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chronic calcific pancreatitis

Nitin R Gaikwad, Sudhir J Gupta, Amol R Samarth, Tushar H Sankalecha
Synchronous appearance of the primary gastrointestinal malignancies is rare. Coexistence of primary pancreatic and hepatocellular carcinoma as synchronous malignancy is even rarer. We report a case of such combination in a 50 year old female who presented with bleeding per rectum and while evaluating we found simultaneous appearance of primary malignancies of pancreas, liver and solitary colonic metastasis from the pancreas in the background of chronic calcific pancreatitis. To the best of our knowledge this combination of synchronous pancreatic and hepatocellular carcinoma and colonic metastasis from the pancreas is unique...
October 2016: Journal of the Association of Physicians of India
Amit Shrivastava, Jagadeesh Singh Rampal, D Nageshwar Reddy, Guduru Venkat Rao
BACKGROUND: Gastro-Intestinal bleeding remains a frequent clinical dilemma and common cause of hospitalization, morbidity and mortality. CASE REPORT: We report a case of pseudo aneurysm of splenic artery developed after an episode of acute on chronic pancreatitis which was treated by direct percutaneous puncture of pseudoaneurysm and embolization by coils. CONCLUSIONS: The aim was to preserve the main splenic artery and avoid the complications of splenic artery embolization like infarcts and abscess...
2016: Polish Journal of Radiology
C Mel Wilcox, Bimaljit S Sandhu, Vikesh Singh, Andres Gelrud, Judah N Abberbock, Stuart Sherman, Gregory A Cote, Samer Al-Kaade, Michelle A Anderson, Timothy B Gardner, Michele D Lewis, Christopher E Forsmark, Nalini M Guda, Joseph Romagnuolo, John Baillie, Stephen T Amann, Thiruvengadam Muniraj, Gong Tang, Darwin L Conwell, Peter A Banks, Randall E Brand, Adam Slivka, David Whitcomb, Dhiraj Yadav
OBJECTIVES: Racial differences in susceptibility and progression of pancreatitis have been reported in epidemiologic studies using administrative or retrospective data. There has been little study, however, on the clinical profile, causes, and outcome of chronic pancreatitis (CP) in black patients. METHODS: We analyzed data on black patients with CP prospectively enrolled in the multicenter North American Pancreatitis Studies from 26 US centers during the years 2000-2014...
October 2016: American Journal of Gastroenterology
Keita Kanai, Masahiro Maruyama, Fumiko Kameko, Kenji Kawasaki, Junpei Asano, Takaya Oguchi, Takayuki Watanabe, Tetsuya Ito, Takashi Muraki, Hideaki Hamano, Akihiro Matsumoto, Norikazu Arakura, Shigeyuki Kawa
OBJECTIVES: Because several studies for autoimmune pancreatitis (AIP) have revealed pancreatic calcification resembling that in chronic pancreatitis (CP), we sought to clarify whether AIP could transform into chronic features similar to advanced CP with severe pancreatic dysfunction. METHODS: Pancreatic functions of 92 AIP patients, 47 definite CP patients, and 30 healthy controls were assessed by fecal elastase-1 concentration (FEC), fasting immunoreactive insulin (IRI), and homeostatic model assessment (HOMA)-R...
September 2016: Pancreas
Surinder S Rana, Arvind Dambalkar, Puneet Chhabra, Ravi Sharma, Ritambhra Nada, Vishal Sharma, Satyavati Rana, Deepak K Bhasin
BACKGROUND: Although exocrine pancreatic insufficiency (EPI) has been reported in a number of patients with celiac disease (CD), it is not clear if this is primarily a functional or a structural defect. We studied pancreatic structural abnormalities by endoscopic ultrasound (EUS) in adult CD patients with EPI. METHODS: Pancreatic exocrine function was prospectively assessed in 36 recently diagnosed CD patients (mean age: 29.8 years) by measuring fecal elastase. Pancreatic structural changes were assessed in CD patients with EPI by EUS and elastography...
July 2016: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
Robert A Moran, Robert Klapheke, Niloofar Y Jalaly, Martin A Makary, Kenzo Hirose, Michael Goggins, Laura Wood, Daniel A Laheru, Anne Marie Lennon, Mouen A Khashab, Vikesh K Singh
Contrary to patients with a cationic trypsinogen gene (PRSS1) mutations, Serine protease inhibitor Kazal-type 1 (SPINK1) heterozygote gene mutation carriers have a very low penetrance for acute, acute recurrent and/or chronic pancreatitis. Despite this, heterozygote SPINK 1 gene mutation patients have a similar age of onset of pancreatitis as PRSS 1 gene mutation patients. While the substantially elevated risk of pancreatic cancer in patients with PRSS1 gene mutations with chronic pancreatitis has been well established, little is known about the risk of pancreatic cancer in SPINK 1 gene mutation carriers with pancreatitis...
September 2016: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Eiji Matsusue, Yoshio Fujihara, Kazunori Maeda, Masaru Okamoto, Atsushi Yanagitani, Kiwamu Tanaka, Kazuhiko Nakamura, Toshihide Ogawa
A rare complication of acute or chronic pancreatitis is the formation of a mediastinal pancreatic pseudocyst (MPP), which is caused by tracking of pancreatic fluids through anatomical openings of the diaphragm into the mediastinum. Herein, we report the imaging characteristics of three cases of this condition. Our results revealed three features in common: (i) the connection between the mediastinum and the pancreatic cystic lesion; (ii) the presence of pleural effusions; and (iii) imaging findings consistent with chronic pancreatitis, such as pancreatic atrophy and calcifications and dilatation and/or stricture of main pancreatic duct (MPD)...
June 2016: Acta Radiologica Open
J Enrique Domínguez Muñoz, Alfredo José Lucendo Villarín, L Fernando Carballo Álvarez, Jose María Tenías, Julio Iglesias García
OBJECTIVE: To estimate the incidence of chronic pancreatitis in Spain as diagnosed with endoscopic ultrasound (EUS), and to assess the risk factors and complications detected. MATERIAL AND METHOD: A descriptive, observational study of chronic pancreatitis cases diagnosed in Spanish health care centers with an EUS unit. A structured questionnaire was used to evaluate the incidence of the disease (cases identified over 18 months: from January 2011 to June 2012), risk factors, EUS criteria, Rosemont classification, and frequency of local complications...
July 2016: Revista Española de Enfermedades Digestivas
Gürhan Şişman, Emine Köroğlu, Yusuf Erzin, İbrahim Hatemi, Murat Tuncer, Hakan Şentürk
BACKGROUND/AIMS: There are no clinical data available about chronic pancreatitis (CP) on a series of patients of sufficient number in Turkey. In this study, the etiology and clinical features of CP were evaluated in one center, which is a tertiary referral hospital. MATERIALS AND METHODS: The files of 168 patients who had been diagnosed with CP in our Medical Faculty between October 2007 and May 2013 were retrospectively analyzed. The etiological factors, symptoms, complications, and treatment methods were analyzed...
May 2016: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
Nima Hafezi-Nejad, Vikesh K Singh, Stephen I Johnson, Martin A Makary, Kenzo Hirose, Elliot K Fishman, Atif Zaheer
Chronic pancreatitis (CP) is an irreversible, inflammatory process characterized by progressive fibrosis of the pancreas that can result in abdominal pain, exocrine insufficiency, and diabetes. Inadequate pain relief using medical and/or endoscopic therapies is an indication for surgery. The surgical management of CP is centered around three main operations including pancreaticoduodenectomy (PD), duodenum-preserving pancreatic head resection (DPPHR) and drainage procedures, and total pancreatectomy with islet autotransplantation (TPIAT)...
October 2016: Abdominal Radiology
I V Maev, Yu A Kucheryavyi, D N Andreev, T V Bideeva
Chronic pancreatitis (CP) is an inflammatory disease of the pancreas, accompanied by damage to the functioning parenchyma and ducts to develop irreversible structural changes (fibrosis, calcification) and irreparable loss of the endocrine and exocrine functions of this organ. Maldigestion is a typical outcome of CP of any etiology with a long-term history. Fat malabsorption is considered as a basis for malnutrition in patients with CP. The severity of malnutrition in patients with CP correlates with three major pathogenetic factors: primary nutrient deficiency, pancreatic maldigestion and secondary malabsorption syndrome (nutrient loss), hypermetabolism that is caused by an inflammatory process in the pancreas and that determines the severity of the disease...
2016: Terapevticheskiĭ Arkhiv
Benjamin R Biteman, Jeffrey N Harr, Fred Brody
INTRODUCTION: Chronic pancreatitis is a painful inflammatory disease that leads to progressive and irreversible destruction of pancreatic parenchyma [1]. A lateral pancreaticojejunostomy, also known as the Puestow procedure, is performed for symptomatic chronic pancreatitis associated with a dilated pancreatic duct secondary to calcifications or strictures [4]. An open approach is used traditionally due to the complexity of the case, and there have only been a handful of laparoscopic case reports [2]...
April 29, 2016: Surgical Endoscopy
Agnieszka Magdalena Rygiel, Małgorzata Wojnicka-Stolarz, Katarzyna Niepokój, Grzegorz Oracz, Jerzy Bal, Katarzyna Wertheim-Tysarowska, Krzysztof Gutkowski
Chronic pancreatitis (CP) is characterized by progressive damage to the exocrine and endocrine cell structures and pancreatic ducts with subsequent fibrosis of the organ. Patients with no apparent etiological factor are classified as having idiopathic CP (ICP). Genetic studies indicate the importance of mutations in the serine protease inhibitor, Kazal type 1 gene (SPINK1) in the pathogenesis of CP This report describes a case of a 29-year-old Polish-Vietnamese patient with the p.Asn34Ser (p.N34S) homozygous mutation in the SPINK1 gene...
July 2015: Developmental Period Medicine
Guru Trikudanathan, Jose Vega-Peralta, Ahmad Malli, Satish Munigala, Yusheng Han, Melena Bellin, Usman Barlass, Srinath Chinnakotla, Ty Dunn, Timothy Pruett, Gregory Beilman, Mustafa Arain, Stuart K Amateau, Shawn Mallery, Martin L Freeman, Rajeev Attam
OBJECTIVES: Studies correlating endoscopic ultrasound (EUS) with histopathology for chronic pancreatitis (CP) are limited by small sample size, and/or inclusion of many patients without CP, limiting applicability to patients with painful CP. The aim of this study was to assess correlation of standard EUS features for CP with surgical histopathology in a large cohort of patients with non-calcific CP (NCCP). METHODS: Adult patients undergoing total pancreatectomy and islet autotransplantation (TPIAT) for NCCP, between 2008 and 2013, with EUS <1 year before surgery...
April 2016: American Journal of Gastroenterology
Rupjyoti Talukdar, Sundeep Lakhtakia, D Nageshwar Reddy, G Venkat Rao, Rebala Pradeep, Rupa Banerjee, Rajesh Gupta, Mohan Ramchandani, Manu Tandan, H Vivekananda Murthy
BACKGROUND AND AIM: The aim of this study was to evaluate the effect of antioxidant-pregabalin combination on pain recurrence in patients with chronic calcific pancreatitis. METHODS: In this randomized, double-blind, placebo-controlled trial, chronic calcific pancreatitis patients with pain recurrence following pancreatic ductal clearance of stones received either antioxidant-pregabalin combination or matching placebo for 2 months followed by open-label antioxidants for the next 4 months in both groups...
September 2016: Journal of Gastroenterology and Hepatology
David C Whitcomb, Luca Frulloni, Pramod Garg, Julia B Greer, Alexander Schneider, Dhiraj Yadav, Tooru Shimosegawa
BACKGROUND: A definition of chronic pancreatitis (CP) is needed for diagnosis and distinguishing CP from other disorders. Previous definitions focused on morphology. Advances in epidemiology, genetics, molecular biology, modeling and other disciplines provide new insights into pathogenesis of CP, and allow CP to be better defined. METHODS: Expert physician-scientists from the United States, India, Europe and Japan reviewed medical and scientific literature and clinical experiences...
March 2016: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Rachel Lundberg, Gregory J Beilman, Ty B Dunn, Tim L Pruett, Martin L Freeman, Peggy E Ptacek, Katherine Louise Berry, R Paul Robertson, Antoinette Moran, Melena D Bellin
OBJECTIVES: Diabetes mellitus is a frequent consequence of chronic pancreatitis (CP). Little is known about pancreatic endocrine function before the development of diabetes mellitus in CP, particularly in females, or those without calcific and/or alcoholic pancreatitis. METHODS: Twenty-five nondiabetic adult patients with CP (19 female; mean [SE] age, 34.2 [2.4] years) were compared with 25 healthy controls matched for age, sex, and body mass index. Subjects underwent frequent sample intravenous glucose tolerance testing (FSIVGTT) and mixed meal tolerance testing (MMTT)...
April 2016: Pancreas
Taija Korpela, Marianne Udd, Andrea Tenca, Outi Lindström, Jorma Halttunen, Sanna Myrskysalo, Arto Mikkola, Leena Kylänpää
OBJECTIVE: Extracorporeal shock wave lithotripsy (ESWL) combined with endotherapy (ET) is the standard treatment for pancreatic duct stones (PDS) in chronic pancreatitis (CP). Our aim was to report the short- and long-term results of ESWL and ET. MATERIAL AND METHODS: Consecutively treated 83 patients with symptomatic PDS using ESWL and ET. Success was defined (i) technically: PDS fragmentation and clearance obtained and (ii) clinically: improvement/resolution of pain...
July 2016: Scandinavian Journal of Gastroenterology
Amitasha Sinha, Yuval A Patel, Michael Cruise, Karen Matsukuma, Atif Zaheer, Elham Afghani, Dhiraj Yadav, Martin A Makary, Kenzo Hirose, Dana K Andersen, Vikesh K Singh
BACKGROUND: Post-operative pain relief in chronic pancreatitis (CP) is variable. Our objective was to determine clinical imaging or histopathologic predictor(s) of post-operative pain relief in CP patients undergoing the Whipple or Frey procedure. METHODS: All patients who underwent a Whipple (n = 30) or Frey procedure (n = 30) for painful CP between January 2003 and September 2013 were evaluated. A toxic etiology was defined as a history of alcohol use and/or smoking...
April 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Sumit Paliwal, Seema Bhaskar, D Nageshwar Reddy, G Venkat Rao, Varghese Thomas, Shivaram Prasad Singh, Giriraj Ratan Chandak
OBJECTIVE: Association of PRSS1-PRSS2 (rs10273639) and CLDN2-MORC4 (rs12688220 and rs7057398) variants with alcohol-related chronic pancreatitis (CP) is established but with nonalcoholic CP is unclear. We addressed this inconsistency using tropical calcific pancreatitis (TCP) as model. METHODS: We sequenced 5'-UTR of PRSS1 and genotyped CLDN2-MORC4 variants in 555 patients with TCP and 801 controls and performed association analysis. Gene-gene interaction between PRSS1 and CLDN2-MORC4 variants and with p...
September 2016: Pancreas
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