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https://www.readbyqxmd.com/read/29662703/aortic-dissection-presenting-as-acute-pancreatitis-suspecting-the-unexpected
#1
Adam Hafeez, Dillon Karmo, Adrian Mercado-Alamo, Alexandra Halalau
Aortic dissection is a life-threatening condition in which the inner layer of the aorta tears. Blood surges through the tear, causing the inner and middle layers of the aorta to separate (dissect). It is considered a medical emergency. We report a case of a healthy 56-year-old male who presented to the emergency room with sudden onset of epigastric pain radiating to his back. His blood pressure was 167/91 mmHg, equal in both arms. His lipase was elevated at 1258 U/L, and he was clinically diagnosed with acute pancreatitis (AP)...
2018: Case Reports in Cardiology
https://www.readbyqxmd.com/read/29660323/nationwide-trends-in-acute-and-chronic-pancreatitis-among-privately-insured-children-and-non-elderly-adults-in-the-united-states-2007-2014
#2
Zachary M Sellers, Donna MacIsaac, Helen Yu, Melody Dehghan, Ke-You Zhang, Rachel Bensen, Jessie J Wong, Cindy Kin, K T Park
BACKGROUND & AIMS: Epidemiologic analyses of acute and chronic pancreatitis (AP and CP) provide insight into causes and strategies for prevention, and affect allocation of resources to its study and treatment. We sought to determine current and accurate incidences of AP and CP, along with the prevalence of CP, in children and adults in the United States. METHODS: We collected data from the Truven MarketScan Research Databases of commercial inpatient and outpatient insurance claims in the United States from 2007 through 2014 (patients 0-64 years old)...
April 13, 2018: Gastroenterology
https://www.readbyqxmd.com/read/29644032/severe-acute-gallstone-pancreatitis-with-diffuse-hemorrhagic-gastritis
#3
Timothy J Harris, William C Beck, Avi Bhavaraju, Benjamin Davis, Mary K Kimbrough, Joseph C Jensen, Anna Privratsky, John R Taylor, Kevin W Sexton
A 67-year-old male presented with acute pancreatitis secondary to gallstones, also known as acute biliary pancreatitis, and subsequently developed gastric outlet obstruction and was transferred to our hospital. A gastro-jejunal feeding tube was placed and an open cholecystectomy was performed. The patient had a pancreatic drain placed for interval increase in pancreatic necrosis and then nearly exsanguinated from gastroduodenal artery pseudoaneurysm bleed. This was managed by coiling the gastroduodenal artery...
March 2018: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29626246/gallstone-pancreatitis-and-choledocholithiasis-using-imaging-and-laboratory-trends-to-predict-the-likelihood-of-persistent-stones-at-cholangiography
#4
Nikhil Panda, Yuchiao Chang, Nalin Chokengarmwong, Myriam Martinez, Liyang Yu, Peter J Fagenholz, Haytham A Kaafarani, David R King, Marc A DeMoya, George C Velmahos, D Dante Yeh
BACKGROUND: Patients with gallstone pancreatitis (GP) or choledocholithiasis (CDL) may have common bile duct (CBD) stones that persist until cholangiography. The aim of this study is to evaluate pre-cholangiogram factors that predict persistent CBD stones. METHODS: Multiple logistic regression analyses were performed to identify demographic, laboratory, and radiologic predictors of persistent CBD stones and non-therapeutic cholangiography among adults with GP or CDL...
April 6, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29624742/temporary-non-flared-fully-covered-self-expandable-metal-stent-placement-for-refractory-benign-choledochojejunal-anastomotic-stricture
#5
Hiroshi Yamauchi, Masayoshi Tadehara, Mitsuhiro Kida
A 74-year-old woman who underwent pylorus-preserving pacreatoduodenectomy + Child and Billroth-II reconstruction for pancreatic carcinoma, developed CJAS and gallstone cholangitis 3 months postoperatively. We performed endoscopic-balloon-dilation, lithotomy, and 7-Fr plastic-stent placement using a short-type single-balloon-enteroscope (channel diameter: 3.2mm, scope length: 1,520mm, Olympus Medical Systems). Four months after stent removal, the CJAS recurred. This article is protected by copyright. All rights reserved...
April 6, 2018: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/29602557/colicky-pain-and-related-complications-after-cholecystectomy-for-mild-gallstone-pancreatitis
#6
David W da Costa, Nicolien J Schepers, Stefan A Bouwense, Bob A Hollemans, Eva Doorakkers, Djamila Boerma, Camiel Rosman, Cees H Dejong, Marcel B W Spanier, Hjalmar C van Santvoort, Hein G Gooszen, Marc G Besselink
BACKGROUND: Same-admission cholecystectomy is advised after gallstone pancreatitis to prevent recurrent pancreatitis, colicky pain and other complications, but data on the incidence of symptoms and complications after cholecystectomy are lacking. METHODS: This was a prospective cohort study during the previously published randomized controlled PONCHO trial on timing of cholecystectomy after mild gallstone pancreatitis. Data on healthcare consumption and questionnaires focusing on colicky pain and biliary complications were obtained during 6 months after cholecystectomy...
March 27, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/29593917/a-case-of-unresolved-and-worsening-retroperitoneal-abscess
#7
Raghav Bansal, Mohamed Barakat, Soohwan Chun, Sonam Rosberger, Joel Baum, Melik Tiba
Retroperitoneal abscess is a rare condition which is difficult to diagnose and treat because of its insidious onset. Herein, we present a case of retroperitoneal abscess secondary to a perforation that occurred during an ERCP. A 54-year-old female patient was admitted to an outside hospital with gallstone pancreatitis and underwent ERCP with sphincterotomy followed by laparoscopic cholecystectomy. An abdominal CT scan was performed at the outside hospital 10 days later for worsening abdominal pain which showed multiple loculated pockets in the right upper and lower quadrant...
2018: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/29575044/correlation-between-neutrophil-lymphocyte-ratio-and-ranson-score-in-acute-pancreatitis
#8
Bahri Abaylı, Genco Gençdal, Şerife Değirmencioğlu
BACKGROUND: Acute pancreatitis (AP) is characterized by inflammation of the pancreas, elevated pancreatic enzymes, and abdominal pain. The neutrophil to lymphocyte ratio (NLR) is used as a marker of inflammation. In this retrospective study, we aimed to investigate novel early prognostic predictors of AP, such as NLR and its correlation with the Ranson score. METHODS: A total 435 patients (Male: 152; 34.9%, Age: 63.53 ± 17.22 years) were included in the study...
March 24, 2018: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/29563826/acute-pancreatitis-current-perspectives-on-diagnosis-and-management
#9
REVIEW
Adarsh P Shah, Moustafa M Mourad, Simon R Bramhall
The last two decades have seen the emergence of significant evidence that has altered certain aspects of the management of acute pancreatitis. While most cases of acute pancreatitis are mild, the challenge remains in managing the severe cases and the complications associated with acute pancreatitis. Gallstones are still the most common cause with epidemiological trends indicating a rising incidence. The surgical management of acute gallstone pancreatitis has evolved. In this article, we revisit and review the methods in diagnosing acute pancreatitis...
2018: Journal of Inflammation Research
https://www.readbyqxmd.com/read/29560600/prevalence-of-cardiovascular-dysfunction-and-its-association-with-outcome-in-patients-with-acute-pancreatitis
#10
Raghavendra Prasada, Narendra Dhaka, Ajay Bahl, Thakur Deen Yadav, Rakesh Kochhar
BACKGROUND: Organ failure (OF) is the most important predictor of outcome in severe acute pancreatitis (SAP). Cardiovascular failure (CVSF) occurs in a variable proportion of patients with SAP. We aimed to study myocardial dysfunction in acute pancreatitis (AP) and its impact on the outcome. METHODS: In this prospective study between January 2011 and July 2012, consecutive eligible patients of AP were enrolled. Myocardial function was assessed by measuring CK-MB (creatine phosphokinase isoenzyme) and echocardiography at admission...
March 21, 2018: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/29547060/interventional-radiology-operated-cholecystoscopy-for-the-management-of-symptomatic-cholelithiasis-approach-technical-success-safety-and-clinical-outcomes
#11
Nishant Patel, Jeffrey Forris Beecham Chick, Joseph J Gemmete, Jordan C Castle, Narasimham Dasika, Wael E Saad, Ravi N Srinivasa
OBJECTIVE: The objective of our study was to report the technique, complications, and clinical outcomes of interventional radiology-operated cholecystoscopy with stone removal for the management of symptomatic cholelithiasis. MATERIALS AND METHODS: Ten (77%) men and three (23%) women (mean age, 65 years) with symptomatic cholelithiasis underwent cholecystostomy followed by interventional radiology-operated cholecystoscopy with stone removal. Major comorbidities precluding cholecystectomy included prior cardiac, pulmonary, or abdominal surgery; cirrhosis; sepsis with hyponatremia; seizure disorder; developmental delay; and cholecystoduodenal fistula...
March 16, 2018: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/29523291/ercp-induced-and-non-ercp-induced-acute-pancreatitis-two-distinct-clinical-entities
#12
Ivana Zitinic, Ivana Plavsic, Goran Poropat, Goran Hauser
Acute pancreatitis (AP) is a common gastrointestinal disease of varied etiology; however, the most common causes of AP are gallstones and alcohol abuse. AP has emerged as the most frequent complication after endoscopic retrograde cholangiopancreatography (ERCP). Post-ERCP pancreatitis is generally a clinically irrelevant condition; however, it can be severe or even fatal in up to 0.8% of cases. Different clinical courses and outcomes have been observed between mild and severe AP of different etiologies (i.e...
April 2018: Medical Hypotheses
https://www.readbyqxmd.com/read/29521066/new-predictor-of-acute-necrotizing-pancreatitis-red-cell-distribution-width
#13
Mehmet Suat Yalçın, Adnan Tas, Banu Kara, Sehmus Olmez, Bunyamin Saritas
BACKGROUND: Acute pancreatitis (AP) is inflammation of the pancreas of various severity ranging from mild abdominal pain to mortality. AP may be classified as acute interstitial edematous pancreatitis (AEP) or acute necrotizing pancreatitis (ANP), according to the revised Atlanta criteria. Most of the patients with AP are AEP (75-85% of patients), while 15-25% of patients have ANP. The mortality rate is 3% in AEP and 15% in ANP. Thus, it is important to predict the severity of AP to decrease the morbidity and mortality...
February 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/29517638/endoscopic-retrograde-cholangiopancreatography-decreases-all-cause-and-pancreatitis-readmissions-in-patients-with-acute-gallstone-pancreatitis-who-do-not-undergo-cholecystectomy-a-nationwide-5-year-analysis
#14
Emad Qayed, Rushikesh Shah, Yara K Haddad
OBJECTIVES: Cholecystectomy is the definitive management of gallstone pancreatitis (GSP). The benefit of endoscopic retrograde cholangiopancreatography (ERCP) in patients who do not undergo cholecystectomy remains unclear. This study aims to evaluate the effect of ERCP on all-cause and pancreatitis readmissions in GSP. METHODS: Adult hospitalizations for GSP in the 2010-2014 National Readmissions Database were divided into the following 3 groups: (1) no cholecystectomy nor ERCP, (2) no cholecystectomy with ERCP, and (3) cholecystectomy group...
April 2018: Pancreas
https://www.readbyqxmd.com/read/29512023/rate-of-recurrence-in-indian-patients-presenting-with-acute-pancreatitis-and-identification-of-chronicity-on-follow-up-possible-risk-factors-for-progression
#15
Rishikesh Kalaria, Philip Abraham, Devendra C Desai, Anand Joshi, Tarun Gupta
BACKGROUND: To study the profile and long-term outcome of Indian patients presenting with acute pancreatitis and the possible risk factors for progression. METHODS: Consecutive patients with acute or recurrent acute pancreatitis seen in our department during July 2013 to December 2014 were included. Details of past episodes were collected and patients were followed up till March 2015. RESULTS: In the 97 patients included (mean age 47.2 [SD 16...
March 7, 2018: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/29501782/bile-spillage-as-a-risk-factor-for-surgical-site-infection-after-laparoscopic-cholecystectomy-a-prospective-study-of-1-001-patients
#16
Thomas Peponis, Trine G Eskesen, Tomaz Mesar, Noelle Saillant, Haytham Ma Kaafarani, D Dante Yeh, Peter J Fagenholz, Marc A de Moya, David R King, George C Velmahos
BACKGROUND: Bile spillage (BS) occurs frequently during laparoscopic cholecystectomy, yet its impact on postoperative outcomes remains unknown. We hypothesized that BS increases the risk of surgical site infections (SSI) after laparoscopic cholecystectomy. STUDY DESIGN: Patients older than 18, who were admitted to an academic hospital for a laparoscopic (or laparoscopic converted to open) cholecystectomy from 05/2010 to 03/2017, were prospectively included. Open cholecystectomies were excluded...
March 1, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29498913/acute-pancreatitis-in-patients-with-severe-hypertriglyceridemia-in-a-multiethnic-minority-population
#17
Ambika Amblee, Divyanshu Mohananey, Micheal Morkos, Sanjib Basu, Ayokunle Abegunde, Malini Ganesh, Neil Bhalerao, Amrutha Mary George, Milli Jain, Leon Fogelfeld
OBJECTIVE: To investigate the prevalence and predictors of hypertriglycerdemic acute pancreatitis (HTG-AP) in a multiethnic minority population. METHODS: A retrospective cross-sectional study from 2003 to 2013 of 1157 adults with serum triglyceride (TG) level ≥ 1000 mg/dL comparing baseline characteristics and risk factors between those with and without HTG-AP. RESULTS: Mean study population age was 49.2±11.5 years; 75.6% males; 31.6% African Americans, 38...
March 2, 2018: Endocrine Practice
https://www.readbyqxmd.com/read/29486665/mirtazapine-induced-pancreatitis-a-case-report
#18
Riley D Bowers, Sara M Valanejad, Ashley A Holombo
Acute pancreatitis has numerous etiologies, with the most common including gallstones, alcohol abuse, and medications such as angiotensin-converting enzyme (ACE) inhibitors, statins, and diuretics. Mirtazapine has been associated with increased serum cholesterol and serum triglyceride levels. However, few studies have reported dangerously elevated triglyceride levels resulting in acute pancreatitis. This report discusses a case of mirtazapine-induced pancreatitis in a 46-year-old African American female. The patient presented to the emergency department with pancreatitis, presumably alcohol-induced as with a prior admission, but she denied any recent alcohol use...
January 1, 2018: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29472508/false-prolongation-of-international-normalized-ratio-associated-with-daptomycin
#19
Susan E Smith, Kelli A Rumbaugh
PURPOSE: Persistent elevation of prothrombin time (PT) and International Normalized Ratio (INR) values in a patient receiving daptomycin is reported. SUMMARY: A morbidly obese 51-year-old man was hospitalized for evaluation for surgical intervention for gallstone pancreatitis and biliary obstruction. Previously prescribed warfarin therapy was withheld due to suspected coagulopathy and an elevated INR (5.1), and warfarin reversal was initiated. After undergoing partial cholecystectomy on hospital day 6, the patient developed sepsis and was treated with i...
March 1, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29462081/the-opioid-epidemic-in-acute-care-surgery-characteristics-of-overprescribing-following-laparoscopic-cholecystectomy
#20
Kristine T Hanson, Cornelius A Thiels, Stephanie F Polites, Halena M Gazelka, Mohamed D Ray-Zack, Martin D Zielinski, Elizabeth B Habermann
BACKGROUND: Postoperative prescribing following acute care surgery must be optimized to limit excess opioids in circulation as misuse and diversion are frequently preceded by a prescription for acute pain. This study aimed to identify patient characteristics associated with higher opioid prescribing following laparoscopic cholecystectomy (LC). METHODS: Among patients age ≥18 years who underwent LC at a single institution 2014-2016, opioids prescribed at discharge were converted to oral morphine equivalents (OME) and compared to developing state guidelines (max 200 OME)...
February 17, 2018: Journal of Trauma and Acute Care Surgery
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