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Pancreatitis pain

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https://www.readbyqxmd.com/read/28339435/impact-of-celiac-plexus-neurolysis-on-survival-in-patients-with-unresectable-pancreatic-cancer-a-retrospective-propensity-score-matching-analysis
#1
Tak Kyu Oh, Woo Jin Lee, Sang Myung Woo, Nam Woo Kim, Jiyeon Yim, Dae Hyun Kim
BACKGROUND: Pain caused by pancreatic cancer (PC) is difficult to control. Celiac plexus neurolysis (CPN) can effectively control the pain and reduce the use of opioids. However, the effect of CPN on survival for patients with unresectable PC remains controversial. OBJECTIVES: To determine if CPN is associated with survival benefits for these patients. STUDY DESIGN: Retrospective, observational cohort study. SETTING: National Cancer Center in Korea...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28337946/up-regulation-of-cxcr4-expression-contributes-to-persistent-abdominal-pain-in-rats-with-chronic-pancreatitis
#2
Hong-Yan Zhu, Xuelian Liu, Xiuhua Miao, Di Li, Shusheng Wang, Guang-Yin Xu
Background Pain in patients with chronic pancreatitis is critical hallmark that accompanied inflammation, fibrosis, and destruction of glandular pancreas. Many researchers have demonstrated that stromal cell-derived factor 1 (also named as CXCL12) and its cognate receptor C-X-C chemokine receptor type 4 (CXCR4) involved in mediating neuropathic and bone cancer pain. However, their roles in chronic pancreatic pain remain largely unclear. Methods Chronic pancreatitis was induced by intraductal injection of trinitrobenzene sulfonic acid to the pancreas...
January 2017: Molecular Pain
https://www.readbyqxmd.com/read/28333601/simultaneous-occurrence-of-varicella-zoster-virus-induced-pancreatitis-and-hepatitis-in-a-renal-transplant-recipient-a-case-report-and-review-of-literature
#3
Puneet Chhabra, Priyadarshi Ranjan, Deepak K Bhasin
INTRODUCTION: Gastrointestinal complications are common after renal transplantation, including oral lesions, esophagitis, gastritis, diarrhea, and colon carcinoma. The differential diagnosis is difficult in this scenario because multiple factors such as drugs, infections, and preexisting gastrointestinal disease come into play. CASE PRESENTATION: We report a case of varicella zoster virus-induced pancreatitis and hepatitis in a renal transplant recipient. The patient underwent renal transplantation 3 years earlier and now presented with severe pain in the epigastrium radiating to his back and had raised serum lipase levels and skin lesions characteristic of varicella...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28332731/undiagnosed-pancreatic-exocrine-insufficiency-and-chronic-pancreatitis-in-functional-gi-disorder-patients-with-diarrhea-or-abdominal-pain
#4
N J Talley, G Holtmann, N Q Nguyen, P R Gibson, P Bampton, M Veysey, J Wong, S Philcox, N Koloski, L Bunby, M Jones
BACKGROUND & AIMS: A previous UK study showed that 6.1% of patients with diarrhea-predominant IBS (IBS-D) had evidence of severe pancreatic exocrine insufficiency (PEI), but these findings need replication. We aimed to identify the prevalence of PEl based on faecal elastase stool testing in consecutive outpatients presenting with chronic unexplained abdominal pain and/or diarrhea and/or IBS-D. METHODS: Patients aged over 40 years presenting to hospital outpatient clinics from 6 sites within Australia with unexplained abdominal pain and/or diarrhea for at least 3 months and/or IBS-D were studied...
March 23, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28332032/qualitative-assessment-of-the-symptoms-and-impact-of-pancreatic-exocrine-insufficiency-pei-to-inform-the-development-of-a-patient-reported-outcome-pro-instrument
#5
Colin D Johnson, Rob Arbuckle, Nicola Bonner, Gary Connett, Enrique Dominguez-Munoz, Philippe Levy, Doris Staab, Nicola Williamson, Markus M Lerch
BACKGROUND: Pancreatic exocrine insufficiency (PEI) affects patients with chronic pancreatitis (CP) and cystic fibrosis (CF) who produce insufficient digestive pancreatic enzymes. Common symptoms include steatorrhoea, diarrhea, and abdominal pain. OBJECTIVE: The objective of the study was to develop and test the content validity of a patient-reported outcome (PRO) instrument assessing PEI symptoms and their impact on health-related quality of life. METHODS: Instrument development was supported by a literature review, expert physician interviews (n = 10: Germany 4, UK 3, France 3), and exploratory, qualitative, concept-elicitation interviews with patients with CF and CP with PEI (n = 61: UK 29, Germany 18, France 14) and expert physicians (n = 10)...
March 22, 2017: Patient
https://www.readbyqxmd.com/read/28331027/malignant-hypercalcaemia-related-to-parathyroid-hormone-related-peptide-pthrp-secretion-from-a-metastatic-pancreatic-neuroendocrine-tumour-net
#6
Megan Symington, Louise Davies, Gregory Kaltsas, Martin O Weickert
A 54-year-old woman presented to our centre with acute abdominal pain and vomiting. Routine blood tests showed severe hypercalcaemia (>4 mmol/L). Serum parathyroid hormone (PTH) was suppressed. CT scan detected a pancreatic mass and some liver lesions, initially suspicious for metastatic pancreatic adenocarcinoma. Liver biopsy however revealed the presence of a well-differentiated, grade 1, metastatic neuroendocrine tumour (NET) where prognosis is considerably better. Serum PTHrP was raised, indicating paraneoplastic hypercalcaemia, most likely secondary to the pancreatic NET...
March 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28327418/solid-pseudopapillary-neoplasm-case-report-of-a-rare-pancreatic-tumor
#7
Cláudio Branco, Sónia Vilaça, Joaquim Falcão
INTRODUCTION: Solid pseudopapillary neoplasm (SPN) is a rare pancreatic tumor. Most patients are female within the second or third decade of life with only a small minority concerning children. Frequently described as low malignant potential tumors, surgical resection remains the main treatment. PRESENTATION OF CASE: The authors present a case of a SPN diagnosed in a 17-year-old Caucasian girl with vomiting and abdominal pain localized to the right upper quadrant...
February 28, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28325588/operative-management-of-chronic-pancreatitis-a-review
#8
REVIEW
John D Tillou, Jacob A Tatum, Joshua S Jolissaint, Daniel S Strand, Andrew Y Wang, Victor Zaydfudim, Reid B Adams, Kenneth L Brayman
BACKGROUND: Pain secondary to chronic pancreatitis is a difficult clinical problem to manage. Many patients are treated medically or undergo endoscopic therapy and surgical intervention is often reserved for those who have failed to gain adequate pain relief from a more conservative approach. RESULTS: There have been a number of advances in the operative management of chronic pancreatitis over the last few decades and current therapies include drainage procedures (pancreaticojejunostomy, etc...
March 14, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28321355/a-rare-presentation-of-sarcoidosis-as-a-pancreatic-head-mass
#9
Shruti Mony, Pradnya D Patil, Rebekah English, Ananya Das, Daniel A Culver, Tanmay S Panchabhai
Sarcoidosis is a multisystem granulomatous syndrome of unknown etiology with noncaseating epithelioid granulomas being the pathognomonic pathological finding. Sarcoidosis most commonly involves the lungs and involvement of the gastrointestinal (GI) tract is uncommon. Pancreatic sarcoidosis is very rare, especially when it is the presenting feature of sarcoidosis and can masquerade as pancreatic cancer. Tissue infiltration in pancreatic sarcoidosis can lead to either a diffuse nodular appearance or a mass-like lesion...
2017: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/28321347/association-of-chronic-pancreatitis-and-malignant-main-duct-ipmn-a-rare-but-difficult-clinical-problem
#10
Zoltán Berger, Hernán De La Fuente, Manuel Meneses, Fernanda Matamala, Makarena Sepúlveda, Claudia Rojas
We report the case of a 70-year-old woman who consulted for recurrent short episodes of mild-to-moderate abdominal pain. Dilated main pancreatic duct was seen on CAT scan and magnetic resonance, with multiple calcifications and intraductal stones, typical in CP. However, for a more pronounced cystic dilatation in the pancreatic head, we could not exclude the coexistence of a main duct IPMN. ERCP was performed, with pancreatic sphincterotomy and extraction of pancreatic stones, but, at the same time, mucin extrusion was seen from the dilated duct through the papilla...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28318763/pancreatic-carcinosarcoma-a-case-report-highlighting-computed-tomography-characteristics
#11
Steven Mszyco, Leslie Teng, Joseph Annunziata, Matthew S Hartman
Primary pancreatic carcinosarcoma is a rare and malignant neoplasm arising within the pancreas. With fewer than a dozen cases ever reported, the recognition and treatment of this rare phenomenon can be difficult. We describe the case of an 85-year-old man who presented with vague right upper quadrant and epigastric abdominal pain and was found to have a pancreatic mass on ultrasound and computed tomography. The patient underwent open pancreaticoduodenectomy and was found to have pancreatic carcinosarcoma on microscopic evaluation...
January 27, 2017: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/28317046/a-rare-case-of-choledochal-cyst-with-pancreas-divisum-case-presentation-and-literature-review
#12
Adrián Ransom-Rodríguez, Ruben Blachman-Braun, Emilio Sánchez-García Ramos, Jesús Varela-Prieto, Erick Rosas-Lezama, Miguel Ángel Mercado
Choledochal cysts are rare congenital malformations of the bile duct characterized by dilatations of the intrahepatic and/or extrahepatic portion of the biliary tree, they are associated to an anomalous arrangement of the pancreaticobiliary duct. Pancreas divisum results from a fusion failure of the pancreatic buds. The coexistence of pancreas divisum and choledochal cyst in adults has been reported in less than 10 well documented cases. This article presents a case of a 42-year-old Peruvian man with intermittent episodes of abdominal pain, initially diagnosed with choledocholithiasis, who underwent open cholecystectomy...
February 2017: Ann Hepatobiliary Pancreat Surg
https://www.readbyqxmd.com/read/28316930/transudative-pleural-effusion-of-malignant-etiology-rare-but-real
#13
Lindsey Johnson, Hafiz Abdul Moiz Fakih, Salim Daouk, Shaheera Saleem, Ali Ataya
A 62-year-old female presented to the emergency room with one-month history of epigastric abdominal pain, nausea and vomiting. She endorsed progressive dyspnea over two weeks. CT of the abdomen demonstrated bilateral pleural effusions and pancreatic inflammation, so the working diagnosis was pancreatitis. A diagnostic thoracentesis was performed and the pleural fluid analysis was classified as transudate by Light's criteria. Given the atypical features in history and concern for malignancy, fluid was sent for cytological examination and immunohistochemistry which suggested a mucinous malignancy...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28315028/potential-for-screening-for-pancreatic-exocrine-insufficiency-using-the-fecal-elastase-1-test
#14
REVIEW
J Enrique Domínguez-Muñoz, Philip D Hardt, Markus M Lerch, Matthias J Löhr
The early diagnosis of pancreatic exocrine insufficiency (PEI) is hindered because many of the functional diagnostic techniques used are expensive and require specialized facilities, which prevent their widespread availability. We have reviewed current evidence in order to compare the utility of these functional diagnostic techniques with the fecal elastase-1 (FE-1) test in the following three scenarios: screening for PEI in patients presenting with symptoms suggestive of pancreatic disease, such as abdominal pain or diarrhea; determining the presence of PEI in patients with an established diagnosis of pancreatic disease, such as chronic pancreatitis or cystic fibrosis; determining exocrine status in disorders not commonly tested for PEI, but which have a known association with this disorder...
March 17, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28301350/a-phase-ii-study-of-ganetespib-as-second-line-or-third-line-therapy-for-metastatic-pancreatic-cancer
#15
Dana B Cardin, Ramya Thota, Laura W Goff, Jordan D Berlin, Clyde M Jones, Gregory D Ayers, Jennifer G Whisenant, Emily Chan
OBJECTIVES: Heat shock protein 90 regulates multiple signaling proteins involved in key pathways of pancreatic cancer pathogenesis. Ganetespib binds to heat shock protein 90 and interferes with its binding to client proteins thus leading to inactivation and degradation of the signaling proteins that promote cancer progression. This phase II study was designed to evaluate the efficacy of ganetespib in patients with refractory metastatic pancreatic cancer (rMPC). METHODS: Patients with rMPC received 175 mg/m ganetespib intravenously once weekly for 3 weeks in 4-week cycles...
March 15, 2017: American Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28289881/modified-biliary-enteric-anastomosis-for-congenital-choledochal-cyst-clinical-and-prognostic-analysis-of-91-cases
#16
Ji Chen, Bin Jiang, Jun Yi, Lei Huang, Xinmin Si
PURPOSE: To report our experience with a modified biliary-enteric anastomosis procedure for the surgical treatment of congenital choledochal cysts. METHODS: Between January 2009 and December 2013, 91 children (19 boys, 72 girls; ages, 6-145 months) with congenital choledochal cysts were treated with our modified surgical procedure in our hospital. Of these patients, 69 had type I cysts, and 22 had type IV B cysts. The main parameters analyzed mainly included the operative time, duration of bowel recovery, resumption of diet, postoperative hospital stay, liver-function tests, postoperative complications, and prognosis...
March 13, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28287940/diagnosis-and-management-of-complications-from-percutaneous-biliary-tract-interventions
#17
Nanda Venkatanarasimha, Karthik Damodharan, Apoorva Gogna, Sum Leong, Chow Wei Too, Ankur Patel, Kiang Hiong Tay, Bien Soo Tan, Richard Lo, Farah Irani
Complications related to percutaneous biliary tract interventions (PBTIs) can range from access site discomfort to life-threatening vascular complications. These complications are relatively uncommon, and most of them are self-limiting. However, major complications for which an increased level of patient care and/or a prolonged hospital stay are required and that may lead to death-albeit rarely-can occur. Some of the most common complications related to PBTI include pain, infection, bile leakage, and catheter blockage...
March 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28286566/gastrointestinal-manifestations-of-mitochondrial-disorders-a-systematic-review
#18
REVIEW
Josef Finsterer, Marlies Frank
Mitochondrial disorders (MIDs) due to respiratory-chain defects or nonrespiratory chain defects are usually multisystem conditions [mitochondrial multiorgan disorder syndrome (MIMODS)] affecting the central nervous system (CNS), peripheral nervous system, eyes, ears, endocrine organs, heart, kidneys, bone marrow, lungs, arteries, and also the intestinal tract. Frequent gastrointestinal (GI) manifestations of MIDs include poor appetite, gastroesophageal sphincter dysfunction, constipation, dysphagia, vomiting, gastroparesis, GI pseudo-obstruction, diarrhea, or pancreatitis and hepatopathy...
January 2017: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/28283565/assessment-of-pancreas-safety-in-the-development-program-of-once-weekly-glp-1-receptor-agonist-dulaglutide
#19
Michael A Nauck, Jean-Louis Frossard, Jamie S Barkin, Greg Anglin, Ingrid E Hensley, Kristine D Harper, Zvonko Milicevic
OBJECTIVE: To assess the risk of acute pancreatitis during treatment with glucagon-like peptide 1 receptor agonist dulaglutide, placebo, and active comparators across phase 2/3 dulaglutide trials. RESEARCH DESIGN AND METHODS: A total of 6,005 patients with type 2 diabetes participated (dulaglutide group N = 4,006 [dose range 0.1-3.0 mg]; active comparator group [metformin, sitagliptin, exenatide twice daily, insulin glargine] N = 1,541; placebo group N = 703; 245 placebo-treated patients subsequently received dulaglutide or sitagliptin and were also included in these groups) for up to 104 weeks...
March 10, 2017: Diabetes Care
https://www.readbyqxmd.com/read/28282277/role-of-stereotactic-body-radiotherapy-in-the-treatment-of-elderly-and-poor-performance-status-patients-with-pancreatic-cancer
#20
Lauren M Rosati, Joseph M Herman
Literature on the management of nonmetastatic pancreatic ductal adenocarcinoma in patients who are elderly or have poor performance status is sparse. The median survival of this unique cohort of patients is < 6 months, and most patients are only offered single-agent gemcitabine or supportive care. Recently, adding nanoparticle albumin-bound paclitaxel to gemcitabine was shown to improve survival of patients with metastatic disease with Eastern Cooperative Group performance status of 2. Although standard chemoradiotherapy provides long-term locoregional control in locally advanced pancreatic cancer, it is difficult for this group of patients to tolerate 6 weeks of therapy...
March 2017: Journal of Oncology Practice
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