW: Polyarthritis can have numerous reasons and may thus constitute a challenge for differential diagnosis. One rare potential reason for sterile polyarthritis is underlying pancreatic disease with systemic hyperlipasemia, most often accompanied by painful skin lesions caused by a subcutaneous inflammatory process known as panniculitis. Systematic evidence on pancreatic panniculitis and polyarthritis is limited, particularly regarding its feature as facultative paraneoplasia with underlying intra- or even extra-pancreatic malignancy...
August 26, 2017: Current Rheumatology Reports
https://www.readbyqxmd.com/read/28837512/the-management-of-acute-pancreatitis-in-the-pediatric-population-a-clinical-report-from-the-naspghan-pancreas-committee
#10
Maisam Abu-El-Haija, Soma Kumar, J Antonio Quiros, Keshawadhana Balakrishnan, Bradley Barth, Samuel Bitton, John F Eisses, Elsie Jazmin Foglio, Victor Fox, Denease Francis, A Jay Freeman, Tanja Gonska, Amit S Grover, Sohail Z Husain, Rakesh Kumar, Sameer Lapsia, Tom Lin, Quin Y Liu, Asim Maqbool, Zachary M Sellers, Flora Szabo, Aliye Uc, Steven L Werlin, Veronique D Morinville
BACKGROUND: While the incidence of acute pancreatitis (AP) in children is increasing, management recommendations rely on adult published guidelines. Pediatric-specific recommendations are needed. METHODS: The NASPGHAN Pancreas committee performed a MEDLINE review using several pre-selected key terms relating to management considerations in adult and pediatric AP. The literature was summarized, quality of evidence reviewed, and statements of recommendations developed...
August 23, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28835974/-hypercalcemic-crisis-and-hypocalcemic-tetany
#11
REVIEW
C Kasperk
A serum calcium level >3.5 mmol/l together with clinical symptoms such as muscle weakness, fatigue, nausea, vomiting, pancreatitis or even coma are characteristic for a hypercalcemic crisis (HC). Primary hyperparathyroidism (1HPT) and malignancy-associated hypercalcemia are the most frequent causal diseases for a HC. The analysis of serum levels for calcium, phosphorous, intact parathyroid hormone, electrophoresis and renal function parameters indicate which further radiological, scintigraphic or serum diagnostic steps are adequate to identify the cause of the patient's acute situation (i...
August 23, 2017: Der Internist
https://www.readbyqxmd.com/read/28835889/grey-turner-s-and-cullen-s-signs-induced-by-spontaneous-hemorrhage-of-the-abdominal-wall-after-coughing
#12
Zhe Fan, Yingyi Zhang
Grey Turner's and Cullen's signs are rare clinical signs, which most appear in patients with severe acute pancreatitis. The present patient complained of abdominal pain after coughing. However, contrast-enhanced CT revealed a hemorrhage of the abdominal wall. Therefore, spontaneous hemorrhage of the abdominal wall was diagnosed. The patient recovered through immobilization and hemostasis therapy. This case report and literature review aims to remind clinicians of manifestations and treatment of spontaneous hemorrhage...
August 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/28826568/acute-hyperlipidemic-pancreatitis-accompanied-by-chylous-ascites-with-normal-amylase-and-lipase-in-pregnancy
#13
Li Yang, Zhiguo Zhao, Kaiming Zhou, Yuling Zhang
Normal serum amylase is uncommon even in acute hypertriglyceridemic pancreatitis (HTGAP). However, normal serum lipase and amylase activity in HTGAP with chylous ascites is exceptionally rare. We report a pregnant woman with HTGAP and chylous ascites that were misdiagnosed. She showed acute abdominal pain and significant systemic inflammatory response, but her serum amylase and lipase levels failed to increase, although ultrasonic imaging finding of the pancreas was normal. Early clinical recognition of chylomicronemia helps clinicians diagnose HTGAP rapidly during pregnancy...
July 2017: Journal of Clinical Lipidology
https://www.readbyqxmd.com/read/28814218/diagnosis-and-management-of-pancreatic-exocrine-insufficiency
#14
Mehrdad Nikfarjam, Jeremy S Wilson, Ross C Smith
In 2015, the Australasian Pancreatic Club (APC) published the Australasian guidelines for the management of pancreatic exocrine insufficiency (http://pancreas.org.au/2016/01/pancreatic-exocrine-insufficiency-guidelines). Pancreatic exocrine insufficiency (PEI) occurs when normal digestion cannot be sustained due to insufficient pancreatic digestive enzyme activity. This may be related to a breakdown, at any point, in the pancreatic digestive chain: pancreatic stimulation; synthesis, release or transportation of pancreatic enzymes; or synchronisation of secretions to mix with ingested food...
August 21, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28808565/acute-pancreatitis-a-7-year-retrospective-cohort-study-of-the-epidemiology-aetiology-and-outcome-from-a-tertiary-hospital-in-jamaica
#15
Gail P Reid, Eric W Williams, Damian K Francis, Michael G Lee
BACKGROUND: Acute pancreatitis (AP) is a significant cause of acute abdominal pain, morbidity and hospitalisation. There was previously a dearth of studies exploring the incidence, risk factors and outcome of AP in the Caribbean region. MATERIALS AND METHODS: All patients with a diagnosis of AP admitted to the University Hospital of the West Indies (UHWI) between 2006 and 2012 were reviewed. The epidemiological profile, risk factors, clinical presentation and outcomes of patients with AP were retrospectively studied...
August 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28791247/the-endovascular-management-of-a-3-5-cm-gastroduodenal-artery-aneurysm-presenting-with-gastritis-and-recurrent-pancreatitis
#16
Baraa Zuhaili, Robert G Molnar, Nitin G Malhotra
Visceral artery aneurysms (VAAs) are a rare entity. Within this subset of aneurysms, gastroduodenal artery (GDA) aneurysms represent an even more rare occurrence. We present a case report of treating GDA aneurysm on semi-elective basis followed by literature review of the clinical presentation and mainstream treatment modalities. GO is a 65-year-old male, with 6-month history of recurrent epigastric pain. He was found to have acute pancreatitis and an adjacent 3.5-cm GDA aneurysm. After conservative treatment of pancreatitis, the aneurysm was treated with coil embolization of the sac and GDA...
July 2017: Avicenna Journal of Medicine
https://www.readbyqxmd.com/read/28790092/abdominal-aortic-aneurysm-in-the-setting-of-clostridium-perfringens-pancreatitis
#17
Paul Anthony Karam, Maitham A Moslim, Woosup Michael Park, Gareth Morris-Stiff
We report a case of a 56-year-old woman who presented with worsening abdominal pain located in the left upper quadrant together with abdominal distention, nausea and anorexia. One month prior to this admission, she had presented and had been diagnosed with concurrent acute pancreatitis and rapidly expanding abdominal aortic aneurysm. The aneurysm was prioritised over the pancreatitis and she underwent uncomplicated endovascular repair. Cross-sectional imaging was consistent with infected pancreatic necrosis and also revealed a large collection located in the anterior pararenal space with extensive gas formation...
August 7, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28761475/the-helminths-causing-surgical-or-endoscopic-abdominal-intervention-a-review-article
#18
REVIEW
Erdal Uysal, Mehmet Dokur
BACKGROUND: Helminths sometimes require surgical or endoscopic intervention. Helminths may cause acute abdomen, mechanical intestinal obstruction, gastrointestinal hemorrhage, perforation, hepatitis, pancreatitis, and appendicitis. This study aimed to determine the surgical diseases that helminths cause and to gather, analyze the case reports, case series and original articles about this topic in literature. METHODS: This study was designed as a retrospective observational study...
April 2017: Iranian Journal of Parasitology
https://www.readbyqxmd.com/read/28755135/macrophage-derived-hmgb1-as-a-pain-mediator-in-the-early-stage-of-acute-pancreatitis-in-mice-targeting-rage-and-cxcl12-cxcr4-axis
#19
Yuhei Irie, Maho Tsubota, Hiroyasu Ishikura, Fumiko Sekiguchi, Yuka Terada, Toshifumi Tsujiuchi, Keyue Liu, Masahiro Nishibori, Atsufumi Kawabata
Extracellular high mobility group box 1 (HMGB1) activates the receptor for advanced glycation end products (RAGE) or Toll-like receptor 4 (TLR4) and forms a heterocomplex with CXCL12 that strongly activates CXCR4, promoting inflammatory and pain signals. In the present study, we investigated the role of HMGB1 in pancreatic pain accompanying cerulein-induced acute pancreatitis in mice. Abdominal referred hyperalgesia accompanying acute pancreatitis occurred within 1 h after 6 hourly injections of cerulein. The anti-HMGB1 neutralizing antibody or recombinant human soluble thrombomodulin (rhsTM), known to inactivate HMGB1, abolished the cerulein-induced referred hyperalgesia, but not pancreatitis itself...
July 28, 2017: Journal of Neuroimmune Pharmacology: the Official Journal of the Society on NeuroImmune Pharmacology
https://www.readbyqxmd.com/read/28751631/medication-as-a-cause-of-acute-pancreatitis
#20
Rupendra Ghatak, Lina Masso, Daniel Kapadia, Zain I Kulairi
BACKGROUND Acute pancreatitis is an inflammatory condition of the pancreas characterized clinically by epigastric abdominal pain and elevated levels of pancreatic enzymes in the blood. Drug-induced pancreatitis has recently gained more attention and as a result, physicians are screening more frequently for medications as a cause of acute pancreatitis. CASE REPORT We report the case of a 74-year-old man with a significant past medical history for coronary artery disease, sleep apnea, and gastroesophageal reflux disease who presented with epigastric pain radiating to the back...
July 28, 2017: American Journal of Case Reports
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