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Chronic pancreatitis pain

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https://www.readbyqxmd.com/read/28639336/classification-of-pancreaticobiliary-maljunction-and-clinical-features-in-children
#1
Naoto Urushihara, Yoshinori Hamada, Terumi Kamisawa, Hideki Fujii, Tsugumichi Koshinaga, Yoshiki Morotomi, Takeshi Saito, Takao Itoi, Kenitiro Kaneko, Hiroaki Fukuzawa, Hisami Ando
PURPOSE: In 2015, the Committee on Diagnostic Criteria of the Japanese Study Group on Pancreaticobiliary Maljunction (PBM) proposed a classification of PBM into four types: (A) stenotic type, (B) non-stenotic type, (C) dilated channel type, and (D) complex type. To validate this classification and clarify the clinical features of the four types of PBM, a retrospective multicenter study was conducted. METHODS: We divided the study group of 317 children with PBM into the four types of PBM...
June 21, 2017: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/28631495/serum-endocannabinoids-in-assessing-pain-in-patients-with-chronic-pancreatitis-and-in-those-with-pancreatic-ductal-adenocarcinoma
#2
Raffaele Pezzilli, Pierangela Ciuffreda, Roberta Ottria, Alessandro Ravelli, Gianvico Melzi d'Eril, Alessandra Barassi
BACKGROUND: The endocannabinoid system plays a substantial role in analgesia. AIM: To analyze N-arachidonoylethanolamine (AEA), N-oleoylethanolamine (OEA), linoleoyl ethanolamide (LEA), α-linoleoyl ethanolamine (α-LNEA), N-palmitoylethanolamine (PEA) and N-stearoyl ethanolamine (SEA) in two groups of patients having chronic pancreatic diseases. PATIENTS AND METHODS: Twenty-six patients with chronic pancreatitis, 26 patients with pancreatic ductal adenocarcinoma and 36 healthy subjects were studied...
June 20, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28626379/fifteen-year-old-male-with-type-2-autoimmune-pancreatitis-an-argument-for-endoscopy
#3
Nathan T Kolasinski, Marc T Johannsen, Justin R Hollon
Type 2 autoimmune pancreatitis, an increasingly recognized etiology of pancreatitis in patients less than 20 years old, has characteristically been diagnosed with the histological finding of duct-centric pancreatitis in a patient who lacks elevated serum immunoglobulin G4. We present the case of a nonobese 15-year-old male, without any chronic medical conditions, who presented with the chief complaint of abdominal pain. The laboratory study results were remarkable for a lipase level of 5,419 U/L and a γ-glutamyl transferase level of 373 U/L...
May 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28623190/primary-tuberculosis-of-cystic-duct-lymph-node
#4
Aamir Ghazanfar, Afifa Asghar, Naqeeb Ullah Khan, Iram Hassan
Tuberculosis (TC) is very common and significant cause of morbidity and mortality worldwide. Isolated cystic duct lymph node TC cases without involvement of gallbladder are exceedingly rare. It is difficult to diagnose preoperatively because of lack of characteristic signs and symptoms of TC. We report a man aged 45 years who presented with right upper abdominal pain since 1week. It was associated with nausea and postprandial fullness. There was no evidence of jaundice and lymphadenopathy. Abdominal examination showed moderate right upper quadrant tenderness with positive Murphy's sign and splenomegaly but no signs of peritonism...
June 16, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28615966/acute-physiological-and-electrical-accentuation-of-vagal-tone-has-no-effect-on-pain-or-gastrointestinal-motility-in-chronic-pancreatitis
#5
Jacob Juel, Christina Brock, Søren S Olesen, Adnan Madzak, Adam D Farmer, Qasim Aziz, Jens B Frøkjær, Asbjørn Mohr Drewes
BACKGROUND: The effective management of pain in chronic pancreatitis (CP) remains a therapeutic challenge. Analgesic drugs, such as opioids, and the underlying pathology can impair gut function. The autonomic nervous system influences hormone secretion and gut motility. In healthy volunteers, electrical (using noninvasive transcutaneous vagal nerve stimulation [t-VNS]) and physiological (using deep slow breathing [DSB]) modulation of parasympathetic tone results in pain attenuation and enhanced gut motility...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28611558/two-spink1-mutations-induce-early-onset-severe-chronic-pancreatitis
#6
Jean Louis Frossard, Michael A Morris
The SPINK1 protein is a potent antiprotease that can inactivate any intrapancreatic trypsin activity that would otherwise induce autodigestion of the pancreas. SPINK1 mutations have been recognized to be associated with chronic pancreatitis in patients without a family history of pancreatitis. We here describe the case of a 24-year-old woman referred to our service for recurrent abdominal pain and search for the cause of chronic calcifying pancreatitis, who was found to carry 2 SPINK1 mutations.
January 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28600220/the-belgian-national-registry-on-chronic-pancreatitis-a-prospective-multi-centre-study-covering-more-than-800-patients-in-one-year
#7
M Fernandez, M Arvanitakis, C Musala, J Devière, W Van Steenbergen, V Putzeys, F Ausloos, B Bastens, P Gast, G Roeyen, F Berrevoet, I Scheers, M Delhaye, P H Deprez
BACKGROUND/OBJECTIVES: The epidemiology, natural history, complications, and therapeutic management of chronic pancreatitis (CP) are not well described at the national level. This multi-centre prospective observational study involving eight Belgian hospitals aimed to improve the understanding of these aspects of CP in Belgium. METHODS: All patients with a diagnosis of CP based on imaging were eligible for this study. Data were gathered regarding epidemiology, etiology, CP complications, and treatment modalities...
May 26, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28597350/short-and-long-term-outcomes-of-the-frey-procedure-for-chronic-pancreatitis-a-single-center-experience-and-summary-of-outcomes-in-japan
#8
Kazuhiro Suzumura, Etsuro Hatano, Toshihiro Okada, Yasukane Asano, Naoki Uyama, Ikuo Nakamura, Seikan Hai, Jiro Fujimoto
PURPOSE: To evaluate the short- and long-term outcomes of the Frey procedure for chronic pancreatitis (CP). METHODS: The subjects of this study were 12 patients who underwent the Frey procedure for CP between January, 2000 and December, 2016. We assessed pain relief, weight gain, and exocrine/endocrine insufficiency during follow-up. RESULTS: The study population comprised 11 men and 1 woman (91.7% vs. 8.3%; mean age, 50.3 ± 6.8 years; range 39-61 years)...
June 8, 2017: Surgery Today
https://www.readbyqxmd.com/read/28595222/-mediastinal-pancreatic-pseudocyst-with-pancreatic-pleural-effusion
#9
Motoko Sasajima, Hideki Kawai, Yohei Suzuki, Yoshitaro Saito, Takeshi Eto
A 72-year-old man with chronic alcohol related pancreatitis was admitted for dyspnea and pain at the upper body. Chest X-ray showed right massive pleural effusion. Chest and abdominal contrast enhanced thin slice computed tomography revealed the route from the pancreatic head reaching the right thoracic cavity via the esophagus hiatus and the communication between the cystic lesion and main pancreatic duct. We drained the pleural effusion that showed abnormally high amylase activity. We diagnosed his illness as mediastinal pancreatic pseudocyst with pancreatic pleural effusion...
June 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28588169/outcome-of-surgical-drainage-of-the-pancreatic-duct-in-chronic-pancreatitis
#10
S R Islam, S Rahman, S Rahman, H Kumar, S A Sarkar
Abdominal pain, one of the major symptoms of chronic pancreatitis, is believed to be caused by obstruction of the pancreatic duct system by stones or strictures. This results in increased intraductal pressure and parenchymal ischemia. Surgical decompression of the duct and ductal drainage can achieve best pain relieve and slow the progression of the disease. We want to share our experience of surgical drainage of pancreatic duct in chronic pancreatitis in our hospital. We studied 20 cases operated in our hospital between January 2010 and October 2015...
April 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28586262/effect-of-laparoscopic-peritoneal-lavage-and-drainage-and-continuous-venovenous-diahemofiltration-on-severe-acute-pancreatitis
#11
Guiliang Wang, Hai Liu, Linfang Xu, Ping Wen, Jianbo Wen, Shu-Feng Zhou, Xianzhong Xiao
BACKGROUND: Severe acute pancreatitis (SAP), one severe and fatal disease, the therapy of which is pretty hard. This study aimed to study the effect of laparoscopic peritoneal lavage and drainage (LPLD) and continuous venovenous diahemofiltration (CVVDH) on SAP. MATERIALS AND METHODS: Two hundred forty-five patients with SAP in total were randomly assigned into four groups according to the therapeutic plan: basic treatment; LPLD; CVVDH; or LPLD+CVVDH. Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, the ratios of multiple organ dysfunction syndrome (MODS), mortality, hospitalization time, hospitalization cost, ratios of complications, the abdominal distention relief time, abdominal pain relief time, plasma concentration of endotoxin, tumor necrosis factor-α (TNF-α), interleukin (IL)-6, and IL-8 were evaluated...
June 6, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28567456/surgery-for-intractable-pain-in-a-patient-with-chronic-pancreatitis-complicated-with-biliary-obstruction-portal-vein-stenosis-and-mesenteric-venous-collaterals
#12
Cuneyt Kayaalp, Murat Sait Dogan, Veysel Ersan
Pancreatic head resection for chronic pancreatitis is a challenging procedure, in the presence of venous collaterals, cavernous transformation, extensive fibrosis or porto-mesenteric stenosis or thrombosis. We present a surgically treated patient for the intractable pain of chronic pancreatitis. Complications with biliary obstruction and portal vein stenosis/thrombosis resulted in cavernous transformation. A pancreaticoduodenectomy combined with portal vein resection was intended in a 51 year-old male, but the procedure was terminated due to the high risk associated with intraoperative bleeding...
May 2017: Annals of Hepato-Biliary-Pancreatic Surgery
https://www.readbyqxmd.com/read/28524909/nonpharmacologic-pain-interventions-a-review-of-evidence-based-practices-for-reducing-chronic-cancer-pain%C3%A2
#13
Linda H Eaton, Jeannine M Brant, Karen McLeod, Chao Yeh
BACKGROUND: Pain is a common issue for patients with cancer and can be challenging to manage effectively. Healthcare professionals need to be knowledgeable about evidence-based nonpharmacologic interventions.
. OBJECTIVES: This systematic review critically appraises the strength and quality of the empirical evidence for nonpharmacologic interventions in reducing chronic cancer pain.
. METHODS: Intervention studies were critically appraised and summarized by an Oncology Nursing Society Putting Evidence Into Practice team of RNs, advanced practice nurses, and nurse scientists...
June 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28523574/medical-management-of-pain-in-chronic-pancreatitis
#14
REVIEW
Vikesh K Singh, Asbjørn M Drewes
The medical management of pain in chronic pancreatitis continues to pose significant challenges for clinicians caring for these patients. There are increasing data, suggesting that pain in chronic pancreatitis is largely due to peripheral and central sensitization that evolves, over time, as a result of nociceptive afferent associated with chronic inflammation and fibrosis of the pancreas. In many instances, patients rapidly progress to requiring opioid analgesics for the adequate treatment of pain despite the unequivocal risks associated with the long-term use of these drugs...
May 18, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28522204/peg-interferon-plus-nucleotide-analogue-treatment-versus-no-treatment-in-patients-with-chronic-hepatitis-b-with-a-low-viral-load-a-randomised-controlled-open-label-trial
#15
Annikki de Niet, Louis Jansen, Femke Stelma, Sophie B Willemse, Sjoerd D Kuiken, Sebastiaan Weijer, Carin M J van Nieuwkerk, Hans L Zaaijer, Richard Molenkamp, R Bart Takkenberg, Maarten Koot, Joanne Verheij, Ulrich Beuers, Hendrik W Reesink
BACKGROUND: Antiviral treatment is currently not recommended for patients with chronic hepatitis B with a low viral load. However, they might benefit from acquiring a functional cure (hepatitis B surface antigen [HBsAg] loss with or without formation of antibodies against hepatitis B surface antigen [anti-HBs]). We assessed HBsAg loss during peg-interferon-alfa-2a (peg-IFN) and nucleotide analogue combination therapy in patients with chronic hepatitis B with a low viral load. METHODS: In this randomised controlled, open-label trial, patients were enrolled from the Academic Medical Center (AMC), Amsterdam, Netherlands...
May 15, 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28520452/-relapsing-autoimmune-pancreatitis-type-1-case-report
#16
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/28512098/a-rare-case-of-thrombotic-microangiopathy-triggered-by-acute-pancreatitis
#17
Kevin Singh, Ahmed Jamal Nadeem, Behzad Doratotaj
Thrombotic microangiopathy (TMA) occurring after acute pancreatitis is rarely described. Without prompt intervention, TMA can be, and often is, lethal, so prompt recognition is important. Here, we present a case of a 61-year-old woman with a history of alcohol misuse who presented with epigastric pain, nausea and vomiting after binge drinking. Elevated serum lipase and imaging were suggestive of acute-on-chronic pancreatitis. Although the patient's symptoms of acute pancreatitis subsided, her anaemia, thrombocytopenia and acute kidney injury worsened...
May 15, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28496202/inhibition-of-jak-stat-signaling-reduces-the-activation-of-pancreatic-stellate-cells-in-vitro-and-limits-caerulein-induced-chronic-pancreatitis-in-vivo
#18
Hannah M Komar, Gregory Serpa, Claire Kerscher, Erin Schwoegl, Thomas A Mace, Ming Jin, Ming-Chen Yang, Ching-Shih Chen, Mark Bloomston, Michael C Ostrowski, Phil A Hart, Darwin L Conwell, Gregory B Lesinski
Chronic pancreatitis (CP) is a fibro-inflammatory disease leading to pain, maldigestion, and pancreatic insufficiency. No therapeutic options exist due to a limited understanding of the biology of CP pathology. Recent findings implicate pancreatic stellate cells (PSC) as prominent mediators of inflammatory and fibrotic processes during CP. Here, we utilized primary and immortalized PSC obtained from mice and patients with CP or pancreatic cancer to examine the effect of Jak/STAT and MAPK pathway inhibition in vitro...
May 11, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28493932/safety-and-tolerability-of-high-dose-ulinastatin-after-2-hour-intravenous-infusion-in-adult-healthy-chinese-volunteers-a-randomized-double-blind-placebo-controlled-ascending-dose-study
#19
Qian Chen, Chaoying Hu, Ye Liu, Yun Liu, Wei Wang, Hongchao Zheng, Lianchen Rong, Jingying Jia, Shixuan Sun, Chen Yu, Yan Mei Liu
Ulinastatin, is a broad-spectrum protease inhibitor purified from human urine, inhibits endogenous proteases such as trypsin, α-chymotrypsin, hyaluronidase, and plasmin. It is widely being used at increasingly higher doses for the treatment of acute or chronic pancreatitis, severe infection, and acute organ failure. We aimed to evaluate the safety and tolerability of high-dose ulinastatin in healthy volunteers in our single center, randomized, double-blind, placebo-controlled, single-dose escalation study...
2017: PloS One
https://www.readbyqxmd.com/read/28488091/outcomes-of-endoscopic-retrograde-cholangiopancreatography-ercp-and-sphincterotomy-for-suspected-sphincter-of-oddi-dysfunction-sod-post-roux-en-y-gastric-bypass
#20
Chin Hong Lim, Cyrus Jahansouz, Martin L Freeman, Daniel B Leslie, Sayeed Ikramuddin, Stuart K Amateau
BACKGROUND: Sphincter of Oddi dysfunction (SOD) is thought to be a cause of chronic abdominal pain post Roux-en-Y gastric bypass, and current practice of performing endoscopic retrograde cholangiopancreatography (ERCP) with or without sphincterotomy is not supported by evidence. In addition to the complexity and risks of the procedure in patients with Roux-en-Y anatomy, the outcomes are uncertain and debatable. We performed a retrospective review and analysis of post-gastric bypass patients who had undergone ERCP with sphincterotomy to determine the effectiveness in patients with suspected SOD...
May 9, 2017: Obesity Surgery
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