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Acute severe pancreatitis

Savino Occhionorelli, Lucia Morganti, Lorenzo Cappellari, Rocco Stano, Dario Andreotti, Giorgio Vasquez
INTRODUCTION: Arterial pseudoaneurysm is a rare and life-threatening complication of pancreatitis, seen more often in chronic than in acute pancreatitis. It involves mostly the splenic artery, while only in 10% of the case it appears in pancreaticoduodenal and gastric artery. This case report described an asymptomatic pseudoaneurysm of the posterior superior pancreaticoduodenal artery and of the right gastric artery, which occurred after 13days from the episode of acute pancreatitis and, then it was treated with vascular angioembolization...
October 18, 2016: International Journal of Surgery Case Reports
Gyotane Umefune, Hirofumi Kogure, Tsuyoshi Hamada, Hiroyuki Isayama, Kazunaga Ishigaki, Kaoru Takagi, Dai Akiyama, Takeo Watanabe, Naminatsu Takahara, Suguru Mizuno, Saburo Matsubara, Natsuyo Yamamoto, Yousuke Nakai, Minoru Tada, Kazuhiko Koike
BACKGROUND: Procalcitonin is being increasingly used to diagnose and grade acute systemic bacterial infection at an early stage of disease onset. The aim of this prospective study was to evaluate the usefulness of procalcitonin for severity grading of acute cholangitis on patient admission. METHODS: Patients with acute cholangitis were prospectively enrolled. The severity of acute cholangitis was graded on the basis of the 2013 Tokyo guidelines (Japanese Society of Hepato-Biliary-Pancreatic Surgery, 2013)...
October 25, 2016: Journal of Gastroenterology
Rostyslav Bilyy, Volodymyr Fedorov, Volodymyr Vovk, Moritz Leppkes, Tetiana Dumych, Valentyna Chopyak, Georg Schett, Martin Herrmann
Neutrophils form neutrophil extracellular traps (NETs) of decondensed DNA and histones that trap and immobilize particulate matter and microbial pathogens like bacteria. NET aggregates reportedly surround and isolate large objects like monosodium urate crystals, which cannot be sufficiently cleared from tissues. In the setting of acute necrotizing pancreatitis, massive tissue necrosis occurs, which is organized as pancreatic pseudocysts (1). In contrast to regular cysts, these pseudocysts are not surrounded by epithelial layers...
2016: Frontiers in Immunology
Maxim Avanesov, Julius M Weinrich, Thomas Kraus, Thorsten Derlin, Gerhard Adam, Jin Yamamura, Murat Karul
OBJECTIVES: The purpose of the retrospective study was to evaluate the additional value of dual-phase multidetector computed tomography (MDCT) protocols over a single-phase protocol on initial MDCT in patients with acute pancreatitis using three CT-based pancreatitis severity scores with regard to radiation dose. METHODS: In this retrospective, IRB approved study MDCT was performed in 102 consecutive patients (73 males; 55years, IQR48-64) with acute pancreatitis...
November 2016: European Journal of Radiology
Guojian Yin, Guoyong Hu, Rong Wan, Ge Yu, Xiaofeng Cang, Jie Xiong, Jianbo Ni, Yanling Hu, Miao Xing, Yuting Fan, Wenqin Xiao, Lei Qiu, Maochun Tang, Yan Zhao, Shaofeng Wang, Xingpeng Wang
OBJECTIVES: Mesenchymal stem cells (MSCs) have shown an obvious protective effect on acute pancreatitis (AP). The purpose of the present study was to analyze the effect of bone marrow MSC-derived microvesicles (bmMSC-MVs) on AP and explore the underlying mechanisms. METHODS: Bone marrow MSCs and bmMSC-MVs were isolated from Sprague-Dawley rats. Cerulein-induced mild AP (MAP) and sodium taurocholate-induced severe AP (SAP) were used as AP models in vivo and in vitro...
October 2016: Pancreas
X Liu, J Wang, Z-H Li
OBJECTIVE: To evaluate the role of glutamine-supplemented total parenteral nutrition (TPN) in severe acute pancreatitis. PATIENTS AND METHODS: Forty-seven patients with severe acute pancreatitis were admitted to Huaihe Hospital, China, over a period of one year (July 2013 to June 2014) were randomly divided into two therapeutic groups. Patients in group 1 (24 patients in total) and group 2 (23 patient in total) were treated with glutamine-supplemented TPN and standard TPN respectively...
October 2016: European Review for Medical and Pharmacological Sciences
Katalin Márta, Nelli Farkas, Imre Szabó, Anita Illés, Áron Vincze, Gabriella Pár, Patrícia Sarlós, Judit Bajor, Ákos Szűcs, József Czimmer, Dóra Mosztbacher, Andrea Párniczky, Kata Szemes, Dániel Pécsi, Péter Hegyi
The recently published guidelines for acute pancreatitis (AP) suggest that enteral nutrition (EN) should be the primary therapy in patients suffering from severe acute pancreatitis (SAP); however, none of the guidelines have recommendations on mild and moderate AP (MAP). A meta-analysis was performed using the preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P). The following PICO (problem, intervention, comparison, outcome) was applied: P: nutrition in AP; I: enteral nutrition (EN); C: nil per os diet (NPO); and O: outcome...
October 20, 2016: International Journal of Molecular Sciences
I Diallo, C A Fall, B Ndiaye, M Mbaye, I Diedhiou, A R Ndiaye, P S Diawara, F Fall, P S Mbaye, S B Gning
Primary hyperparathyroidism (PHPT) is rarely associated with the occurrence of acute or chronic pancreatitis. Hypercalcemia plays a major role in the pathogenesis. We report five cases of pancreatitis revealing PHPT. Patients and Methods. This is a retrospective study of 4 years, including all patients admitted to intensive care unit or gastroenterology department, for an acute or chronic pancreatitis revealing primary hyperparathyroidism. Results. We included 5 patients, all female, with mean age 54 years [40-76 years]...
2016: International Scholarly Research Notices
Ryo Fujiwara, Mitsuhiro Narita, Susumu Kageyama, Akihiro Kawauchi, Takahisa Nakayama, Natsumi Nishi, Hiroyuki Sugihara, Yusaku Okada
A 67-year-old man presented at our hospital with severe edema on the left side of his neck, chest and brachial regions. He had a history of right radical nephrectomy due to renal cell carcinoma (RCC, clear cell subtype, stage II) 15 years earlier. Thereafter, metastases to the pancreatic tail and right lung, and left lung metastasis were removed at 8 years and 11 years, respectively, after the nephrectomy. Four years earlier, he had also undergone total gastrectomy for gastric carcinoma (poorly differentiated adenocarcinoma, stage IV) and subsequent maintenance chemotherapy for gastric carcinoma...
September 2016: Hinyokika Kiyo. Acta Urologica Japonica
Guoliang Wang, Jingchao Zhang, Danhua Dui, Haoyuan Ren, Jin Liu
The pathogenesis of severe acute pancreatitis (SAP) remains unclear. The Janus kinase and signal transducer and activator of transcription (JAK/STAT) pathway is important for various cytokines and growth factors. This study investigated the effect of the late inflammatory factor high mobility group box 1 (HMGB1) on the activation of JAK2/STAT3 in pancreatic acinar cells and the inhibitory effects of AG490 (a JAK2 inhibitor) and rapamycin (a STAT3 inhibitor) on this pathway. Rat pancreatic acinar cells were randomly divided into the control, HMGB1, AG490, and rapamycin groups...
October 18, 2016: Bosnian Journal of Basic Medical Sciences
M B Rehman, B V Tudrej, J Soustre, M Buisson, P Archambault, D Pouchain, H Vaillant-Roussel, F Gueyffier, J-L Faillie, M-C Perault-Pochat, C Cornu, R Boussageon
BACKGROUND: Guidelines for type 2 diabetes (T2D) recommend reducing HbA1c through lifestyle interventions and glucose-lowering drugs (metformin, then combination with dipeptidyl peptidase-4 inhibitors [DPP-4Is] among other glucose-lowering drugs). However, no double-blind randomized clinical trial (RCT) compared with placebo has so far demonstrated that DDP-4Is reduce micro- and macrovascular complications in T2D. Moreover, the safety of DPP-4Is (with increased heart failure and acute pancreatitis) remains controversial...
October 10, 2016: Diabetes & Metabolism
Chao-Ming Tseng, Wei-Chih Liao, Chi-Yang Chang, Ching-Tai Lee, Cheng-Hao Tseng, Yao-Chun Hsu, Jaw-Town Lin
BACKGROUND: Pancreatic safety remains a concern for diabetic patients using incretin-based medications. We aimed to determine if there was an association between incretin-based therapy and an increased risk for acute pancreatitis and pancreatic cancer in patients with type 2 diabetes mellitus (DM). METHODS: This retrospective population-based cohort study analyzed data from the Taiwan National Health Insurance Research Database. A total of 13 171 eligible type 2 DM patients who had received incretin-based treatment for a minimum of two months were matched 1:1 for age, gender, diabetes complications severity index, and inception date with DM patients who never used this pharmacotherapy...
October 7, 2016: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Rafael Coimbra Ferreira Beltrame, Maurício Friderichs, Bárbara Rayanne Fior, Pedro Guilherme Schaefer, Gustavo Gomes Thomé, Dirceu Reis da Silva, Elvino José Guardão Barros, Renato Seligman, Francisco Veríssimo Veronese
The IgG4-related disease has a wide clinical spectrum where multiple organs can be affected, and the diagnosis depends on typical histopathological findings and an elevated IgG4 expression in plasma cells in the affected tissue. We describe the clinical presentation and evolution of a patient with acute tubulointerstitial nephritis, severe kidney failure and systemic manifestations such as lymphadenomegaly and chronic pancreatitis. The diagnosis was confirmed by the clinical picture and kidney and lymph node histopathology, in which immunohistochemistry of the lymphoid tissue showed policlonality and increased expression of IgG4, with a IgG4/total IgG ratio > 80%...
July 2016: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
Ana Rita Francisco, Inês Gonçalves, Fátima Veiga, Mónica Mendes Pedro, Fausto J Pinto, Dulce Brito
Severe hypertriglyceridemia has been consistently associated with an increased risk of cardiovascular disease and other complications, namely acute pancreatitis. We report a case of a 64 year-old woman with hypertrophic cardiomyopathy and metabolic syndrome with triglyceride level of 3260 mg/dL. Plasma exchange was performed with simultaneous medical treatment to achieve a rapid and effective lowering of triglycerides in order to prevent clinical complications. After three plasmapheresis sessions a marked reduction in triglyceride and total cholesterol levels was observed...
July 2016: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
Valentina Ferri, Benedetto Ielpo, Hipolito Duran, Eduardo Diaz, Isabel Fabra, Riccardo Caruso, Luisi Malave, Carlos Plaza, Silvia Rodriguez, Lina Garcia, Virginia Perez, Yolanda Quijano, Emilio Vicente
INTRODUCTION: Pancreatic disease can be complicated by extrabdominal manifestations such as panniculitis and polyarthritis. The symptomatic triad comprising pancreatic disease, panniculitis and polyarthritis is also known as PPP syndrome and is characterized by severe chronic sequels and high mortality rate. We describe a case of PPP syndrome successfully treated with spleen preserving total pancreatectomy; in addition we performed a literature review. PRESENTATION OF CASE: A 67 years old male presented panniculitis and polyarthritis without clinical abdominal symptoms...
September 28, 2016: International Journal of Surgery Case Reports
Sara Bertilsson, Per Swärd, Anders Håkansson, Rafid Tofik, Bengt Rippe, Evangelos Kalaitzakis
BACKGROUND AND AIMS: The disease course of acute pancreatitis (AP) ranges from mild and self-limiting to severe inflammation, associated with significant morbidity and mortality. At present, there are no universally accepted and reliable predictors for severity. Microproteinuria has been associated with the presence of systemic inflammatory response syndrome as well as trauma, although its association with AP is not well understood. The aim of this study was to investigate the value of microproteinuria to predict development of organ failure in AP...
October 12, 2016: Digestive Diseases and Sciences
Elisabetta Fenocchio, Ilaria Depetris, Delia Campanella, Lucia Garetto, Fabrizio Carnevale Schianca, Danilo Galizia, Giovanni Grignani, Massimo Aglietta, Francesco Leone
BACKGROUND: Gemcitabine is currently the standard chemotherapy for the adjuvant treatment of pancreatic cancer. This chemotherapeutic agent is generally well-tolerated, myelosuppression and gastrointestinal toxicity being common side effects. Nevertheless, gemcitabine-induced pulmonary toxicity has been rarely reported. Despite its low incidence, the spectrum of pulmonary injury is wide, including potentially fatal conditions. We report a case of acute interstitial pneumonia related to gemcitabine, completely solved with Imatinib Mesylate (IM)...
October 12, 2016: BMC Cancer
Fabíula Francisca Abreu, Ana Carla Araujó de Souza, Simone Aparecida Teixeira, Antônio Garcia Soares, Daiane Franco Teixeira, Rosilene Calazans Soares, Marilia Trindade Santana, Sandra Lauton Santos, Soraia Kátia Pereira Costa, Marcelo Nicolas Muscará, Enilton Aparecido Camargo
INTRODUCTION: Acute pancreatitis (AP) may be severe and cause hospitalization or death, and the available treatment is insufficient to control pancreatic inflammation and pain. Rutin is a natural flavonoid with the potential to treat AP via anti-inflammatory, antinociceptive and antioxidant activities. AIM: This study investigated the beneficial effects of rutin on experimental AP induced by L-arginine administration in mice. METHODS: The L-arginine-induced AP model was used in Swiss mice (n = 6-8)...
October 13, 2016: Free Radical Research
Sheng-Huei Wang, Yu-Ching Chou, Wei-Chuan Shangkuan, Kuang-Yu Wei, Yu-Han Pan, Hung-Che Lin
BACKGROUND: Hypertriglyceridemia is the third most common cause of acute pancreatitis, but whether the level of triglyceride (TG) is related to severity of pancreatitis is unclear. AIM: To evaluate the effect of TG level on the severity of hypertriglyceridemic pancreatitis (HTGP). DESIGN: Retrospective cohort study. METHODS: We reviewed the records of 144 patients with HTGP from 1999 to 2013 at Tri-Service General Hospital...
2016: PloS One
Jing Zhou, Lu Ke, Dongliang Yang, Yizhe Chen, Gang Li, Zhihui Tong, Weiqin Li, Jieshou Li
BACKGROUND: Splanchnic venous thrombosis (SVT) is a relatively rare but important complication of necrotizing acute pancreatitis (NAP). Clinical manifestations and severity of this complication in different patients vary greatly, ranging from mild abdominal discomfort even asymptomatic to lethal gastrorrhagia or hepatic failure. The aim of the present study was to develop a model to predict the clinical manifestations of SVT in NAP patients. METHODS: This retrospective cohort study was conducted in the surgical intensive care unit (SICU) of Jinling Hospital...
October 3, 2016: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
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