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Acute pancreatitis nonsurgical treatment

Niels Teich, Wolfgang Mohl, Bernd Bokemeyer, Burkhard Bündgens, Jürgen Büning, Stephan Miehlke, Dietrich Hüppe, Christian Maaser, Tobias Klugmann, Wolfgang Kruis, Britta Siegmund, Ulf Helwig, Joseph Weismüller, Attyla Drabik, Andreas Stallmach
BACKGROUND AND AIMS: Azathioprine [AZA] is recommended for maintenance of steroid-free remission in inflammatory bowel disease IBD. The aim of this study has been to establish the incidence and severity of AZA-induced pancreatitis, an idiosyncratic and major side effect, and to identify specific risk factors. METHODS: We studied 510 IBD patients [338 Crohn's disease, 157 ulcerative colitis, 15 indeterminate colitis] with initiation of AZA treatment in a prospective multicentre registry study...
January 2016: Journal of Crohn's & Colitis
Massimo Tonolini, Alessandra Pagani, Roberto Bianco
Endoscopic retrograde cholangiopancreatography (ERCP) is currently a primarily therapeutic procedure that is extensively employed to treat several biliopancreatic disorders. Although widely considered a safe procedure, ERCP is associated with a non-negligible morbidity and occasional mortality. Due to the number and complexity of operative ERCPs performed, radiologists are increasingly faced with urgent requests for investigation of suspected post-procedural complications, which often have similar clinical and laboratory manifestations...
June 2015: Insights Into Imaging
Badereddin Mohamad Al-Ali, Felix Thimary, Karl Pummer
Radical open nephrectomy is considered the standard treatment for kidney tumors or masses greater than 10 cm. We present a rare case of acute pancreatitis that occurred after right radical transperitoneal nephrectomy, which was treated by nonsurgical conservative interventions. The incidence of acute pancreatitis after renal surgery is not known in the literature. A 56-year-old man developed acute pancreatitis postoperatively after radical transperitoneal nephrectomy. An initial CT scan showed an enlarged pancreas with hypodense, heterogeneous consistency and with peripancreatic, perihepatic, mesenteric, and pelvic fluid collections...
2012: Central European Journal of Urology
Isabel Pascual, Luis Sabater, Ramón Añón, Julio Calvete, Gema Pacheco, Elena Muñoz, Javier Lizarraga, Juan Sastre, Andrés Peña, Francisco Mora, Jaime Pérez-Griera, Joaquin Ortega, Adolfo Benages
OBJECTIVES: This study aimed to compare primary surgical versus nonsurgical treatment in a series of patients with infected pancreatic necrosis (IPN) and to investigate whether the success of nonsurgical approach is related to a less severe disease. METHODS: Thirty-nine consecutive patients with IPN have been included and further subdivided into two groups: primary surgical (n = 21) versus nonsurgical (n = 18). Outcome measures were the differences in mortality, morbidity, and pancreatic function...
September 2013: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Nikhil Nadkarni, Sanjay D'Cruz, Ravinder Kaur, Atul Sachdev
OBJECTIVES: Surgery is the mainstay treatment of emphysematous pancreatitis (EP). The aim of the present study was to assess the outcomes of patients with EP managed nonsurgically. METHODS: The patients with EP without organ dysfunction were managed nonsurgically with antibiotic therapy, nutritional support, and if required radiological drainage. The main outcome measure was survival. RESULTS: Nine patients were diagnosed with EP. They had computed tomographic severity index of 10, APACHE score of 11 (±3...
July 2013: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
Zachary R Heeter, Ellen Hauptmann, Robert Crane, Mehran Fotoohi, David Robinson, Justin Siegal, Richard A Kozarek, Michael Gluck
PURPOSE: Pancreaticocolonic fistulas (PCFs) are uncommon complications of acute necrotizing pancreatitis (ANP). Studies advocating primary surgical treatment showed severe morbidity and mortality with nonsurgical treatment, with survival rates of approximately 50%. However, a nonsurgical treatment scheme with primary percutaneous drainage and other interventions may show improved outcomes. This retrospective single-center study describes the presentation, diagnosis, course, treatment strategy, and outcome of successfully treated PCFs, with an emphasis on nonsurgical interventions...
January 2013: Journal of Vascular and Interventional Radiology: JVIR
Marc D Trust, Kristin M Sheffield, Casey A Boyd, Jaime Benarroch-Gampel, Dong Zhang, Courtney M Townsend, Taylor S Riall
BACKGROUND: The recommended therapy for mild gallstone pancreatitis is cholecystectomy on initial hospitalization. METHODS: Using a 5% national Medicare sample (1996-2005), we evaluated adherence to current recommendations for gallstone pancreatitis (cholecystectomy rates on initial hospitalization and the use of endoscopic retrograde cholangiopancreatography [ERCP]/sphincterotomy). We evaluated predictors of cholecystectomy, gallstone-related readmissions, and 2-year mortality...
September 2011: Surgery
Hyung Seok Nam, Gwang Ha Kim, Dong Uk Kim, Mun Ki Choi, Yang Seon Yi, Jong Min Hwang, Suk Kim
Endoscopic retrograde biliary drainage (ERBD) is useful for the palliative decompression of biliary obstruction. However, the complications of ERBD include cholangitis, hemorrhage, acute pancreatitis, obstruction of the stent, and duodenal perforation. Pressure necrosis on the duodenal mucosa by the stent may contribute to perforation. Although duodenal perforation following ERBD is very rare compared to other complications, it can result in a fatal outcome. Recent reports describe nonsurgical treatment for small gastrointestinal perforation with localized peritonitis and suggest that endoclipping may be appropriate in the management of a well selected group of patients with iatrogenic perforation...
February 2011: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
Michelangelo Miccini, Stefano Amore Bonapasta, Matteo Gregori, Marco Bononi, Vittorio Fornasari, Adriano Tocchi
BACKGROUND: Transduodenal sphincterotomy (TS) has fallen into disuse since endoscopists developed techniques to treat sphincter problems nonsurgically. However, some patients experience recurrent sphincter strictures after endoscopic sphincterotomy (ES), with the ampulla endoscopically inaccessible, and pancreas divisum (PD); these patients are referred to a surgeon because they are unsuitable for ES. METHODS: The medical records of patients who underwent TS at the First Department of Surgery of the Medical School, University of Rome "La Sapienza," between January 1997 and December 2005 were reviewed...
August 2010: American Journal of Surgery
Branislav Stefanović, Branislava Stefanović, Srdjan Mijatović, Dejan Radenković, Nada Popović, Ana Sijacki, Vesna Lacković
BACKGROUND: Recently, a growing number of case reports and case series have suggested that the use of recombinant activated factor VII (rFVIIa) may be effective in treatment of patients with non-hemophilic acquired coagulopathy not responding to conventional treatment such as major surgery, major trauma, sepsis, necrotizing pancreatitis and bleeding due to cerebral arteriovenous malformations. CASE REPORT: We presented a septic patient with massive, life-threatening bleeding caused by retroperitoneal necrosis, due to severe acute necrotizing pancreatitis...
November 2009: Vojnosanitetski Pregled. Military-medical and Pharmaceutical Review
Holly L Spraker, Georgios P Spyridis, Ching-Hon Pui, Scott C Howard
Treatment with asparaginase for acute lymphoblastic leukemia can cause acute pancreatitis. Complication of pancreatitis by pancreatic pseudocyst formation can prolong the hospital stay, delay chemotherapy, and necessitate long-term parenteral nutrition. We report 5 children with acute lymphoblastic leukemia who developed acute pancreatitis complicated by pancreatic pseudocysts. They required modifications to their chemotherapy regimen and prolonged parenteral nutrition but no surgical intervention. All 5 patients survive in first remission and their pseudocysts resolved after 3 to 37 months or continued to decrease in size at last follow-up...
December 2009: Journal of Pediatric Hematology/oncology
V Becker, W Huber, A Meining, C Prinz, A Umgelter, L Ludwig, M Bajbouj, J Gaa, R M Schmid
BACKGROUND: Infection of pancreatic necrosis is a life-threatening complication during the course of acute pancreatitis. In critically ill patients, surgical or extended endoscopic interventions are associated with high morbidity and mortality. Minimally invasive procedures on the other hand are often insufficient in patients suffering from large necrotic areas containing solid or purulent material. We present a strategy combining percutaneous and transgastric drainage with continuous high-volume lavage for treatment of extended necroses and liquid collections in a series of patients with severe acute pancreatitis...
2009: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Michael D Johnson, R Matthew Walsh, J Michael Henderson, Nancy Brown, Jeffrey Ponsky, John Dumot, Gregory Zuccaro, John Vargo
GOALS: Compare patient characteristics and outcome and also physician referral patterns between surgically and nonsurgically managed patients with pancreatic pseudocysts. BACKGROUND: Treatment of pancreatic pseudocysts can be accomplished by surgical, endoscopic, or percutaneous procedures. The ideal treatment method has not yet been defined. PATIENTS: All patients treated for pancreatic pseudocyst between 1999 and 2005 were identified in our health services database...
July 2009: Journal of Clinical Gastroenterology
Guillaume Ducarme, Paul Châtel, Arnaud Alves, Pascal Hammel, Dominique Luton
INTRODUCTION: Acute pancreatitis during pregnancy is a severe disease with a high materno-fetal mortality, which recently decreased because of earlier diagnosis and improvement in maternal and neonatal intensive care. CASE: We describe a 19-year-old woman who presented at 37 weeks gestation with acute abdominal pain and attacks of vomiting. Obstetrical and fetal examinations were normal. Biochemical investigations and magnetic resonance imaging showed a gallstone migration with necrotizing pancreatitis (Balthazar 5 points)...
April 2009: Archives of Gynecology and Obstetrics
Kai-hong Huang, Ping Lin, Sheng-li Nie, Jian-hua Liu, Ling-yun Wang, Qi-kui Chen, Zhao-hua Zhu
OBJECTIVE: To explore the clinical characteristics and pathogenetic patterns of acute pancreatitis (AP) in Guangdong region. METHODS: Analysis and summary of the clinical data of 1316 AP patients admitted into the Sun Yat-sen Memorial Hospital of Sun Yat-sen University and the Guangdong Provincial People's Hospital between 1986 and 2005 were made. RESULTS: The AP rates among 1986 - 1990, 1991 - 995, 1996 - 2000, 2001 - 2005 year subsections were 0...
October 2007: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
R M Dravid, R E Paul
Interpleural blockade is effective in treating unilateral surgical and nonsurgical pain from the chest and upper abdomen in both the acute and chronic settings. It has been shown to provide safe, high-quality analgesia after cholecystectomy, thoracotomy, renal and breast surgery, and for certain invasive radiological procedures of the renal and hepatobiliary systems. It has also been used successfully in the treatment of pain from multiple rib fractures, herpes zoster, complex regional pain syndromes, thoracic and abdominal cancer, and pancreatitis...
October 2007: Anaesthesia
Kaori Ito, Alexander Perez, Hiromichi Ito, Edward E Whang
BACKGROUND: Nonsurgical interventions are increasingly applied for pancreatic pseudocysts. We hypothesized that surgical therapy applied after failure of percutaneous or endoscopic therapies for pseudocysts is associated with poorer outcomes than cases in which surgery is the initial intervention. MATERIALS AND METHODS: Medical records of all 284 patients admitted with pancreatic pseudocysts at our institution (1/1990-9/2005) were analyzed. Forty-six patients underwent surgery as the initial intervention (group A)...
October 2007: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Generoso Uomo
No abstract text is available yet for this article.
2007: JOP: Journal of the Pancreas
Jun Kyu Lee, Kyeong Keun Kwak, Joo Kyung Park, Won Jae Yoon, Sang Hyub Lee, Ji Kon Ryu, Yong-Tae Kim, Yong Bum Yoon
OBJECTIVES: We conducted this study to evaluate the efficacy of nonsurgical treatment for patients with infected pancreatic necrosis (IPN). METHODS: Among 224 patients with acute pancreatitis from 2000 to 2004, there were 31 patients diagnosed as having IPN complication. The diagnostic criteria for IPN were either a positive culture or free gas in the pancreas of patients with acute pancreatic necrosis. Nonsurgical management including percutaneous drainage or endoscopic drainage (ED) followed by vigorous irrigation was initially attempted in all patients...
May 2007: Pancreas
Chong-U Cheang, Sai-Wai Ho, Yi-Torng Tee, Chi-Feng Su, Gin-Den Chen
OBJECTIVE: Abruptio placentae induced by acute pancreatitis during pregnancy is very rare. We present a pregnant woman with a series of complications due to acute necrotizing pancreatitis. CASE REPORT: Presented herein is a 21-year-old, nulliparous woman at 33 weeks' gestation. The initial episode of abdominal pain was thought to be acute appendicitis (which in actuality was identified to be acute pancreatitis) and was complicated with abruptio placentae, uteroplacental apoplexy, and intrauterine fetal demise...
March 2007: Taiwanese Journal of Obstetrics & Gynecology
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