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https://www.readbyqxmd.com/read/29401491/urgent-endoscopic-retrograde-cholangiopancreatography-is-not-superior-to-early-ercp-in-acute-biliary-pancreatitis-with-biliary-obstruction-without-cholangitis
#1
Hee Seung Lee, Moon Jae Chung, Jeong Youp Park, Seungmin Bang, Seung Woo Park, Si Young Song, Jae Bock Chung
Acute pancreatitis is a common diagnosis worldwide, with gallstone disease being the most prevalent cause (50%). The American College of Gastroenterology recommends urgent endoscopic retrograde cholangiopancreatography (ERCP) (within 24 h) for patients with biliary pancreatitis accompanied by cholangitis. Most international guidelines recommend that ERCP be performed within 72 h in patients with biliary pancreatitis and a bile duct obstruction without cholangitis, but the optimal timing for endoscopy is controversial...
2018: PloS One
https://www.readbyqxmd.com/read/29388462/safety-and-tolerability-of-new-generation-anti-obesity-medications-a-narrative-review
#2
Dhiren K Patel, Fatima Cody Stanford
The prevalence of obesity and associated comorbidities is rising. Despite their weight-loss efficacy, new generation anti-obesity medications are only prescribed to a minority of adults with obesity, possibly, which in part may be due to safety concerns. This review presents detailed safety profiles for orlistat, phentermine/topiramate, lorcaserin, naltrexone/bupropion and liraglutide 3.0 mg, and discusses the associated risk-benefit profiles. Two anti-obesity medications presented safety issues that warranted further discussion; phentermine/topiramate (fetal toxicity) and liraglutide 3...
February 8, 2018: Postgraduate Medicine
https://www.readbyqxmd.com/read/29370777/neutrophil-to-lymphocyte-ratio-and-platelet-to-lymphocyte-ratio-can-predict-the-severity-of-gallstone-pancreatitis
#3
Seung Kook Cho, Saehyun Jung, Kyong Joo Lee, Jae Woo Kim
BACKGROUND: Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) predict severity in various diseases. In this study, we evaluated the value of NLR and PLR as prognostic factors in acute pancreatitis (AP). METHODS: Patients with AP were prospectively enrolled from March 2014 to September 2016 at Yonsei University Wonju College of Medicine. NLR and PLR were obtained at admission and were compared with other known prognostic scoring systems...
January 25, 2018: BMC Gastroenterology
https://www.readbyqxmd.com/read/29340918/validation-of-aast-egs-grade-for-acute-pancreatitis
#4
Moustafa Younis, Matthew Hernandez, Mohamed Ray-Zack, Nadeem N Haddad, Asad Choudhry, Pooja Reddy, Martin D Zielinski
BACKGROUND: The AAST recently developed an emergency general surgery (EGS) disease grading system to measure anatomic severity. We aimed to validate this grading system for acute pancreatitis and compare cross sectional imaging-based AAST EGS grade and compare with several clinical prediction models. We hypothesize that increased AAST EGS grade would be associated with important physiological and clinical outcomes and is comparable to other severity grading methods. METHODS: Single institution retrospective review of adult patients admitted with acute pancreatitis during 10/2014-1/2016 was performed...
January 16, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29320323/multimodality-imaging-including-dual-energy-ct-in-the-evaluation-of-gallbladder-disease
#5
Lisa Ratanaprasatporn, Jennifer W Uyeda, Jeremy R Wortman, Ian Richardson, Aaron D Sodickson
Imaging of the gallbladder has a key role in the examination of patients with abdominal pain-especially pain localized to the right upper quadrant. Pathologic conditions that affect the gallbladder include cholelithiasis and associated complications such as acute and chronic cholecystitis, choledocholithiasis, gallstone pancreatitis, and cancer. Modalities used to image the gallbladder include ultrasonography (US), computed tomography (CT), magnetic resonance (MR) imaging, and nuclear scintigraphy. US is the primary imaging modality used to evaluate entities suspected of being gallbladder disease, as it is both sensitive and specific for demonstrating gallstones, biliary duct dilatation, and inflammatory features...
January 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/29299374/probable-paclitaxel-induced-pancreatitis-uncommon-case-report-and-literature-review
#6
Hanan Raiss, Lamiae El Amarti, Jean Dominique Tigaud, Mohamed Layachi, Amandine Bruyas, Saber Boutayeb, Hassan Errihani
Acute pancreatitis is an inflammatory disorder of the pancreas characterized by upper abdominal pain, nausea, and vomiting, with elevated serum amylase or lipase. Gallstones and alcohol are the two main etiologies; drug-induced pancreatitis is uncommon. Paclitaxel associated with pancreatitis is very rare and since that time, only seven case reports have been published. We report a case of a 54-year-old female who developed an acute pancreatitis after administration of the first cycle of neoadjuvant chemotherapy with paclitaxel (175 mg/m2 over 3 h) and carboplatin (AUC 6) for ovarian adenocarcinoma...
December 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/29280919/short-article-presence-extent-and-location-of-pancreatic-necrosis-are-independent-of-aetiology-in-acute-pancreatitis
#7
Robert C Verdonk, Hanna Sternby, Alexandra Dimova, Povilas Ignatavicius, Peter Koiva, Anne K Penttila, Lucas Ilzarbe, Sara Regner, Jonas Rosendahl, Thomas L Bollen
OBJECTIVE: The most common aetiologies of acute pancreatitis (AP) are gallstones, alcohol and idiopathic. The impact of the aetiology of AP on the extent and morphology of pancreatic and extrapancreatic necrosis (EXPN) has not been clearly established. The aim of the present study was to assess the influence of aetiology on the presence and location of pancreatic necrosis in patients with AP. PATIENTS AND METHODS: We carried out a post-hoc analysis of a previously established multicentre cohort of patients with AP in whom a computed tomography was available for review...
March 2018: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29241388/hypercalcemia-induced-pancreatitis-in-pregnancy-following-calcium-carbonate-ingestion
#8
May S Trezevant, John C Winton, Ashley K Holmes
BACKGROUND: Calcium carbonate is often used to relieve Gastroesophageal Reflux Disease (GERD) in pregnant patients. This report describes a potentially serious complication. CASE: A pregnant female presented at 34 weeks gestation with abdominal pain, nausea, and vomiting. Home medications included an unquantifiable amount of calcium carbonate 500 mg due to constant consumption for GERD. Laboratory findings included elevated calcium, amylase, lipase, and triglyceride level...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29237668/left-sided-sinistroposition-of-the-gall-bladder-incidental-presentation-during-elective-cholecystectomy
#9
Nilesh H Doctor, Vijay Waman Dhakre
A 59-year-old male patient presented with mild gallstone pancreatitis. He underwent laparoscopic cholecystectomy during the same admission, where we encountered a left-sided gall bladder (GB). This was managed during laparoscopic surgery by modifying the laparoscopic port positions, and we did not encounter any other variations in the biliary anatomy. Thorough knowledge regarding anatomical variations of the GB will help in managing rare cases and avoid injuries to vital structures.
December 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29222221/acute-pancreatitis-following-oesophagogastroduodenoscopy
#10
Nnamdi Arinze Nwafo
Acute pancreatitis is a well-recognised complication of endoscopic procedures like endoscopic retrograde cholangiopancreatography but not oesophagogastroduodenoscopy (OGD). I report a case of a 33-year-old woman, admitted with severe epigastric pain and vomiting 2 hours after an elective OGD for evaluation of chronic gastrointestinal symptoms. Pancreatitis was diagnosed on the basis of elevated lipase (40 790 U/L; normal 11-82) and findings on imaging studies. Other common causes of acute pancreatitis such as gallstones, alcohol and medications were ruled out...
December 7, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29205025/can-we-prevent-post-ercp-pancreatitis
#11
Antti Siiki, Johanna Laukkarinen
Endoscopic retrograde cholangiopancreatography (ERCP) is the primary method for treating cholestasis and biliary tract gallstones. Although noninvasive imaging has replaced ERCP in diagnostics, ERCP remains the mainstay in collecting diagnostic specimens from the biliary tract. ERCP carries a risk of post-ERCP pancreatitis, which can vary from mild to life-threatening. Difficult cannulation is the most important risk factor for pancreatitis. Careful patient selection and adequate endoscopy training are the foundation of safe ERCP practice...
2017: Duodecim; Lääketieteellinen Aikakauskirja
https://www.readbyqxmd.com/read/29201486/gallstone-pancreatitis-a-common-but-often-overlooked-cause-of-abdominal-pain-in-post-liver-transplant-patients
#12
Napatt Kanjanahattakij, Kamolyut Lapumnuaypol, Sanna Fatima, Eyob Feyssa
Introduction: In general population, gallstone pancreatitis is the most common cause of pancreatitis. However, there are very few literatures that address this topic in post-liver-transplant patients. Clinical Case: A 69-year-old female who had a liver transplant in 2015 due to hepatocellular carcinoma and nonalcoholic steatohepatitis (NASH) cirrhosis. She had a recent episode of acute cellular rejection that was treated with high dose methylprednisolone 1 week prior to admission...
2017: Case Reports in Transplantation
https://www.readbyqxmd.com/read/29195671/alcohol-smoking-and-benign-hepato-biliary-disease
#13
REVIEW
Daniel Mønsted Shabanzadeh, Srdan Novovic
Gallstone disease and pancreatitis are the most frequent benign hepato-biliary causes of hospital admissions. Gallstone disease is prevalent, but symptomatic disease develops only in about one out of five carriers. Alcohol intake seems to protect gallstone formation in cohort studies possibly through effects on bile cholesterol metabolism, the enterohepatic circulation, and gallbladder function. The impact of smoking on gallstone formation seems minor. Both alcohol intake and smoking do not alter the clinical course of gallstone disease carriers...
October 2017: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/29189884/adaptive-immune-cell-dysregulation-and-role-in-acute-pancreatitis-disease-progression-and-treatment
#14
REVIEW
Pascaline Fonteh, Martin Smith, Martin Brand
Acute pancreatitis (AP) is an inflammation of the pancreas caused by various stimuli including excessive alcohol consumption, gallstone disease and certain viral infections. Managing specifically the severe form of AP is limited due to lack of an understanding of the complex immune events that occur during AP involving immune cells and inflammatory molecules such as cytokines. The relative abundance of various immune cells resulting from the immune dysregulation drives disease progression. In this review, we examine the literature on the adaptive immune cells in AP, the prognostic value of these cells in stratifying patients into appropriate care and treatment strategies based on cell frequency in different AP severities are discussed...
November 30, 2017: Archivum Immunologiae et Therapiae Experimentalis
https://www.readbyqxmd.com/read/29174078/acute-pancreatitis-admission-trends-a-national-estimate-through-the-kids-inpatient-database
#15
Maisam Abu-El-Haija, Samer El-Dika, Alice Hinton, Darwin L Conwell
OBJECTIVES: To evaluate national health care use and costs for pediatric acute pancreatitis. STUDY DESIGN: The Kids' Inpatient Database for 2006, 2009, and 2012 was queried for patients with a principal diagnosis of acute pancreatitis. Cases were grouped by age: preschool (<5 years of age), school age (5-14 years of age), and adolescents (>14 years of age). RESULTS: A total of 27 983 discharges for acute pancreatitis were found. The number of admissions increased with age: young n = 1279, middle n = 8012, and older n = 18 692...
November 21, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29164335/clinical-characteristics-of-acute-pancreatitis-in-pregnancy-experience-based-on-121-cases
#16
Lingyu Luo, Hao Zen, Hongrong Xu, Yin Zhu, Pi Liu, Liang Xia, Wenhua He, Nonghua Lv
PURPOSE: Acute pancreatitis in pregnancy (APIP) is a rare condition; however, it markedly affects maternal and fetal health. This study aimed to describe the types, clinical characteristics, mortality, and the safety and necessity of gestation termination of acute pancreatitis in pregnancy (APIP). METHODS: We retrospectively reviewed 121 APIP cases in the Gastroenterology Department of The First Affiliated Hospital of Nanchang University. APIP diagnosis were based on 2012 Atlanta Criteria...
November 21, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29156853/the-importance-of-routine-bedside-biliary-ultrasonography-in-the-management-of-patients-admitted-to-the-emergency-department-with-isolated-acute-epigastric-pain
#17
Vermi Değerli, Tanzer Korkmaz, Hülya Mollamehmetoğlu, Cem Ertan
Background/aim: The aim of our study was to emphasize the importance of routine bedside biliary ultrasonography (USG) for the differential diagnosis of biliary tract disorders in patients admitted with acute isolated epigastric pain. Materials and methods: Adult patients who were admitted to the emergency department with acute isolated epigastric pain were included in the study. Emergency residents (ERs) were asked whether they planned to perform biliary USG during the initial evaluation and following diagnosis/treatment (secondary evaluation) of these patients...
August 23, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29142480/case-of-familial-hyperlipoproteinemia-type-iii-hypertriglyceridemia-induced-acute-pancreatitis-role-for-outpatient-apheresis-maintenance-therapy
#18
Mohannad Abou Saleh, Emad Mansoor, Gregory S Cooper
Hypertriglyceridemic pancreatitis (HTGP) accounts for up to 10% of acute pancreatitis presentations in non-pregnant individuals and is the third most common cause of acute pancreatitis after alcohol and gallstones. There are a number of retrospective studies and case reports that have suggested a role for apheresis and insulin infusion in the acute inpatient setting. We report a case of HTGP in a male with hyperlipoproteinemia type III who was treated successfully with insulin and apheresis on the initial inpatient presentation followed by bi-monthly outpatient maintenance apheresis sessions for the prevention of recurrent HTGP...
October 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29132523/pancreatitis-and-pancreatic-cancer
#19
REVIEW
Anne Walling, Robert Freelove
Most cases of acute pancreatitis are related to gallstones. More than 80% resolve within a few days. The diagnosis is based on upper abdominal pain, elevated lipase and/or amylase, and transabdominal ultrasound findings. Management requires early aggressive hydration, pain control, nutritional support, and monitoring for progression. Patients who develop hypovolemia, systemic inflammatory response, pancreatic necrosis, and organ failure have high mortality, risk of recurrence, and progression to chronic pancreatitis (CP)...
December 2017: Primary Care
https://www.readbyqxmd.com/read/29132521/gallbladder-dysfunction-cholecystitis-choledocholithiasis-cholangitis-and-biliary-dyskinesia
#20
REVIEW
Thad Wilkins, Edward Agabin, Jason Varghese, Asif Talukder
The prevalence of gallstones is 10% to 15% in adults. Individuals with acute cholecystitis present with right upper quadrant pain, fever, and leukocytosis. Management includes supportive care and cholecystectomy. The prevalence of choledocholithiasis is 10% to 20%, and serious complications include cholangitis and gallstone pancreatitis. The goal of management in individuals with choledocholithiasis consists of clearing common bile duct stones. Acute ascending cholangitis is a life-threatening condition involving acute inflammation and infection of the common bile duct...
December 2017: Primary Care
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