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Pancreatitis after ERCP

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https://www.readbyqxmd.com/read/28520452/-relapsing-autoimmune-pancreatitis-type-1-case-report
#1
Alena Ondrejková, Bohuslav Kianička, Hana Nechutová, Lukáš Hruška, Ivo Novotný, Miroslav Souček
Autoimmune pancreatitis (AIP) is a rare form of chronic pancreatitis, classified into 2 subtypes - AIP type 1 and AIP type 2. We present a case of a 31-years-old female admitted to our institution with upper abdominal pain and obstructive jaundice. Endoscopic retrograde cholangiopancreatoscopy (ERCP) revealed stenosis of intrapancreatic distal bile duct. Diffuse parenchymal enlargement and typical features of AIP were shown by computed tomography (CT) and endoscopic ultrasonography (EUS). The patient´s serum IgG4 was elevated at 3...
2017: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28512648/revision-of-biliary-sphincterotomy-by-re-cut-balloon-dilation-or-temporary-stenting-comparison-of-clinical-outcome-and-complication-rate-with-video
#2
Gianfranco Donatelli, Jean-Loup Dumont, Fabrizio Cereatti, Thierry Tuszynski, Bertrand Marie Vergeau, Bruno Meduri
Background and study aims Revision of endoscopic retrograde cholangiopancreatography (ERCP) may be necessary following previous biliary endoscopic sphincterotomy for recurrent biliary symptoms related to biliary stone recurrence, cholangitis or post-biliary endoscopic sphincterotomy (bEST) papillary stenosis and cholestasis. The aim of this retrospective study was to evaluate the clinical outcome and complication rate associated with re-cut, balloon dilation and biliary metal stenting in revision ERCP. Patients and methods From January 2010 to January 2015, 139 subjects with stigma of a previous sphincterotomy required a revision ERCP (64 Men/75 Women; mean age 71 years; range 32 - 101 years)...
May 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28506070/hepatic-hematoma-after-ercp-two-new-case-reports
#3
María Del Moral Martínez, Ana Delgado Maroto, María Eloísa Cervilla Sáez de Tejada, Francisco Javier Casado Caballero, Francisco Javier Salmerón Escobar
ERCP is an endoscopic procedure with a complication risk ranging from 2.5 to 8%. The most frequent complications are pancreatitis, cholangitis, hemorrhage or perforation. Hepatic hematoma after ERCP is a potentially serious, rare complication. Not many cases are reported in the literature. We present here two new cases of hepatic hematoma following ERCP along with a review of the literature and possible therapeutic options.
May 16, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28496540/recombinant-factor-viia-use-for-endoscopic-retrograde-cholangiopancreatography-with-sphincterotomy-in-a-patient-with-choledocholithiasis-and-unusual-coagulopathy
#4
Molham Abdulsamad, Pavithra Reddy, Suvarna Guvvala, Anil Dev
Endoscopic retrograde cholangiopancreatography (ERCP) is a procedure that combines the use of endoscopy and fluoroscopy to diagnose and treat pancreaticobiliary disorders. The risks of ERCP include pancreatitis, infection, bleeding and perforation. Bleeding during ERCP typically develops after sphincterotomy, hence patients should be screened and tested for coagulopathy before undergoing ERCP. Coagulopathy is a major risk factor for ERCP-related bleeding. Inherited factor VII (FVII) deficiency is a rare autosomal recessive hemorrhagic disorder that can lead to significant coagulopathy and severe bleeding if not appropriately recognized and treated preoperatively...
April 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28496535/spontaneous-rupture-of-a-choledochal-cyst-during-post-partum-a-rare-presentation
#5
Ashish Gupta, Karikal Chakaravarthi, Lileswar Kaman
With the advent of newer radiological investigations, choledochal cysts are being diagnosed more often in present era. These cysts are commonly diagnosed in early childhood and infancy, although some go undetected to be diagnosed in adulthood. These malformations are associated with multiple complications like cholangitis, jaundice, pancreatitis, rupture or even malignancy. Here we describe a post partum female, who was diagnosed to have choledochal cyst during sixth month of pregnancy. She presented with obstructive jaundice in cholangitis and was subjected to endoscopic retrograde cholangiopancreatography (ERCP) with stenting...
April 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28489835/-knowing-an-infrequent-complication-of-endoscopic-retrograde-cholangiopancreatography
#6
Luis Barreda Cevasco, Javier Targarona Modena, Juan Carlos Marcos Enriquez, Carlos Arroyo Basto, Elizabeth Morón
OBJECTIVE: Describe the clinical and tomographic characteristics in relation to the extra peritoneal distribution of collections and air in patients with periampullary perforation after performing endoscopic retrograde cholangiopancreatography (ERCP) with or without sphincterotomy. MATERIALS AND METHODS: Observational, descriptive study in patients with periampullary perforation after ERCP with or without sphincterotomy, treated in the Pancreas Surgery Service at Edgardo Rebagliati Martins Hospital, Lima, Peru between January 2013 and January 2015...
January 2017: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
https://www.readbyqxmd.com/read/28472195/safety-of-endoscopy-in-cancer-patients-on-antiangiogenic-agents-a-retrospective-multicenter-outcomes-study
#7
Toufic Kachaamy, Digant Gupta, Persis Edwin, Pankaj Vashi
BACKGROUND/AIMS: The use of antiangiogenic agents (AAs) in cancer treatment has increased because they offer survival benefit in combination with cytotoxic chemotherapy. Given their potential to cause gastrointestinal (GI) perforation and bleeding, it is currently recommended that AAs be held for 28 days before and after surgery. However, there are no specific guidelines which address their use around endoscopic procedures because data regarding the safety of endoscopy in cancer patients while on AAs is scarce despite the fact that these patients often require endoscopy...
2017: PloS One
https://www.readbyqxmd.com/read/28465786/analysis-of-the-risk-factors-for-severity-in-post-endoscopic-retrograde-cholangiopancreatography-pancreatitis-the-indication-of-prophylactic-treatments
#8
Hiroshi Matsubara, Fumihiro Urano, Yuki Kinoshita, Shozo Okamura, Hiroki Kawashima, Hidemi Goto, Yoshiki Hirooka
AIM: To determine the risk factors of severe post endoscopic retrograde cholangiopancreatography pancreatitis (sPEP) and clarify the indication of prophylactic treatments. METHODS: At our hospital, endoscopic retrograde cholangiopancreatography (ERCP) was performed on 1507 patients from May 2012 to December 2015. Of these patients, we enrolled all 121 patients that were diagnosed with post endoscopic retrograde PEP. Fourteen of 121 patients diagnosed as sPEP were analyzed...
April 16, 2017: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28455159/metal-versus-plastic-stents-for-anastomotic-biliary-strictures-after-liver-transplantation-a-randomized-controlled-trial
#9
Fernanda Prata Martins, Gustavo Andrade De Paulo, Mônica L C Contini, Angelo Paulo Ferrari
BACKGROUND AND AIMS: biliary anastomotic stricture occurs in 15% to 20% of patients after deceased orthotopic liver transplantation (OLT). Usually treated endoscopically with multiple plastic stents (MPSs), although the use of fully covered self-expandable metal stents (cSEMSs) is emerging. This study aims to compare efficacy and safety of cSEMSs versus MPSs in these patients. METHODS: single center, open-label, randomized clinical trial. Patients were randomized to single cSEMSs for 6 months or to MPS placement, exchanged every 3 months during 1 year...
April 25, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28391672/endoscopic-ultrasound-guided-pancreatic-duct-intervention
#10
REVIEW
Yuto Shimamura, Jeffrey Mosko, Christopher Teshima, Gary R May
Endoscopic ultrasound-guided pancreatic duct intervention (EUS-PDI) is an emerging endoscopic approach allowing access and intervention to the pancreatic duct (PD) for patients with failed endoscopic retrograde pancreatography (ERP) or patients with surgically altered anatomy. As opposed to biliary drainage for which percutaneous drainage is an alternative following failed endoscopic retrograde cholangiopancreatography (ERCP), the treatment options after failed ERP are very limited. Therefore, endoscopic ultrasound (EUS)-guided access to the PD and options for subsequent drainage may play an important role as an alternative to surgical intervention...
March 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/28385584/a-study-of-the-clinical-utility-of-a-20-minute-secretin-stimulated-endoscopic-pancreas-function-test-and-performance-according-to-clinical-variables
#11
Luis F Lara, Morihito Takita, James S Burdick, Daniel C DeMarco, Ronnie R Pimentel, Tolga Erim, Marlon F Levy
BACKGROUND AND AIMS: Direct pancreas juice testing of bicarbonate, lipase, or trypsin after stimulation by secretin or cholecystokinin is used to determine exocrine function, a surrogate for diagnosing chronic pancreatitis (CP). Endoscopic pancreas function tests (ePFTs), where a peak bicarbonate concentration (PBC) ≥80 mEq/L in pancreas juice is considered normal, are now used more frequently. In this ePFT, aspirates start 35 minutes after secretin administration because pancreas output peaks 30 minutes after secretagogue administration...
April 3, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28374181/diclofenac-does-not-reduce-the-risk-of-post-endoscopic-retrograde-cholangiopancreatography-pancreatitis-in-low-risk-units
#12
Mia Rainio, Outi Lindström, Marianne Udd, Johanna Louhimo, Leena Kylänpää
BACKGROUND: Nonsteroidal anti-inflammatory drugs have an inhibitory role in pathogenesis of pancreatitis. Guidelines from the European Society of Gastrointestinal Endoscopy recommend routine rectal administration of 100 mg of diclofenac or indomethacin immediately before or after ERCP for all patients without contraindications. AIMS: Our aim was to evaluate the effect of diclofenac in preventing post-ERCP pancreatitis (PEP) in a high-volume, low-PEP-risk ERCP unit...
April 3, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28364277/pediatric-choledochal-cysts-diagnosis-and-current-management
#13
REVIEW
Kevin C Soares, Seth D Goldstein, Mounes A Ghaseb, Ihab Kamel, David J Hackam, Timothy M Pawlik
Choledochal cysts are rare congenital disorders first described by Vater and Ezler in 1723. Their exact etiology remains incompletely understood; however, an anomalous pancreaticobiliary union (APBDU) and subsequent reflux of biliary contents into the biliary tree are thought to play a role. Accordingly, APBDU-associated choledochal cyst patients are significantly more likely to have evidence of hepatitis, cholangitis or pancreatitis and pathologically confirmed inflammation. In 1977, Todani and colleagues modified the original Alonso-Lej classification to include five types of CC...
June 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28355667/pancreas-divisum-in-children-and-duodenum-preserving-resection-of-the-pancreatic-head
#14
Jiri Snajdauf, Ondrej Petru, Jiri Nahlovsky, Michal Rygl, Barbora Frybova, Jiri Bronsky, Vladimir Mixa, Radan Keil
Introduction A retrospective study was performed to evaluate the clinical features, diagnostic methods, and treatment alternatives in children with pancreas divisum (PD). Materials and Methods Patients who underwent treatment for PD between 1999 and 2014 at our department were evaluated for sex, age, presenting symptoms, physical examination findings, biochemical markers, diagnostic methods, treatment modalities, and results of treatment during follow-up. Results Seven patients who underwent treatment of symptomatic PD were included in the study...
March 29, 2017: European Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28321347/association-of-chronic-pancreatitis-and-malignant-main-duct-ipmn-a-rare-but-difficult-clinical-problem
#15
Zoltán Berger, Hernán De La Fuente, Manuel Meneses, Fernanda Matamala, Makarena Sepúlveda, Claudia Rojas
We report the case of a 70-year-old woman who consulted for recurrent short episodes of mild-to-moderate abdominal pain. Dilated main pancreatic duct was seen on CAT scan and magnetic resonance, with multiple calcifications and intraductal stones, typical in CP. However, for a more pronounced cystic dilatation in the pancreatic head, we could not exclude the coexistence of a main duct IPMN. ERCP was performed, with pancreatic sphincterotomy and extraction of pancreatic stones, but, at the same time, mucin extrusion was seen from the dilated duct through the papilla...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28315036/diagnosing-chronic-pancreatitis
#16
REVIEW
Ahmad Anaizi, Phil A Hart, Darwin L Conwell
Diagnosing CP can range from routine in those with severe disease and obvious calcifications on CT imaging to elusive in those patients with early changes in CP. The workup of suspected CP should follow a progressively noninvasive to more invasive STEP-wise approach in a patient with a suspicious clinical presentation and risk factors that raise their pretest probability of disease. After a thorough history and physical examination, basic laboratories should be obtained such as lipase, amylase, metabolic panel, and indirect PFTs (fecal elastase-1, serum trypsin)...
March 17, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28298192/how-to-select-patients-and-timing-for-rectal-indomethacin-to-prevent-post-ercp-pancreatitis-a-systematic-review-and-meta-analysis
#17
REVIEW
Jianhua Wan, Yuping Ren, Zhenhua Zhu, Liang Xia, Nonghua Lu
BACKGROUND: Acute pancreatitis is a severe complication of endoscopic retrograde cholangiopancreatography (ERCP). Previous meta-analyses have shown that indomethacin effectively prevents this complication; however, the data are limited. We performed a systematic review and meta-analysis to clarify the applications for rectal indomethacin. METHODS: A systematic search was performed in June 2016. Human prospective, randomized, placebo-controlled trials that compared rectally administered indomethacin with a placebo for the prevention of post-ERCP pancreatitis (PEP) were included...
March 15, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/28273606/an-impressive-choledochal-cyst-and-its-surgical-resection
#18
Nhu Thao Nguyen Galván, Kayla Kumm, Dor Yoeli, Ellen Witte, Michael Kueht, Ronald Timothy Cotton, Abbas Rana, Christine A O'Mahony, John A Goss
INTRODUCTION: Choledochal cysts are rare congenital dilations of the biliary tree that can present with non-specific symptoms such as abdominal pain, jaundice, cholelithiasis and pancreatitis. Although most commonly identified in children, they can be found in the adult population. However, because of the non-specific symptoms, this diagnosis may be difficult to make in the adult. A physician therefore must keep this diagnosis within their differential, as it may arise in an unexpected patient population who may present with a convoluted work up...
February 21, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28208000/two-cases-of-plug-or-stone-in-remnant-intrapancreatic-choledochal-cysts-treated-with-endoscopic-retrograde-cholangiopancreatography
#19
Eunbee Kim, Min Ho Kang, Jisun Lee, Hanlim Choi, Jae-Woon Choi, Joung-Ho Han, Seon Mee Park
Incomplete resection of choledochal cysts (CCs) that extend deep into the pancreas can lead to protein plug or stone formation, pancreatitis, and cholangiocarcinoma. We encountered two cases of choledocholithiasis in remnant intrapancreatic CCs (IPCCs), in which the patients exhibited symptoms after 3 and 21 years of cyst excision. A 21-year-old woman who had undergone excision of a CC, as a neonate, presented with epigastric pain. Abdominal computed tomography (CT) revealed stones inside the remnant pancreatic cyst, which were removed by endoscopic retrograde cholangiopancreatography (ERCP), and her symptoms improved...
February 16, 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/28207747/chronic-pancreatitis-multicentre-prospective-data-collection-and-analysis-by-the-hungarian-pancreatic-study-group
#20
Ákos Szücs, Tamás Marjai, Andrea Szentesi, Nelli Farkas, Andrea Párniczky, György Nagy, Balázs Kui, Tamás Takács, László Czakó, Zoltán Szepes, Balázs Csaba Németh, Áron Vincze, Gabriella Pár, Imre Szabó, Patrícia Sarlós, Anita Illés, Szilárd Gódi, Ferenc Izbéki, Judit Gervain, Adrienn Halász, Gyula Farkas, László Leindler, Dezső Kelemen, Róbert Papp, Richárd Szmola, Márta Varga, József Hamvas, János Novák, Barnabás Bod, Miklós Sahin-Tóth, Péter Hegyi
INTRODUCTION: Chronic pancreatitis is an inflammatory disease associated with structural and functional damage to the pancreas, causing pain, maldigestion and weight loss and thus worsening the quality of life. AIMS AND METHODS: Our aim was to find correlations from a multicentre database representing the epidemiological traits, diagnosis and treatment of the disease in Hungary. The Hungarian Pancreatic Study Group collected data prospectively from 2012 to 2014 on patients suffering from chronic pancreatitis...
2017: PloS One
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