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Necrotizing pancreatitis

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https://www.readbyqxmd.com/read/29906644/retroperitoneal-versus-open-intraperitoneal-necrosectomy-in-step-up-therapy-for-infected-necrotizing-pancreatitis-a-meta-analysis
#1
REVIEW
Yun-Bing Wang, Xiao-Li Yang, Long Chen, Zheng-Ju Chen, Chun-Mu Miao, Jin Xia
BACKGROUND: Step-up therapy is the recommended therapy for infected necrotizing pancreatitis (INP). However, the most appropriate secondary therapy for use after initial drainage has not been fully determined. This meta-analysis was designed to evaluate the efficacy and safety of retroperitoneal versus open intraperitoneal necrosectomy as part of a step-up strategy for INP. MATERIALS AND METHODS: Eight online databases were searched for randomized controlled trials (RCTs) and cohorts comparing retroperitoneal and open intraperitoneal step-up approaches for treating INP...
June 12, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29894416/the-accuracy-of-pancreatic-perfusion-computed-tomography-and-angiography-in-predicting-necrotizing-pancreatitis-a-systematic-review
#2
Xavier J N M Smeets, Geke Litjens, Kim Gijsbers, Mathias Prokop, Joost P H Drenth, John Hermans, Erwin J M van Geenen
Early prediction of necrotizing pancreatitis is important for tailoring treatment, but current scoring systems have moderate accuracy and can be calculated only 24 to 48 hours after disease onset. Evaluation of (micro)circulatory changes in acute pancreatitis at admission by perfusion computed tomography (PCT) or angiography could predict necrosis earlier. Our aim was to systematically review the evidence for angiographic and PCT prediction of necrotizing pancreatitis. We performed a systematic review and searched MEDLINE and Embase...
July 2018: Pancreas
https://www.readbyqxmd.com/read/29870787/protective-effects-of-flavonoids-from-coreopsis-tinctoria-nutt-on-experimental-acute-pancreatitis-via-nrf-2-are-mediated-antioxidant-pathways
#3
Dan Du, Linbo Yao, Rui Zhang, Na Shi, Yan Shen, Xinmin Yang, Xiaoying Zhang, Tao Jin, Tingting Liu, Liqiang Hu, Zhihua Xing, David N Criddle, Qing Xia, Wei Huang, Robert Sutton
ETHNOPHARMACOLOGICAL RELEVANCE: Oxidative stress is a prominent feature of clinical acute pancreatitis (AP). Coreopsis tinctoria has been used traditionally to treat pancreas disorders like diabetes mellitus in China and Portugal and its flavonoid-rich fraction contain the main phytochemicals that have antioxidant and anti-inflammatory activities. AIM OF THE STUDY: To investigate the effects of flavonoids isolated from C. tinctoria on experimental AP and explore the potential mechanism...
June 2, 2018: Journal of Ethnopharmacology
https://www.readbyqxmd.com/read/29869080/the-role-of-endoscopic-treatment-of-pancreatic-duct-disruption-in-patients-with-walled-off-pancreatic-necrosis
#4
Mateusz Jagielski, Marian Smoczyński, Krystian Adrych
BACKGROUND: The place of endoscopic techniques in the treatment of main pancreatic duct (MPD) disruption arising in the course of acute necrotizing pancreatitis (ANP) remains unclear. The aim of this study was to describe the findings of endoscopic retrograde pancreatography (ERP) in patients with walled-off necrosis (WON). It was attempted to evaluate the role of endoscopic treatment of pancreatic duct disruption in patients with WON. METHODS: The retrospective analysis of results and complications with particular emphasis to all ERP procedures in the group of 226 patients was conducted, which underwent endoscopic treatment of symptomatic WON between years 2001 and 2016 in the Department of Gastroenterology and Hepatology of Medical University of Gdańsk...
June 4, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29808967/protective-effects-of-tumor-necrosis-factor-alpha-inhibitors-on-methotrexate-induced-pancreatic-toxicity
#5
Tolga Mercantepe, Yıldıray Kalkan, Levent Tumkaya, İbrahim Sehitoglu, Filiz Mercantepe, Sermet Yıldırmıs
BACKGROUND: Methotrexate (MTX), a folate antagonist, is commonly used in the treatment of many different types of cancer and inflammatory diseases, including pancreatic cancer, although its side effects on the pancreas have not yet been researched. The mechanism of MTX-induced toxicity is not well known, and it has been reported in high-dose toxicity studies that the pancreas is sensitive to toxic effects. OBJECTIVES: The aim of our study was to determine whether adalimumab (ADA) has a preventive effect on MTX-induced pancreas toxicity in rats...
May 24, 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/29800677/manduca-sexta-serpin-12-controls-the-prophenoloxidase-activation-system-in-larval-hemolymph
#6
Fan Yang, Yang Wang, Niranji Sumathipala, Xiaolong Cao, Michael R Kanost, Haobo Jiang
Insect prophenoloxidase activation is coordinated by a serine protease network, which is regulated by serine protease inhibitors of the serpin superfamily. The enzyme system also leads to proteolytic processing of a Spätzle precursor. Binding of Spätzle to a Toll receptor turns on a signaling pathway to induce the synthesis of defense proteins. Previous studies of the tobacco hornworm Manduca sexta have revealed key members of the protease cascade, which generates phenoloxidase for melanogenesis and Spätzle to induce immunity-related genes...
August 2018: Insect Biochemistry and Molecular Biology
https://www.readbyqxmd.com/read/29798987/-dic-syndrome-related-mortality-in-acute-necrotic-pancreatitis
#7
G V Rodoman, T I Shalaeva, E A Stepanov
AIM: To improve the results of acute necrotic pancreatitis management via an analysis of changes in the main causes of mortality in patients with this disease over the last decade. MATERIAL AND METHODS: We have analyzed medical records of patients with acute necrotic pancreatitis followed by lethal outcome for the period 2015-2016. In all cases autopsy was performed in order to determine morbidity and mortality. Complications of pancreatic necrosis significant for tanatogenesis, treatment and prevention strategy were compared with those for 2005-2006...
2018: Khirurgiia
https://www.readbyqxmd.com/read/29796908/endoscopic-necrosectomy-through-percutaneous-self-expanding-metal-stents-may-be-a-promising-additive-in-treatment-of-necrotizing-pancreatitis
#8
Andreas Thorsen, Anders Malthe Borch, Srdan Novovic, Palle Nordblad Schmidt, Lise Lotte Gluud
BACKGROUND: The recommended treatment of infected walled-off necrosis (WON) in necrotizing pancreatitis entails a step-up treatment approach starting with endoscopic necrosectomy (ETDN). AIMS: To report a small number of cases from 2013 to 2016 that were not amenable to or failed to respond to ETDN, and to describe a new, minimally invasive technique that may be a promising supplement to ETDN in this difficult patient population. METHODS: Using the Seldinger technique, a fully covered self-expanding metal stent (SEMS) was placed percutaneously in order to drain, irrigate, and debride WON...
May 24, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29784597/the-association-between-portal-system-vein-diameters-and-outcomes-in-acute-pancreatitis
#9
X J N M Smeets, G Litjens, D W da Costa, W Kievit, H C van Santvoort, M G H Besselink, P Fockens, M J Bruno, J J Kolkman, J P H Drenth, T L Bollen, E J M van Geenen
BACKGROUND/OBJECTIVES: Acute pancreatitis (AP) progresses to necrotizing pancreatitis in 15% of cases. An important pathophysiological mechanism in AP is third spacing of fluids, which leads to intravascular volume depletion. This results in a reduced splanchnic circulation and reduced venous return. Non-visualisation of the portal and splenic vein on early computed tomography (CT) scan, which might be the result of smaller vein diameter due to decreased venous flow, is associated with infected necrosis and mortality in AP...
May 15, 2018: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/29777518/total-pancreatic-necrosis-after-organophosphate-intoxication
#10
Rui Hou, Hongmin Zhang, Huan Chen, Yuankai Zhou, Yun Long, Dawei Liu
Cases of acute pancreatitis induced by organophosphate intoxication are encountered occasionally in clinics, but very few of them develop into severe pancreas necrosis and irreversible pancreatic function impairment. Here, we report a 47-year-old female organophosphate poisoning case after ingestion of massive insecticides; she was considered to have total necrosis and function failure of the pancreas via serum amylase test, glucose level test, and CT imaging. The patient exhibited no relief under the regular medicine treatment, which included sandostatin, antibiotics, intravenous atropine, and pralidoxime methiodide...
May 18, 2018: Frontiers of Medicine
https://www.readbyqxmd.com/read/29776456/pancreatitis-and-systemic-coronavirus-infection-in-a-ferret-mustela-putorius-furo
#11
Sarah E Wills, Hugues H Beaufrère, Brigitte A Brisson, Russell S Fraser, Dale A Smith
A 1-y-old spayed female ferret (Mustela putorius furo) was referred for additional diagnostic evaluation after physicalexamination by the referring veterinarian revealed a cranial abdominal mass. The ferret had a 2-wk history of inappetence,weight loss, and lethargy. On presentation, the ferret was thin, and an approximately 3-cm mass was palpable in the cranialabdomen. No other abnormalities were noted. Abdominal ultrasonography confirmed the presence of a soft-tissue structure, with a moderate blood supply and mesenteric lymphadenopathy...
May 18, 2018: Comparative Medicine
https://www.readbyqxmd.com/read/29773762/endoscopic-treatment-of-extensive-walled-off-pancreatic-necrosis-with-the-use-of-single-transluminal-gateway-transcystic-multiple-drainage-sgtmd
#12
Mateusz Jagielski, Marian Smoczyński, Krystian Adrych
The paper presents a description of the course of severe acute necrotizing pancreatitis as well as endoscopic treatment of an extensive infected walled-off pancreatic necrosis (WOPN), being the consequence of acute pancreatitis. The basic strategy of interventional treatment was to extend access to necrotic areas with use of single transluminal gateway transcystic multiple drainage (SGTMD). Endoscopic transmural access (transgastric) was applied. Endoscopic necrosectomy under fluoroscopic guidance was repeated nine times during active transluminal drainage...
April 30, 2018: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/29771768/high-density-infiltration-of-v-domain-immunoglobulin-suppressor-of-t-cell-activation-up-regulated-immune-cells-in-human-pancreatic-cancer
#13
Jinʼe Liu, Xiaoxue Xie, Chunxiao Xuan, Tingting Li, Lanlan Wang, Lianghong Teng, Jun Liu
V-domain immunoglobulin suppressor of T-cell activation (VISTA) is constitutively expressed in hematopoietic lineage and is highly up-regulated in tumor infiltrated myeloid cells and regulatory T cells in animal models. However, its expression in human pancreatic tumor microenvironment remains unknown. In this research, we aimed at the expression of VISTA in human pancreatic cancer samples. METHODS: We performed immunohistochemistry to determine VISTA expression in human pancreatic cancer samples...
May 15, 2018: Pancreas
https://www.readbyqxmd.com/read/29755786/laparoscopic-assisted-transgastric-ercp-a-single-institution-experience
#14
Katherine Habenicht Yancey, Lauren Katherine McCormack, Stephen Samuel McNatt, Myron Sheavictor Powell, Adolfo Zachariah Fernandez, Carl Joseph Westcott
Background: Laparoscopic-assisted transgastric endoscopic retrograde cholangiopancreatography (LAERCP) is used for treatment in patients after Roux-en-Y gastric bypass (RYGB), where transoral access to the biliary tree is not possible. We describe our technique and experience with this procedure. Methods: Electronic medical record search was performed from September 2012 to January 2016, identifying patients who underwent LAERCP per operative records. Charts were reviewed for demographic, clinical, and outcomes data...
2018: Journal of Obesity
https://www.readbyqxmd.com/read/29755019/the-importance-of-acoustic-radiation-force-impulse-arfi-elastography-in-the-diagnosis-and-clinical-course-of-acute-pancreatitis
#15
Muhsin Kaya, Serdar Değirmenci, Cemil Göya, Elif Tuba Tuncel, Feyzullah Uçmak, Mehmet Ali Kaplan
BACKGROUND/AIMS: Acute pancreatitis (AP) is characterized by acute inflammation of the pancreas and it has a highly variable clinical course. The aim of our study was to evaluate the value of acoustic radiation force impulse (ARFI) elastography in the diagnosis and clinical course of AP. MATERIALS AND METHODS: Consecutive patients with a diagnosis of AP (patients group) and healthy subject (control group) were prospectively enrolled to the study. Demographic features and clinical, laboratory, and radiological data were recorded...
May 2018: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/29752684/natural-history-of-gas-configurations-and-encapsulation-in-necrotic-collections-during-necrotizing-pancreatitis
#16
Janneke van Grinsven, Sandra van Brunschot, Mark C van Baal, Marc G Besselink, Paul Fockens, Harry van Goor, Hjalmar C van Santvoort, Thomas L Bollen
BACKGROUND: Decision-making on invasive intervention in patients with clinical signs of infected necrotizing pancreatitis is often related to the presence of gas configurations and the degree of encapsulation in necrotic collections on imaging. Data on the natural history of gas configurations and encapsulation in necrotizing pancreatitis are, however, lacking. METHODS: A post hoc analysis was performed of a previously described prospective cohort in 21 Dutch hospitals (2004-2008)...
May 11, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29748057/massive-bleeding-from-inferior-mesenteric-vein-with-hypovolemic-shock-a-rare-complication-of-acute-pancreatitis
#17
Sun Hwa Lee, Seong Jong Yun, Seokyong Ryu, Seung Woon Choi, Hye Jin Kim, Tae Kyung Kang, Sung Chan Oh, Suk Jin Cho
BACKGROUND: Acute pancreatitis may cause massive intra-abdominal bleeding as vascular complications caused by the erosion of a major pancreatic or peripancreatic vessel. In terms of treatment, the differentiation between arterial bleeding and venous bleeding using abdominal computed tomography (CT) angiography is important. In addition, hypovolemic shock caused by bleeding from the inferior mesenteric vein (IMV) in acute pancreatitis has not been reported. CASE REPORT: A 58-year-old man presented to our emergency department with complaints of abdominal pain of 10 hours' duration...
May 7, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29747233/comparison-of-endoscopic-and-percutaneous-drainage-of-symptomatic-necrotic-collections-in-acute-necrotizing-pancreatitis
#18
Shanan Woo, Ryan Walklin, Travis Ackermann, Sheng Wei Lo, Hamish Shilton, Charles Pilgrim, Peter Evans, James Burnes, Daniel Croagh
INTRODUCTION: Primary endoscopic and percutaneous drainage for pancreatic necrotic collections is increasingly used. We aim to compare the relative effectiveness of both modalities in reducing the duration and severity of illness by measuring their effects on systemic inflammatory response syndrome (SIRS). METHODS: We retrospectively reviewed all cases of endoscopic and percutaneous drainage for pancreatic necrotic collections performed in 2011-2016 at two hospitals...
May 10, 2018: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/29740206/usefulness-of-three-dimensional-visualization-technology-in-minimally-invasive-treatment-for-infected-necrotizing-pancreatitis
#19
Peng-Fei Wang, Zhi-Wei Liu, Shou-Wang Cai, Jun-Jun Su, Lei He, Jian Feng, Xian-Lei Xin, Shi-Chun Lu
AIM: To explore the value of three-dimensional (3D) visualization technology in the minimally invasive treatment for infected necrotizing pancreatitis (INP). METHODS: Clinical data of 18 patients with INP, who were admitted to the PLA General Hospital in 2017, were retrospectively analyzed. Two-dimensional images of computed tomography were converted into 3D images based on 3D visualization technology. The size, number, shape and position of lesions and their relationship with major abdominal vasculature were well displayed...
May 7, 2018: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29720864/role-of-thrombophilia-in-splanchnic-venous-thrombosis-in-acute-pancreatitis
#20
Sobur Uddin Ahmed, Surinder S Rana, Jasmina Ahluwalia, Neelam Varma, Ravi Sharma, Rajesh Gupta, Mandeep Kang
Background: Splanchnic venous thrombosis (SVT) is a common vascular complication of acute pancreatitis (AP). We conducted this study to prospectively investigate the frequency, risk factors, and extent of SVT in patients with AP and to evaluate the role of thrombophilia in its causation. Methods: Patients with AP presenting between January 2015 and June 2016 were prospectively evaluated with contrast-enhanced computed tomography (CT) for the presence of SVT. These patients underwent a detailed analysis of coagulation parameters...
May 2018: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
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