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Chronic pancreatitis pain

E Bellon, J R Izbicki, M Bockhorn
Chronic pancreatitis (CP) is an irreversible, inflammatory process, which is characterized by progressive fibrosis of the pancreas and leads to abdominal pain, endocrine and exocrine insufficiency. Surgical therapy is indicated by the absence of pain relief and local complications. The target of the surgical approach is to relieve the pancreatic and bile ducts and resection of the fibrotic and calcified parenchyma. Drainage procedures, such as the Partington-Rochelle method, are used in patients with isolated congestion of the pancreatic duct without further organ complications, such as inflammatory processes of the pancreatic head; however, patients with CP often have an inflammatory swelling of the pancreatic head...
October 18, 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Aliye Uc, Dana K Andersen, Melena D Bellin, Jason I Bruce, Asbjørn M Drewes, John F Engelhardt, Christopher E Forsmark, Markus M Lerch, Mark E Lowe, Brent A Neuschwander-Tetri, Stephen J OʼKeefe, Tonya M Palermo, Pankaj Pasricha, Ashok K Saluja, Vikesh K Singh, Eva M Szigethy, David C Whitcomb, Dhiraj Yadav, Darwin L Conwell
A workshop was sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases to focus on research gaps and opportunities in chronic pancreatitis (CP) and its sequelae. This conference marked the 20th year anniversary of the discovery of the cationic trypsinogen (PRSS1) gene mutation for hereditary pancreatitis. The event was held on July 27, 2016, and structured into 4 sessions: (1) pathophysiology, (2) exocrine complications, (3) endocrine complications, and (4) pain. The current state of knowledge was reviewed; many knowledge gaps and research needs were identified that require further investigation...
November 2016: Pancreas
Marjan de Vries, Dagmar C M van Rijckevorsel, Kris C P Vissers, Oliver H G Wilder-Smith, Harry van Goor
BACKGROUND & AIMS: Delta-9-tetrahydrocannabinol (THC) is the most abundant cannabinoid from the plant Cannabis sativa. There is only equivocal evidence that THC has analgesic effects. We performed a phase 2 controlled trial to evaluate the analgesic efficacy, pharmacokinetics, safety, and tolerability of an oral tablet containing purified THC in patients with chronic abdominal pain. METHODS: Sixty-five patients with chronic abdominal pain for 3 months or more (numeric rating scale scores of 3 or more) after surgery or due to chronic pancreatitis were randomly assigned to groups given the THC tablet or identical matching placebos for 50-52 days...
October 5, 2016: Clinical Gastroenterology and Hepatology
K Teo, M H Johnson, S Truter, S Pandanaboyana, J A Windsor
BACKGROUND: Patients with chronic pancreatitis (CP) frequently report chronic abdominal pain that adversely impacts their quality of life. Assessment of pain in CP is required for clinical management and clinical studies. International consensus guidelines recognized a lack of specific and validated pain assessment tools for CP. Therefore, the aim of this systematic review is to identify and compare all clinical studies that assessed pain in the context of a treatment for pain in CP. METHODS: A systematic literature search was performed in PubMed, Cochrane Library and Ovid MEDLINE...
September 14, 2016: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Lesley Andrews
No abstract text is available yet for this article.
September 2016: Gastroenterology Nursing: the Official Journal of the Society of Gastroenterology Nurses and Associates
A G Kriger, A V Smirnov, S V Berelavichus, D S Gorin, G G Karmazanovsky, N N Vetsheva, Ya I Nerestyuk, D V Kalinin, A V Glotov
AIM: to define optimal treatment of duodenal dystrophy in patients with chronic pancreatitis. MATERIAL AND METHODS: 515 patients with chronic pancreatitis have been treated for the period 2004-2015 in A.V.Vishnevsky Institute of Surgery. Duodenal dystrophy (DD) was diagnosed in 79 (15.3%) of them. The diagnosis was confirmed by sonography, CT, MRI and endosonography. 5 patients are under observation without surgery. 74 patients were operated after previous medical therapy during 39 months on the average...
2016: Khirurgiia
Luis Manuel Souza-Gallardo, Mauricio de la Fuente-Lira, Roberto Galaso-Trujillo, José Luis Martínez-Ordaz
BACKGROUND: Tumour markers are substances produced by the tumour itself, or by the host in response to a tumour. These markers could be measured either in the blood or in body secretions. One of the most common tumour markers used in gastrointestinal diseases is Ca 19-9. It is the marker most used for pancreatic cancer, but can be elevated in many benign processes. Thus, it is not a specific marker. CLINICAL CASE: The case is presented of a male patient with 4 years of moderate abdominal pain, weight loss, and persistent elevation of Ca 19-9...
September 5, 2016: Cirugia y Cirujanos
Linlin Yang, Quanmin Li, Xinming Liu, Shiguang Liu
Diabetes mellitus (DM) is a common chronic medical problem worldwide; one of its complications is painful peripheral neuropathy, which can substantially erode quality of life and increase the cost of management. Despite its clinical importance, the pathogenesis of painful diabetic neuropathy (PDN) is complex and incompletely understood. Voltage-gated sodium channels (VGSCs) link many physiological processes to electrical activity by controlling action potentials in all types of excitable cells. Two isoforms of VGSCs, NaV1...
2016: International Journal of Molecular Sciences
Maomei Ruan, Min Liu, Lingxiao Cheng, Wenhui Xie, Libo Chen
BACKGROUD: Heterotopic pancreas (HP), a relatively uncommon congenital anomaly, is rarely noted during F-FDG positron-emission tomography/computed tomography (PET/CT) scan. METHODS: A 60-year-old woman was referred to our hospital due to a 10-day history of abdominal pain with elevated levels of serum amylase and lipase. Abdominal CT and ultrasound examinations were negative. In order to search for the cause, an F-FDG PET/CT whole body scan was suggested to an old woman revealing the presence of F-FDG accumulating nodule in small intestine...
September 2016: Medicine (Baltimore)
Paul M Hobbs, William G Johnson, David Y Graham
One of the most challenging issues arising in patients with chronic pancreatitis is the management of abdominal pain. Many competing theories exist to explain pancreatic pain including ductal hypertension from strictures and stones, increased interstitial pressure from glandular fibrosis, pancreatic neuritis, and ischemia. This clinical problem is superimposed on a background of reduced enzyme secretion and altered feedback mechanisms. Throughout history, investigators have used these theories to devise methods to combat chronic pancreatic pain including: Lifestyle measures, antioxidants, analgesics, administration of exogenous pancreatic enzymes, endoscopic drainage procedures, and surgical drainage and resection procedures...
August 6, 2016: World Journal of Gastrointestinal Pharmacology and Therapeutics
Thibaut Vaysse, Isabelle Boytchev, Guillemette Antoni, Damien Sainte Croix, André Daniel Choury, Valérie Laurent, Gilles Pelletier, Catherine Buffet, Rita Bou-Farah, Franck Carbonnel
INTRODUCTION: There is still uncertainty regarding the efficacy and optimal modalities of extracorporeal shock wave lithotripsy (ESWL) in the treatment of chronic pancreatitis. The aims of the present study were to assess the safety and the efficacy of ESWL, either alone or followed by therapeutic endoscopic retrograde cholangiopancreatography (adjuvant ERCP) and to determine predictive factors of efficacy, in a real-life setting. PATIENTS AND METHODS: This study included all consecutive patients who underwent an ESWL in a single University Hospital between 2001 and 2012...
November 2016: Scandinavian Journal of Gastroenterology
Takeshi Ogura, Saori Onda, Wataru Takagi, Masayuki Kitano, Tastsushi Sano, Atsushi Okuda, Akira Miyano, Daisuke Masuda, Toshihisa Takeuchi, Shinya Fukunishi, Kazuhide Higuchi
BACKGROUND: Temporary stent placement is widely performed for pancreatic duct stenosis due to chronic pancreatitis. A fully covered self-expandable metal stent (FCSEMS) has a larger diameter, and therefore longer stent patency, and the effect of expansion of the main pancreatic duct stricture may be obtained. However, if stent migration upstream occurs, stent removal is extremely difficult. In addition, because of the diameter gap between the FCSEMS and the main pancreatic duct, stent-induced ductal change may occur...
September 2016: Therapeutic Advances in Gastroenterology
Supawon Srettabunjong, Wiratchaya Limgitisupasin
INTRODUCTION: Acute pancreatitis (AP) is an uncommon disease with a wide clinical course varying from mild and self-limiting to severe with eventual death. However, death caused by AP is rare. Most cases of AP reported in the English-language literature are based on clinical data; few are medico-legal studies. CASE PRESENTATION: The author recently experienced a case of sudden unexpected death in a young man caused by extensive severe hemorrhagic AP secondary to cholelithiasis, not chronic alcoholism, which is a much more prominent etiology of AP in medico-legal perspectives...
August 2016: Medicine (Baltimore)
Kara L Raphael, Field F Willingham
Hereditary pancreatitis (HP) is a rare cause of acute, recurrent acute, and chronic pancreatitis. It may present similarly to other causes of acute and chronic pancreatitis, and often there has been a protracted evaluation prior to the diagnosis of HP. Since it was first described in 1952, multiple genetic defects that affect the action of digestive enzymes in the pancreas have been implicated. The most common mutations involve the PRSS1, CFTR, SPINK1, and CTRC genes. New mutations in these genes and previously unrecognized mutations in other genes are being discovered due to the increasing use of next-generation genomic sequencing...
2016: Clinical and Experimental Gastroenterology
Jörg Kleeff, Christian Stöß, Julia Mayerle, Lynne Stecher, Matthias Maak, Peter Simon, Ulrich Nitsche, Helmut Friess
BACKGROUND: If conservative treatment of chronic pancreatitis is unsuccessful, surgery is an option. The choice of the most suitable surgical method can be difficult, as the indications, advantages, and disadvantages of the available methods have not yet been fully documented with scientific evidence. METHODS: In April 2015, we carried out a temporally unlimited systematic search for publications on surgery for chronic pancreatitis. The target parameters were morbidity, mortality, pain, endocrine and exocrine insuffi - ciency, weight gain, quality of life, length of hospital stay, and duration of urgery...
July 25, 2016: Deutsches Ärzteblatt International
Nicholas G Brown, Douglas A Howell, Brian C Brauer, John Walker, Sachin Wani, Raj J Shah
BACKGROUND AND AIMS: Pancreatic duct (PD) cannulation via the major papilla may be compromised by downstream obstruction of the ventral PD from a stone or stricture. In patients with a patent accessory PD, cannulation of the minor papilla permits stenting or stone removal upstream of the ventral PD obstruction. Data on this technique are limited. METHODS: University of Colorado Hospital and Maine Medical Center endoscopy databases were queried for ERCPs with minor papilla cannulation...
August 13, 2016: Gastrointestinal Endoscopy
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
Laura E Edgington-Mitchell, Thomas Wartmann, Alicia K Fleming, Vasilena Gocheva, Wouter A van der Linden, Nimali P Withana, Martijn Verdoes, Luigi Aurelio, Daniel Edgington-Mitchell, TinaMarie Lieu, Belinda S Parker, Bim Graham, Thomas Reinheckel, John B Furness, Johanna A Joyce, Peter Storz, Walter Halangk, Matthew Bogyo, Nigel W Bunnett
Pancreatitis is an inflammatory disease of the pancreas characterized by dysregulated activity of digestive enzymes, necrosis, immune infiltration, and pain. Repeated incidence of pancreatitis is an important risk factor for pancreatic cancer. Legumain, a lysosomal cysteine protease, has been linked to inflammatory diseases such as atherosclerosis, stroke, and cancer. Until now, legumain activation has not been studied during pancreatitis. We used a fluorescently quenched activity-based probe to assess legumain activation during caerulein-induced pancreatitis in mice...
September 1, 2016: American Journal of Physiology. Gastrointestinal and Liver Physiology
Vishal Sharma, Surinder Singh Rana, Vinita Chaudhary, Narendra Dhaka, Manish Manrai, Jegan Sivalingam, Ravi Sharma, Usha Dutta, Deepak Kumar Bhasin
Double duct sign where there is a simultaneous dilatation of both the common bile duct (CBD) and pancreatic duct is usually associated with sinister causes like malignancies of pancreatic head or ampulla. Occasionally, benign causes like chronic pancreatitis or sphincter of Oddi dysfunction (SOD) may cause double duct sign. Chronic opium abuse is a rare cause of the double duct sign, and endoscopic ultrasound (EUS) findings of this rare entity have been occasionally reported. We report about a 54-year-old male with a history of chronic alcohol and opioid abuse evaluated for episodes of abdominal pain and found to have opioid-related SOD and improved with biliary sphincterotomy...
July 2016: Endoscopic Ultrasound
S A Hoogenboom, S J Lekkerkerker, P Fockens, M A Boermeester, J E van Hooft
BACKGROUND/OBJECTIVES: Patients with chronic pancreatitis (CP) are at risk of malnutrition due to malabsorption, pain and/or alcohol consumption. This can cause vitamin D insufficiency or deficiency, which is associated with osteoporosis and increased risks of fractures. We aimed to perform a meta-analysis to determine the prevalence of vitamin D insufficiency and deficiency in CP patients. Furthermore, we compared these results with healthy controls. METHODS: We performed a systematic review and meta-analysis on the literature by searching PubMed and EMBASE (January 2000-December 2015) on CP and vitamin D...
September 2016: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
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