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https://www.readbyqxmd.com/read/28821411/diagnosis-and-treatment-in-chronic-pancreatitis-an-international-survey-and-case-vignette-study
#1
Yama Issa, Hjalmar C van Santvoort, Paul Fockens, Marc G Besselink, Thomas L Bollen, Marco J Bruno, Marja A Boermeester
BACKGROUND: The aim of the study was to evaluate the current opinion and clinical decision-making process of international pancreatologists, and to systematically identify key study questions regarding the diagnosis and treatment of chronic pancreatitis (CP) for future research. METHODS: An online survey, including questions regarding the diagnosis and treatment of CP and several controversial clinical case vignettes, was send by e-mail to members of various international pancreatic associations: IHPBA, APA, EPC, ESGE and DPSG...
August 15, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28816176/-severely-increased-serum-lipid-levels-in-diabetic-ketoacidosis-case-report
#2
Hrafnkell Stefansson, Kristinn Sigvaldason, Hilmar Kjartansson, Helga Águsta Sigurjonsdottir
Severe hypertriglyceridemia is a known, but uncommon complication of diabetic ketoacidosis. We discuss the case of a 23-year-old, previously healthy, woman who initially presented to the emergency department with abdominal pain. Grossly lipemic serum due to extremely high triglyceride (38.6 mmol/L) and cholesterol (23.2 mmol/L) levels were observed with a high blood glucose (23 mmol/L) and a low pH of 7.06 on a venous blood gas. She was treated successfully with fluids and insulin and had no sequale of pancreatitis or cerebral edema...
July 2017: Læknablađiđ
https://www.readbyqxmd.com/read/28814218/diagnosis-and-management-of-pancreatic-exocrine-insufficiency
#3
Mehrdad Nikfarjam, Jeremy S Wilson, Ross C Smith
In 2015, the Australasian Pancreatic Club (APC) published the Australasian guidelines for the management of pancreatic exocrine insufficiency (http://pancreas.org.au/2016/01/pancreatic-exocrine-insufficiency-guidelines). Pancreatic exocrine insufficiency (PEI) occurs when normal digestion cannot be sustained due to insufficient pancreatic digestive enzyme activity. This may be related to a breakdown, at any point, in the pancreatic digestive chain: pancreatic stimulation; synthesis, release or transportation of pancreatic enzymes; or synchronisation of secretions to mix with ingested food...
August 21, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28808857/the-surgeon-s-role-in-treating-chronic-pancreatitis-and-incidentally-discovered-pancreatic-lesions
#4
Vikrom K Dhar, Brent T Xia, Syed A Ahmad
Chronic pancreatitis and incidentally discovered pancreatic lesions present significant diagnostic and therapeutic challenges for surgeons. While both decompressive and resection procedures have been described for treatment of chronic pancreatitis, optimal management must be tailored to each patient's individual disease characteristics, parenchymal morphology, and ductal anatomy. Surgeons should strive to achieve long-lasting pain relief while preserving native pancreatic function. For patients with incidentally discovered pancreatic lesions, differentiating benign, pre-malignant, and malignant lesions is critical as earlier treatment is thought to result in improved survival...
August 14, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28808565/acute-pancreatitis-a-7-year-retrospective-cohort-study-of-the-epidemiology-aetiology-and-outcome-from-a-tertiary-hospital-in-jamaica
#5
Gail P Reid, Eric W Williams, Damian K Francis, Michael G Lee
BACKGROUND: Acute pancreatitis (AP) is a significant cause of acute abdominal pain, morbidity and hospitalisation. There was previously a dearth of studies exploring the incidence, risk factors and outcome of AP in the Caribbean region. MATERIALS AND METHODS: All patients with a diagnosis of AP admitted to the University Hospital of the West Indies (UHWI) between 2006 and 2012 were reviewed. The epidemiological profile, risk factors, clinical presentation and outcomes of patients with AP were retrospectively studied...
August 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28806261/unexpected-fibrosing-mediastinitis-shown-on-fdg-pet-ct-in-a-patient-with-igg4-related-disease
#6
Ying Kan, Leilei Yuan, Wei Wang, Jigang Yang
A 66-year-old man presented to our hospital because of abdominal pain for 5 days. A contrast abdominal CT raised the possibility of pancreatic carcinoma. FDG PET/CT showed increased FDG accumulation not only in the pancreas and the retroperitoneum, but also in the posterior mediastinum, which was not typical of pancreatic carcinoma. The patient was subsequently diagnosed having immunoglobulin G4-related disease following the histopathologic examination.
August 12, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28802775/catastrophic-antiphospholipid-syndrome-caps-induced-ischemic-pancreatic-ducts-injury-mimicking-intraductal-papillary-mucinous-neoplasm-ipmn
#7
Léa Savey, Jean-Charles Piette, Jérome Bellanger, Laurent Palazzo, Zahir Amoura, Alain Sauvanet, Jean-François Pouget-Abadie, Philippe Sogni, Joseph Emmerich, Nathalie Costedoat-Chalumeau
OBJECTIVES: Catastrophic antiphospholipid syndrome (CAPS) is a life-threatening disease characterized by multiple small-vessel occlusions of rapid onset. Ischemic pancreatic duct lesions secondary to CAPS have never been reported. METHODS: We describe 4 patients who presented lesions suspected to be intraductal papillary mucinous neoplasm (IPMN) of the pancreas following a CAPS. RESULTS: All patients had a history of CAPS months or years before the IPMN diagnosis...
July 10, 2017: Seminars in Arthritis and Rheumatism
https://www.readbyqxmd.com/read/28796136/local-and-systemic-expression-of-immunomodulatory-factors-in-chronic-pancreatitis
#8
Hannah M Komar, Phil A Hart, Zobeida Cruz-Monserrate, Darwin L Conwell, Gregory B Lesinski
Inflammatory and fibrotic events that drive chronic pancreatitis (CP) are likely orchestrated via signaling of soluble cytokines and chemokines systemically and within the pancreas. However, a comprehensive summary of the expression of such factors during CP has not been reported to date. This information is important given continued interest in targeting cytokines that influence CP pathogenesis. Reported data on the expression change of soluble immunomodulatory factors in human CP patients were identified via a literature search using a single search term...
September 2017: Pancreas
https://www.readbyqxmd.com/read/28795293/endoscopic-palliation-of-pancreatic-cancer
#9
REVIEW
Vishal B Gohil, Jason B Klapman
Pancreas cancer is a fourth-leading cause of cancer death in the USA and its incidence is rising as the population is aging. The majority of patients present at an advanced stage due to the silent nature of the disease and treatment have focused more on palliation than curative intent. Gastroenterologists have become integral in the multidisciplinary care of these patients with a focus on providing endoscopic palliation of pancreas cancer. The three most common areas that gastroenterologists palliate endoscopically are biliary obstruction, cancer-related pain, and gastric outlet obstruction...
August 9, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28791598/opioid-medications-in-the-management-of-chronic-abdominal-pain
#10
REVIEW
Dajie Wang
PURPOSE OF REVIEW: Chronic abdominal pain is a complex medical condition. The causes of chronic abdominal pain are extremely diverse ranging from chronic pancreatitis, Crohn's disease, to chronic pain with no clear etiology. Treatment of chronic abdominal pain remains a challenge in our clinical practice. While current interventions with celiac plexus blocks and pain medications provide some relief for these patients, but these treatments are typically less efficacious and limited by various adverse effects...
August 8, 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/28791352/establishment-of-a-murine-pancreatic-cancer-pain-model-and-microarray-analysis-of-pain%C3%A2-associated-genes-in-the-spinal-cord-dorsal-horn
#11
Liqin Wang, Huihong Xu, Yanhu Ge, Hai Zhu, Dawei Yu, Weifeng Yu, Zhijie Lu
There is emerging evidence on the mechanisms of pancreatic cancer pain. Following the establishment of an orthotropic transplantation model of pancreatic cancer, microarray analysis was performed to identify changes in the expression levels of pain‑associated genes in the spinal cord. A mouse model of pancreatic cancer‑induced pain was established by implanting SW 1990 cells into the pancreases of female BALB/c‑nu mice. The survival rate and body weight were measured following orthotropic transplantation...
August 4, 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/28791247/the-endovascular-management-of-a-3-5-cm-gastroduodenal-artery-aneurysm-presenting-with-gastritis-and-recurrent-pancreatitis
#12
Baraa Zuhaili, Robert G Molnar, Nitin G Malhotra
Visceral artery aneurysms (VAAs) are a rare entity. Within this subset of aneurysms, gastroduodenal artery (GDA) aneurysms represent an even more rare occurrence. We present a case report of treating GDA aneurysm on semi-elective basis followed by literature review of the clinical presentation and mainstream treatment modalities. GO is a 65-year-old male, with 6-month history of recurrent epigastric pain. He was found to have acute pancreatitis and an adjacent 3.5-cm GDA aneurysm. After conservative treatment of pancreatitis, the aneurysm was treated with coil embolization of the sac and GDA...
July 2017: Avicenna Journal of Medicine
https://www.readbyqxmd.com/read/28790864/case-report-bilateral-tunneled-epidural-catheters-to-prevent-unilateral-analgesia-for-cancer-related-pain
#13
Raj B Padalia, Corey J Reeves, Neal Shah, Ankur A Patel, Devang M Padalia
OBJECTIVE: Unilateral analgesia often occurs with epidural analgesia. Traditional methods of troubleshooting this problem can be insufficient in obtaining adequate pain relief in a timely manner for terminal cancer patients. This case report demonstrates a safe and effective solution which can be utilized in these circumstances. CASE REPORT: A 55-year-old female with stage IV pancreatic cancer and life expectancy of a few weeks presented to the interventional pain clinic with intractable sacral pain...
2017: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/28790092/abdominal-aortic-aneurysm-in-the-setting-of-clostridium-perfringens-pancreatitis
#14
Paul Anthony Karam, Maitham A Moslim, Woosup Michael Park, Gareth Morris-Stiff
We report a case of a 56-year-old woman who presented with worsening abdominal pain located in the left upper quadrant together with abdominal distention, nausea and anorexia. One month prior to this admission, she had presented and had been diagnosed with concurrent acute pancreatitis and rapidly expanding abdominal aortic aneurysm. The aneurysm was prioritised over the pancreatitis and she underwent uncomplicated endovascular repair. Cross-sectional imaging was consistent with infected pancreatic necrosis and also revealed a large collection located in the anterior pararenal space with extensive gas formation...
August 7, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28771447/chronic-pancreatitis
#15
Dennis Yang, Chris E Forsmark
PURPOSE OF REVIEW: Summarize key clinical advances in chronic pancreatitis reported in 2016. RECENT FINDINGS: Early diagnosis of chronic pancreatitis remains elusive. Recent studies suggest that endoscopic ultrasound may be less accurate than previously thought and new MRI techniques may be helpful. Genetic predisposition may independently affect the clinical course of chronic pancreatitis and the risk for pancreatic cancer. Cigarette smoking may have a greater negative impact on chronic pancreatitis than previously thought and moderate alcohol consumption may be protective...
September 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28767594/retroperitoneal-bronchogenic-cyst-resembling-an-adrenal-tumor-with-high-levels-of-serum-carbohydrate-antigen-19-9-a-case-report
#16
Min Wang, Xu He, Xia Qiu, Chuan Tian, Jian Li, Mingnan Lv
RATIONALE: Retroperitoneal bronchogenic cysts without specific clinical manifestations are extremely rare and difficult to diagnose preoperatively and are easily misdiagnosed as left adrenal or pancreatic tumors. PATIENT CONCERNS: A 48-year-old woman with the chief complaint of obscure epigastric pain for 1 month and with no other gastrointestinal symptoms and no significant medical history. The patient had signed informed consent for publication of this case report...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28767565/small-intestine-follicular-dendritic-cell-sarcoma-with-liver-metastasis-a-case-report
#17
Yun-Chen Chang, Ivy Yenwen Chau, Yi-Chen Yeh, Gar-Yang Chau
RATIONALE: Follicular dendritic cell sarcoma (FDCS) is a rare neoplasia composed of spindle or oval cells with follicular dendritic cell differentiation, usually occurring in lymphoid tissue. In this report, we present a case of FDCS of the small intestine with liver metastasis. PATIENT CONCERNS: A 19-year-old female presented with recent onset of left upper abdominal pain. Abdominal computed tomography scan showed a large tumor mass in the liver lateral segment with compression to the pancreas upper part, and a smaller mass in the terminal ileum, respectively...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28765897/the-toll-like-receptor-4-antagonist-tak-242-protects-against-chronic-pancreatitis-in-rats
#18
Long-Fei Pan, Lei Yu, Li-Ming Wang, Jun-Tao He, Jiang-Li Sun, Xiao-Bo Wang, Zheng-Hai Bai, Hai Wang, Ting-Lin Yan, Hong-Hong Pei
Chronic pancreatitis is a progressive disease characterized by irreversible morphological changes to the pancreas, typically causing pain and permanent loss of function. It is a poorly understood disease with the pathogenesis remaining unclear. The authors' previous data demonstrated that the inhibition of Toll‑like receptor 4 (TLR4) using TLR4 antagonist kinase (TAK)‑242 attenuates taurocholate‑induced oxidative stress via the regulation of mitochondrial function in the pancreatic acinar cells of mice...
July 27, 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/28761543/spinal-capillary-hemangiomas-two-cases-reports-and-review-of-the-literature
#19
Thara Tunthanathip, Sanguansin Rattanalert, Thakul Oearsakul, Kanet Kanjanapradit
Hemangiomas have rarely been found in the spinal cord. A few cases of spinal capillary hemangioma have been reported since 1987. The authors reported the two cases of capillary hemangioma including the tumor at conus medullaris and the another mimicked von Hippel-Lindau disease. A 15-year-old man was presented with coccydynia and left leg pain. A magnetic resonance imaging (MRI) revealed an intradural extramedullary enhancing mass at conus medullaris. Another case, a 31-year-old man was presented with a history of familial history of brain tumor, retinal hemangioma both eyes, multiple pancreatic cyst and syringobulbia with syringohydromyelia...
July 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28761475/the-helminths-causing-surgical-or-endoscopic-abdominal-intervention-a-review-article
#20
REVIEW
Erdal Uysal, Mehmet Dokur
BACKGROUND: Helminths sometimes require surgical or endoscopic intervention. Helminths may cause acute abdomen, mechanical intestinal obstruction, gastrointestinal hemorrhage, perforation, hepatitis, pancreatitis, and appendicitis. This study aimed to determine the surgical diseases that helminths cause and to gather, analyze the case reports, case series and original articles about this topic in literature. METHODS: This study was designed as a retrospective observational study...
April 2017: Iranian Journal of Parasitology
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