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Chronic pancreatitis pain

Agnieszka E Zawada, Małgorzata Moszak, Dorota Skrzypczak, Marian Grzymisławski
Diabetes mellitus is a systemic disease which affects patients of various age. Hyperglycemia induces damage of vascular endothelium, development of chronic inflammation, organic and functional lesions in several systems and organs. The principal gastroenterological complaints linked to the manifestation of the disease include abdominal pain, diarrhea, nausea, flatulence, and vomiting. However, complications in the alimentary system may manifest exclusively by difficulties in reaching normoglycemia and numerous persistent episodes of hypoglycemia...
March 13, 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Kazunori Yoh, Hiroki Nishikawa, Hirayuki Enomoto, Yoshinori Iwata, Akio Ishii, Yukihisa Yuri, Noriko Ishii, Yuho Miyamoto, Kunihiro Hasegawa, Chikage Nakano, Ryo Takata, Takashi Nishimura, Nobuhiro Aizawa, Yoshiyuki Sakai, Naoto Ikeda, Tomoyuki Takashima, Hiroko Iijima, Shuhei Nishiguchi
Introduction: In most chronic pancreatitis (CP) cases, malabsorption, pain, and weight loss are the leading clinical symptoms, which significantly worsen the quality of life (QOL) and decreased QOL in patients with CP can cause sleep disorder. There is a growing body of evidence that recognises the favourable effects of physical exercise (PE), however, there are limited data currently available concerning patients with CP undergoing PE. Actigram is a device for gathering objective sleep/awake data in the natural sleeping surroundings over an extended time period...
2018: BMJ Open Gastroenterology
Andrzej Rafal Hellmann, Salvatore Paiella, Justyna Kostro, Iwona Marek, Krystian Adrych, Zbigniew Śledziński, Stanisław Hać, Claudio Bassi
OBJECTIVES: The primary aim of this study was to determine the blood levels of SPINK1 in patients with chronic pancreatitis (CP) submitted to surgical or endoscopic decompression of pancreatic duct (PD). Additionally, we measured trypsin activity levels. METHODS: Two groups were identified, surgical (group A) and endoscopic (group B). Levels of SPINK1 and trypsin activity were measured at baseline and 6 months after pancreatic duct decompression and then compared within the groups...
March 3, 2018: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Jack Braha, Scott Tenner
Pseudocysts evolve from fluid collections and/or disruptions of the pancreatic duct. They may occur secondary to acute pancreatitis, pancreatic trauma, or chronic pancreatitis. Lacking the clinical information, radiologists may inappropriately call a fluid collection or any cystic lesion a pseudocyst. With no clear history of acute pancreatitis or chronic pancreatitis, this is rare. Complications include infection, intracystic hemorrhage, or rupture. Pseudocysts can become painful, especially with chronic pancreatitis, and can cause early satiety and weight loss when their size affects the stomach and bowel...
April 2018: Gastrointestinal Endoscopy Clinics of North America
Hassan Tariq, Muhammad Umar Kamal, Vamshidhar Vootla, Mohamed ElZaeedi, Masooma Niazi, Brian Gilchrist, Ariyo Ihimoyan, Anil Dev, Sridhar Chilimuri
We present a case of an 18-year-old male who presented with complains of abdominal pain, nausea and vomiting for 2 years. An esophagogastroduodenoscopy (EGD) revealed a 3 mm nodule on the lesser curvature of the stomach and prominent gastric folds. Biopsy of the nodule revealed a well-differentiated neuroendocrine tumor (NET) in lamina prop with focal extension into muscularis mucosa consistent with a gastric carcinoid. Tumor cells stained with neuron-specific enolase (NSE), chromogranin and synaptophysin only...
February 2018: Gastroenterology Research
Liansheng Liu, Yaohui Zhu, Michaël Noë, Qian Li, Pankaj Jay Pasricha
BACKGROUND & AIMS: Chronic pancreatitis (CP) is characterized by pancreatic inflammation and fibrosis, associated with increased pancreatic expression of transforming growth factor beta (TGFB). It is not clear how these might contribute to pain. We investigated whether TGFB signaling via SMAD induces sensitization of pancreatic sensory neurons to increase nociception. METHODS: CP was induced in Sprague-Dawley rats by infusion of trinitrobenzene sulfonic acid; some rats were given intrathecal infusions of TGFB1...
March 2, 2018: Gastroenterology
Jianzhong Lin, Yang Yu, Yi Chen, Ming Zheng, Dan Zhou
RATIONALE: The incidence of heterotopic pancreas (HP) is relatively rare and mainly found in the upper gastrointestinal tract, and no case of HP cyst in the adrenal gland has been reported. Informed consent has been obtained from the patient for the publication of the case details. PATIENT CONCERNS: A 21-year-old woman who presented with chronic lower back pain for a week without urinary disturbance or gastrointestinal discomfortable. DIAGNOSES: Ultrasound (US) revealed a left renal cyst, and computed tomography (CT) showed a cyst in the area of the adrenal gland...
January 2018: Medicine (Baltimore)
Samuel Han, Boskey Patel, May Min, Lisa Bocelli, Joan Kheder, Amy Wachholtz, Wahid Wassef
OBJECTIVES: The aim of this study was to evaluate the impact of smoking on quality of life in patients with chronic pancreatitis. METHODS: This is a cross-sectional study of chronic pancreatitis patients followed at a single institution comparing smokers with non-smokers. The primary outcome was quality of life and secondary outcomes included demographics, drug and alcohol use, anxiety and depression, pain level, nutritional status, and metabolic factors. RESULTS: 48 smokers and 45 non-smokers participated in this study...
February 26, 2018: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
José Lariño-Noia, Daniel de la Iglesia, Julio Iglesias-García, Fernando Macías, Laura Nieto, Iria Bastón, Carmen Villalba, J Enrique Domínguez-Muñoz
OBJECTIVE: Whether chronic pancreatitis (CP) may present with dyspepsia is controversial. We aimed at evaluating the frequency and risk factors of changes of CP in patients presenting with epigastric pain syndrome (EPS)-like symptoms. DESIGN: A prospective, observational, cross-sectional study was carried out in patients with EPS-like symptoms. Patients underwent endoscopic ultrasound (EUS) evaluation of the pancreas, and changes of CP were defined as the presence of five or more EUS criteria of the disease...
February 13, 2018: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Alexander J Kim, Sankha Basu, Carolyn Glass, Edgar L Ross, Nathalie Agar, Qing He, David Calligaris
Opioids are often used for analgesia via continuous intrathecal delivery by implantable devices. Higher concentration and daily dose of opioid have been postulated as risk factors for intrathecal granuloma formation. We present a 42-year-old female patient with chronic abdominal pain from refractory pancreatitis, with an intrathecal drug delivery device implanted 21 years prior, delivering continuous intrathecal morphine. After many years without concerning physical signs or complaint, with gradual increases in daily morphine dose, she presented with rapidly progressive neurologic deficits, including lower extremity, bladder, and bowel symptoms...
February 26, 2018: Pain Practice: the Official Journal of World Institute of Pain
Li Zhao, Xueqing Li, Zhimin Shi
OBJECTIVE: To observe the clinical therapeutic effects on severe acute pancreatitis (SAP) treated with electroacupuncture (EA), sparse-dense wave and 2 Hz/15 Hz, at Dachangshu (BL 25) and Shangjuxu (ST 37) assisting ulinastetin and explore the effective therapeutic method for SAP. METHODS: A total of 120 patients of SAP were randomized into an observation group and a control group, 60 cases in each one. In the control group, the routine western medicine was adopted with the intravenous drip with ulinastatin...
February 12, 2018: Zhongguo Zhen Jiu, Chinese Acupuncture & Moxibustion
R E Izrailov, V V Tsvirkun, R B Alikhanov, A V Andrianov
AIM: To analyze the features and efficacy of laparoscopic Frey procedure. MATERIAL AND METHODS: For the period from August 2012 to May 2017 Frey procedure was carried out in 31 patients with chronic calculous pancreatitis Buchler type C. There were 20 men and 11 women aged 48.6±9 years. Mean pancreatic head dimension was 35.5±14 mm, diameter of the main pancreatic duct - 9.6±2.7 mm. RESULTS: Completely laparoscopic procedure was made in 28 (90...
2018: Khirurgiia
Melena D Bellin, Maisam Abu-El-Haija, Katherine Morgan, David Adams, Gregory J Beilman, Srinath Chinnakotla, Darwin L Conwell, Ty B Dunn, Martin L Freeman, Timothy Gardner, Varvara A Kirchner, Luis F Lara, Leslie Long-Simpson, Jaimie D Nathan, Bashoo Naziruddin, John A Nyman, Timothy L Pruett, Sarah J Schwarzenberg, Vikesh K Singh, Kerrington Smith, Jennifer L Steel, Martin Wijkstrom, Piotr Witkowski, James S Hodges
BACKGROUND/OBJECTIVES: Total pancreatectomy with islet autotransplantation (TPIAT) is considered for managing chronic pancreatitis in selected patients when medical and endoscopic interventions have not provided adequate relief from debilitating pain. Although more centers are performing TPIAT, we lack large, multi-center studies to guide decisions about selecting candidates for and timing of TPIAT. METHODS: Multiple centers across the United States (9 to date) performing TPIAT are prospectively enrolling patients undergoing TPIAT for chronic pancreatitis into the Prospective Observational Study of TPIAT (POST), a NIDDK funded study with a goal of accruing 450 TPIAT recipients...
February 6, 2018: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Dongwook Oh, Jae Hoon Lee, Tae Jun Song, Do Hyun Park, Sung Koo Lee, Myung-Hwan Kim, Sang Soo Lee
OBJECTIVES: Fully covered self-expandable metal stents (FCSEMSs) placement has been tried for pancreatic ductal strictures in chronic pancreatitis. However, the long-term outcome of this procedure remains unknown. This study aimed to investigate the procedural and long-term outcomes of FCSEMS placement in patients with benign refractory pancreatic ductal strictures. METHODS: Between August 2011 and September 2015, 18 patients underwent endoscopic treatment with FCSEMSs for a benign refractory pancreatic ductal stricture...
February 17, 2018: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
Andrea Párniczky, Maisam Abu-El-Haija, Sohail Husain, Mark Lowe, Grzegorz Oracz, Miklós Sahin-Tóth, Flóra K Szabó, Aliye Uc, Michael Wilschanski, Heiko Witt, László Czakó, Tassos Grammatikopoulos, Ib Christian Rasmussen, Robert Sutton, Péter Hegyi
BACKGROUND: Pediatric pancreatitis is an underdiagnosed disease with variable etiology. In the past 10-15 years the incidence of pediatric pancreatitis has increased, it is now 3.6-13.3 cases per 100,000 children. Up-to-date evidence based management guidelines are lacking for the pediatric pancreatitis. The European Pancreatic Club, in collaboration with the Hungarian Pancreatic Study Group organized a consensus guideline meeting on the diagnosis and management of pancreatitis in the pediatric population...
January 4, 2018: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Søren S Olesen, Theresa Krauss, Ihsan Ekin Demir, Oliver H Wilder-Smith, Güralp O Ceyhan, Pankaj J Pasricha, Asbjørn M Drewes
Introduction: Chronic pancreatitis (CP) is a disease characterized by inflammation of the pancreas resulting in replacement of the normal functioning parenchyma by fibrotic connective tissue. This process leads to progressively impairment of exocrine and endocrine function and many patients develop a chronic pain syndrome. Objectives: We aimed to characterize the neurobiological signature of pain associated with CP and to discuss its implications for treatment strategies...
November 2017: Pain Reports (Baltimore, Md.)
Juan Wei, XiaoFang Dong, FangMing Du, Sheng Tang, HangPing Wei
RATIONALE: Pancreatic cancer is common in people older than 40 years, and the incidence peaks at the age of 70 years and older. Chemoradiotherapy has been generally considered a high-risk procedure in elderly patients with local recurrent pancreatic cancer. Gamma knife stereotactic radiosurgery has the advantage in protecting the surrounding tissues, and providing short-term effects. It has been successfully used in patients with brain metastases.The efficacy of GKSRS in other malignancies has barely been studied...
December 2017: Medicine (Baltimore)
Bartosz Zabicki, Nattakarn Limphaibool, Marte Johanne Veilemand Holstad, Robert Juszkat
OBJECTIVES: To present the various techniques used in the management of pancreatitis-related pseudoaneurysms of visceral vessels. METHODS: The retrospective clinical study was carried out at the Department of Diagnostic and Interventional Radiology at Poznan University of Medical Sciences from 2011 to 2016. The fifteen patients included in the study were diagnosed with pseudoaneurysms of visceral arteries, as a complication of chronic pancreatitis. The diagnosis was made using contrast-enhanced computed tomography, followed by angiography...
2018: PloS One
Aaron R Kuzel, Muhammad Uzair Lodhi, Mustafa Rahim
Pancreatic divisum is a condition that occurs in 4-14% of the population. Pancreatic divisum occurs in development when the ventral bud and dorsal bud of the pancreas fail to fuse. Patients with this condition are usually asymptomatic, however, 25-38% of these patients experience recurrent pancreatitis that may further progress to chronic pancreatitis. This case is of a 20-year-old female presenting with abdominal pain in the left and right upper quadrants of the abdomen with a significant history of recurrent pancreatitis since the age of seven...
November 17, 2017: Curēus
Keum Nahn Jee
Mass forming chronic pancreatitis is very rare. Diagnosis could be done by the pathologic findings of focal inflammatory fibrosis without evidence of tumor in pancreas. A 34-year-old man presented with right upper abdominal pain for a few weeks and slightly elevated bilirubin level on clinical findings. Radiological findings of multidetector-row computed tomography, magnetic resonance (MR) imaging with MR cholangiopancreatography and endoscopic ultrasonography revealed focal branch pancreatic duct dilatation with surrounding delayed enhancing solid component at uncinate process and head of pancreas, suggesting branch duct type intraductal papillary mucinous neoplasm...
January 14, 2018: World Journal of Gastroenterology: WJG
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