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Chronic pancreatitis pain

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https://www.readbyqxmd.com/read/28231072/total-pancreatectomy-with-islet-autotransplantation-resolves-pain-in-young-children-with-severe-chronic-pancreatitis
#1
Melena D Bellin, Gregory P Forlenza, Kaustav Majumder, Megan Berger, Martin L Freeman, Gregory J Beilman, Ty B Dunn, Timothy L Pruett, Michael Murati, Joshua J Wilhelm, Marie Cook, David E R Sutherland, Sarah J Schwarzenberg, Srinath Chinnakotla
OBJECTIVES: Fear of diabetes and major surgery may prohibit referral of young children severely affected by pancreatitis for total pancreatectomy with islet autotransplant (TPIAT). We evaluated outcomes in our youngest TPIAT recipients, 3 to 8 years of age at surgery. METHODS: Medical records were reviewed for 17 children (9 girls) ages 8 years or younger undergoing TPIAT from 2000 to 2014. Most (14/17) had genetic risk factors for pancreatitis. Since 2006, TPIAT recipients were followed prospectively with health questionnaires including assessments of pain and narcotic use, and scheduled hemoglobin A1c (HbA1c) and mixed-meal tolerance tests (6 mL/kg Boost HP) before surgery, and at regular intervals after...
March 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28218203/cystic-dystrophy-of-the-duodenal-wall-a-rare-but-need-to-know-disease
#2
Lydia Plana Campos, Carlos Alventosa Mateu, Javier Sempere García-Argüelles, Ana Belén Durá Ayet, Inma Bort Pérez, Patricia Suárez Callol
Cystic dystrophy of the duodenal wall (CDDW) is a serious but uncommon complication of heterotopic pancreatic tissue characterized by increased duodenal wall thickness associated with intraparietal cystic lesions. It is mainly observed in middle-aged male patients with alcoholic chronic pancreatitis. Clinical symptoms are usually nonspecific and it is important to take them into account in patients with the abovementioned history. Imaging techniques have been useful for diagnosis, especially endoscopic ultrasound (EUS), to visualize cystic lesions in the wall...
January 2017: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/28208933/a-rare-case-report-of-hepatic-subcapsular-pseudocyst-of-pancreas
#3
Noor Topno, Sandeep Ghosh, Arup Baruah
A pancreatic pseudocyst arises as a result of acute or chronic pancreatitis, pancreatic trauma, or obstruction of the pancreatic duct by a neoplasm. Most of the pseudocysts are located within the head and the body of the pancreas but 20% are extra-pancreatic. We report a case of a 33-year-old gentleman presenting with acute on chronic alcoholic pancreatitis with hepatic sub-capsular pseudocyst involving left lobe of liver, with intra-cystic bleed was successfully treated with Ultrasonography (USG) guided drainage...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28207747/chronic-pancreatitis-multicentre-prospective-data-collection-and-analysis-by-the-hungarian-pancreatic-study-group
#4
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
https://www.readbyqxmd.com/read/28201840/clinical-response-to-dorsal-duct-drainage-via-the-minor-papilla-in-refractory-obstructing-chronic-calcific-pancreatitis
#5
Chang-Il Kwon, Mark A Gromski, Stuart Sherman, Ihab I El Hajj, Jeffrey J Easler, James Watkins, Lee McHenry, Glen A Lehman, Evan L Fogel
Background and study aims Complete stone removal from the main pancreatic duct might not be achieved in all patients with obstructive chronic calcific pancreatitis. We report our results for endoscopic dorsal pancreatic duct (DPD) bypass of obstructing stones in the ventral pancreatic duct (VPD). Patients and methods 16 patients with obstructive chronic calcific pancreatitis were treated with a DPD bypass. Clinical success was defined as significant pain relief and no hospital admissions for pain management during the ongoing treatment period...
February 15, 2017: Endoscopy
https://www.readbyqxmd.com/read/28197205/from-pathogenesis-clinical-manifestation-and-diagnosis-to-treatment-an-overview-on-autoimmune-pancreatitis
#6
REVIEW
Ou Cai, Shiyun Tan
Autoimmune pancreatitis (AIP) is a special type of chronic pancreatitis which is autoimmune mediated. The international consensus diagnostic criteria (ICDC) 2011 proposed two types of AIP: type I is associated with histological pattern of lymphoplasmacytic sclerosing pancreatitis (LPSP), characterized by serum IgG4 elevation, whereas type 2 is named idiopathic duct-centric pancreatitis (IDCP), with granulocytic epithelial lesion (GEL) and immunoglobulin G4 (IgG4) negative. The pathogenic mechanism is unclear now; based on genetic factors, disease specific or related antigens, innate and adaptive immunity may be involved...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28196019/pancreatoscopy-directed-electrohydraulic-lithotripsy-for-pancreatic-ductal-stones-in-painful-chronic-pancreatitis-using-spyglass
#7
Noor L H Bekkali, Sam Murray, Gavin J Johnson, Steven Bandula, Zahir Amin, Michael H Chapman, Stephen P Pereira, George J M Webster
OBJECTIVE: Painful chronic pancreatitis is often associated with main duct obstruction due to stones. Approaches to management are challenging, including surgery, extracorporeal shock wave lithotripsy, or endoscopic approaches. Here, we report our experience of pancreatoscopy + electrohydraulic lithotripsy (EHL) for pancreatic duct (PD) stones using SpyGlass. METHODS: We retrospectively audited the use of SpyGlass (Legacy and DS) + EHL. Indication, procedural details, and clinical outcomes were assessed...
February 14, 2017: Pancreas
https://www.readbyqxmd.com/read/28174520/modulation-of-human-peripheral-blood-mononuclear-cell-signaling-by-medicinal-cannabinoids
#8
Wesley K Utomo, Marjan de Vries, Henri Braat, Marco J Bruno, Kaushal Parikh, Mònica Comalada, Maikel P Peppelenbosch, Harry van Goor, Gwenny M Fuhler
Medical marijuana is increasingly prescribed as an analgesic for a growing number of indications, amongst which terminal cancer and multiple sclerosis. However, the mechanistic aspects and properties of cannabis remain remarkably poorly characterized. In this study we aimed to investigate the immune-cell modulatory properties of medical cannabis. Healthy volunteers were asked to ingest medical cannabis, and kinome profiling was used to generate comprehensive descriptions of the cannabis challenge on inflammatory signal transduction in the peripheral blood of these volunteers...
2017: Frontiers in Molecular Neuroscience
https://www.readbyqxmd.com/read/28160344/eus-guided-celiac-plexus-block-and-neurolysis
#9
REVIEW
Ichiro Yasuda, Hsiu-Po Wang
Endoscopic ultrasound-guided celiac plexus neurolysis (EUS-CPN) is widely used for reducing pain originating from upper abdominal organs. It is mainly indicated to treat pancreatic cancer pain, but also to relieve pain due to chronic pancreatitis. Real-time guidance and color Doppler imaging by endoscopic sonography made the procedure easier and safer, resulting in greater pain relief. Currently, two techniques are used for EUS-CPN. The classic approach, known as the central technique, involves injection of a neurolytic agent at the base of the celiac axis...
February 3, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28144616/steroid-induced-psychosis-after-eus-guided-celiac-plexus-blockade
#10
David C Olson, Jason J Lewis
A 46-year-old female with no previous personal or family psychiatric history underwent endoscopic ultrasound (EUS)-guided celiac plexus blockade (CPB) to treat pain related to cystic fibrosis transmembrane conductance regulator-associated chronic pancreatitis. She had excellent response to her first three CPBs using bupivacaine and triamcinolone. The patient's subsequent CPBs were complicated by symptoms of racing thoughts, delusional thinking, and insomnia. She was diagnosed with acute psychosis secondary to triamcinolone...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28143718/comparative-efficacy-of-bilateral-thoracoscopic-splanchnicectomy-for-intractable-pain-secondary-to-pancreatic-cancer-vs-chronic-pancreatitis
#11
Neal Bhutiani, Gerald A Cheadle, Michael H Bahr, Gary C Vitale
BACKGROUND: Splanchnicectomy has been evaluated for treatment of chronic pain in both pancreatic cancer and chronic pancreatitis patients, though its efficacy has not been compared in these two patient populations. This study aims to compare bilateral thoracoscopic splanchnicectomy (BTS) in treatment of abdominal pain secondary to pancreatic cancer (PC) and chronic pancreatitis (CP). METHODS: A University of Louisville database was evaluated from July 1998 to March 2016 for patients undergoing BTS for intractable pain secondary to PC (n=48) or CP (n=75)...
January 28, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28089214/prevalence-of-chronic-pancreatitis-results-of-a-primary-care-physician-based-population-study
#12
Gabriele Capurso, Livia Archibugi, Piera Pasquali, Alessandro Aceti, Paolo Balducci, Patrizia Bianchi, Francesco Buono, Stefano Camerucci, Rosanna Cantarini, Sergio Centofanti, Patrizia Colantonio, Riccarda Cremaschi, Sergio Crescenzi, Caterina Di Mauro, Davide Di Renzi, Andrea Filabozzi, Alfonso Fiorillo, Giuseppe Giancaspro, Paola Giovannetti, Giuseppe Lanna, Claudio Medori, Emilio Merletti, Enzo Nunnari, Francesca Paris, Marco Pavone, Angela Piacenti, Almerindo Rossi, Maria Cristina Scamuffa, Giovanni Spinelli, Marco Taborchi, Biagio Valente, Antonella Villanova, Alberto Chiriatti, Gianfranco Delle Fave
BACKGROUND: Data on chronic pancreatitis prevalence are scanty and usually limited to hospital-based studies. AIM: Investigating chronic pancreatitis prevalence in primary care. METHODS: Participating primary care physicians reported the prevalence of chronic pancreatitis among their registered patients, environmental factors and disease characteristics. The data were centrally reviewed and chronic pancreatitis cases defined according to M-ANNHEIM criteria for diagnosis and severity and TIGAR-O classification for etiology...
December 27, 2016: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28079861/endoscopic-vs-surgical-interventions-for-painful-chronic-pancreatitis-what-is-needed-for-future-clinical-trials
#13
REVIEW
John A Windsor, Nageshwar D Reddy
The treatment of painful chronic pancreatitis remains controversial. The available evidence from two randomized controlled trials favor surgical intervention, whereas an endotherapy-first approach is widely practiced. Chronic pancreatitis is complex disease with different genetic and environmental factors, different pain mechanisms and different treatment modalities including medical, endoscopic, and surgical. The widely practiced step-up approach remains unproven. In designing future clinical trials there are some important pre-requisites including a more comprehensive pain assessment tool, the optimization of conservative medical treatment and interventional techniques...
January 12, 2017: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/28078128/endoscopic-ultrasound-in-pancreatic-cancer-innovative-applications-beyond-the-basics
#14
REVIEW
Joseph Yoo, C Andrew Kistler, Linda Yan, Andrew Dargan, Ali A Siddiqui
Endoscopic ultrasound (EUS) has become a mainstay in assisting in the diagnosis and staging of pancreatic cancer. In addition, EUS provides a modality to treat chronic pain through celiac plexus neurolysis. Currently, there is growing data and utilization of EUS in more diverse and innovative applications aimed at providing more sophisticated diagnostic, prognostic and therapeutic options for patients with pancreatic cancer. EUS delivery of chemotherapy, viral and biological vectors and fiducial markers may eventually revolutionize the way clinicians approach the care of a patient with pancreatic cancer...
December 2016: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28075092/diabetes-mellitus-management-of-gastrointestinal-complications
#15
Beth Careyva, Brian Stello
Gastrointestinal disorders are common complications of diabetes mellitus and include gastroparesis, nonalcoholic fatty liver disease, gastroesophageal reflux disease, and chronic diarrhea. Symptoms of gastroparesis include early satiety, postprandial fullness, nausea, vomiting of undigested food, bloating, and abdominal pain. Gastroparesis is diagnosed based on clinical symptoms and a delay in gastric emptying in the absence of mechanical obstruction. Gastric emptying scintigraphy is the preferred diagnostic test...
December 15, 2016: American Family Physician
https://www.readbyqxmd.com/read/28060696/acute-pancreatitis-and-posterior-reversible-encephalopathy-syndrome-a-case-report
#16
Vítor Magno Pereira, Luís Marote Correia, Tiago Rodrigues, Gorete Serrão Faria
The posterior reversible encephalopathy syndrome is a neurological syndrome characterized by headache, confusion, visual disturbances and seizures associated with identifiable areas of cerebral edema on imaging studies. The authors report the case of a man, 33 years-old, leukodermic with a history of chronic alcohol and tobacco consumption, who is admitted to the emergency department for epigastric pain radiating to the back and vomiting with about six hours of evolution and an intense holocranial headache for two hours...
September 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/28060186/acupuncture-for-pain-in-chronic-pancreatitis-a-single-blinded-randomized-crossover-trial
#17
Jacob Juel, Stefano Liguori, Aldo Liguori, Jakob L Poulsen, Massimiliano Valeriani, Carina Graversen, Søren S Olesen, Asbjørn M Drewes
OBJECTIVES: Many patients with painful chronic pancreatitis (CP) have insufficient effect of treatment, and the prevalence of adverse effects is high. Consequently, alternatives to conventional management are needed. We aimed to study the effect of acupuncture in painful CP. METHODS: This was a prospective, single-blinded, randomized crossover trial. Fifteen patients with CP were assigned to a session of acupuncture followed by sham stimulation or vice versa. Patients rated clinical pain scores daily on a 0 to 10 visual analogue scale (VAS) and completed the Patient Global Impression of Change...
February 2017: Pancreas
https://www.readbyqxmd.com/read/28058022/role-of-original-and-modified-frey-s-procedures-in-chronic-pancreatitis
#18
Chun-Lu Tan, Hao Zhang, Min Yang, Shao-Jun Li, Xu-Bao Liu, Ke-Zhou Li
AIM: To retrospectively review patients with chronic pancreatitis (CP) treated with Frey's procedures between January 2009 and January 2014. METHODS: A retrospective review was performed of patients with CP treated with Frey's procedures between January 2009 and January 2014 in the Department of Pancreatic Surgery. A cross-sectional study of postoperative pain relief, quality of life (QoL), and alcohol and nicotine abuse was performed by clinical interview, letters and telephone interview in January 2016...
December 21, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28050442/pancreatic-tuberculosis-a-puzzle-for-physicians-a-rare-case-and-review-of-literature
#19
Prashanth Ashok Kumar, Gursharan Singh, John Biku Joseph, S Swaminathan, L Venkatakrishnan
Pancreatic Tuberculosis is an uncommon form of extra pulmonary tuberculosis that resembles malignancy of pancreas and serve as a diagnostic challenge for physicians. Conservative management with Anti Tuberculosis Therapy (ATT) will suffice for pancreatic tuberculosis whereas a malignancy may require major surgeries which may lead to significant morbidity. Here, we discuss the case of a female patient who presented with abdominal pain and vomiting and is a known case of chronic calcific pancreatitis. Radiological findings were that of malignancy of the pancreas...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28049286/is-islet-transplantation-a-realistic-approach-to-curing-diabetes
#20
REVIEW
Sang-Man Jin, Kwang-Won Kim
Since the report of type 1 diabetes reversal in seven consecutive patients by the Edmonton protocol in 2000, pancreatic islet transplantation has been reappraised based on accumulated clinical evidence. Although initially expected to therapeutically target long-term insulin independence, islet transplantation is now indicated for more specific clinical benefits. With the long-awaited report of the first phase 3 clinical trial in 2016, allogeneic islet transplantation is now transitioning from an experimental to a proven therapy for type 1 diabetes with problematic hypoglycemia...
January 2017: Korean Journal of Internal Medicine
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