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Necrotizing pancreatitis

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https://www.readbyqxmd.com/read/28713067/eus-guided-drainage-of-peripancreatic-fluid-collections-with-lumen-apposing-metal-stents-and-plastic-double-pigtail-stents-comparison-of-efficacy-and-adverse-event-rates
#1
Gabriel D Lang, Cassandra Fritz, Trisha Bhat, Koushik K Das, Faris M Murad, Dayna S Early, Steven A Edmundowicz, Vladimir M Kushnir, Daniel K Mullady
BACKGROUND AND AIMS: Transmural drainage with double-pigtail plastic stents (DPPSs) was the mainstay of endoscopic therapy for symptomatic peri-pancreatic fluid collections (PPFCs) until the introduction of lumen-apposing covered self-expanding metal stents (LAMSs). Currently, there is limited data regarding the efficacy and adverse event rate of LAMS compared with DPPS. METHODS: A retrospective analysis of EUS-guided PPFC drainages at a single tertiary care center between 2008 and 2015 was performed...
July 13, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28702167/clostridium-perfringens-s-necrotizing-acute-pancreatitis-a-case-of-success
#2
Rita Castro, Joana Mendes, Luís Amaral, Rui Quintanilha, Tiago Rama, António Melo
The authors report a case of a 62-year-old man with upper abdominal pain with few hours of onset and vomits. The initial serum amylase was 2306 U/L. The first CT showed signs of a non-complicated acute pancreatitis. He suffered clinical deterioration and for this reason he was admitted on the intensive care unit where he progressed to multiple organ failure in <24 h. A new CT scan was performed that showed pneumoperitoneum and pneumoretroperitoneum. He underwent an exploratory laparotomy and pancreatic necrosectomy and vacuum pack laparostomy were performed...
June 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28697152/transcutaneous-endoscopic-necrosectomy-for-walled-off-pancreatic-necrosis-in-the-paracolic-gutter
#3
Monica Saumoy, Nikhil A Kumta, Amy Tyberg, Elizabeth Brown, Micheal D Lieberman, Soumitra R Eachempati, Ronald S Winokur, Monica Gaidhane, Reem Z Sharaiha, Michel Kahaleh
BACKGROUND: Walled-off pancreatic necrosis (WON) is a sequelae of acute pancreatitis that requires debridement, once infected. Recently, endoscopic necrosectomy has become the mainstay for management. However, peripancreatic collections that extend to the paracolic gutter or lesser sac, are more challenging to treat endoscopically. We report an endoscopic method for management of necrotic collections that extend into the paracolic gutter. METHODS: Consecutive patients, with symptomatic WON extending into the retroperitoneum, were included in a prospective registry...
July 10, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28680009/contrast-enhanced-harmonic-endoscopic-ultrasonography-in-gallbladder-cancer-and-pancreatic-cancer
#4
Mitsuru Sugimoto, Tadayuki Takagi, Rei Suzuki, Naoki Konno, Hiroyuki Asama, Ko Watanabe, Jun Nakamura, Hitomi Kikuchi, Yuichi Waragai, Mika Takasumi, Yuki Sato, Takuto Hikichi, Hiromasa Ohira
Endoscopic ultrasonography (EUS) plays a major role in diagnosing gallbladder (GB) cancer and pancreatic cancer (PC). In cases of GB cancer, EUS allows for precise observations of morphology and wall layers. However, proficiency is required for the morphologic diagnosis of GB tumors. Therefore, contrast-enhanced harmonic EUS (CH-EUS) began to be performed to diagnose GB lesions. CH-EUS enables real-time observation of the hemodynamics of GB tumors. The enhanced patterns generated by CH-EUS improve precision in the diagnosis of such tumors...
July 5, 2017: Fukushima Journal of Medical Science
https://www.readbyqxmd.com/read/28658791/ectopic-parathyroid-adenoma-presenting-as-a-mediastinal-mass
#5
Aneesha Vaidya, Mangala Gouri, H M Sudha, Vijaya Mysorekar, Avinash Balekudura
A parathyroid adenoma present in an ectopic site, in the anterior mediastinum, is a rare cause of persistent hyperparathyroidism. Though its occurrence in the mediastinum is unusual, existence has been noted in literature for more than a century. We describe a case of a 35-year-old male presenting with complaints of pain abdomen, clinically diagnosed as acute necrotizing pancreatitis, with raised serum calcium. Patient received symptomatic treatment for the pancreatitis which subsided. However, high levels of serum calcium persisted...
May 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28655321/stratified-analysis-and-clinical-significance-of-elevated-serum-triglyceride-levels-in-early-acute-pancreatitis-a-retrospective-study
#6
Jianhua Wan, Wenhua He, Yin Zhu, Yong Zhu, Hao Zeng, Pi Liu, Liang Xia, Nonghua Lu
BACKGROUND: Hypertriglyceridemia is one of the three most common causes of AP, which is associated with the AP prognosis that has not been clearly defined. METHODS: In this retrospective study, 1539 AP patients, who had serum triglyceride (TG) levels measured within the first 72 h, were assessed. The study groups consisted of patients with normal, mild, moderate, and severe/very severe HTG levels based on the Endocrine Society Clinical Practice Guidelines. We collected baseline demographic information, laboratory values, complications, and clinical outcome data in different HTG severity groups to analyze the clinical significance of elevated TG levels in AP...
June 27, 2017: Lipids in Health and Disease
https://www.readbyqxmd.com/read/28650394/visceral-adiposity-predicts-severity-of-acute-pancreatitis
#7
Ashwinee Natu, Tyler Stevens, Lorna Kang, Scott Yasinow, Emad Mansoor, Rocio Lopez, Brooke Glessing, Erick Remer, Tyler Richards, Amit Gupta, Amitabh Chak, Peter J W Lee
OBJECTIVES: The aim of this study was to determine the association of visceral adiposity with severe outcomes in acute pancreatitis (AP). METHODS: This retrospective study included consecutive patients with AP admitted to a tertiary care hospital between January 2010 and January 2015 who underwent a computed tomography scan. The visceral adipose tissue (VAT) volume was estimated using the method of Linder and colleagues. Multivariable logistic regression analysis was conducted to assess VAT as a predictor of severe AP compared with other validated predictors of severity...
June 22, 2017: Pancreas
https://www.readbyqxmd.com/read/28639964/drug-induced-necrotizing-pancreatitis-with-a-focus-on-canagliflozin
#8
Kinner M Patel, Erik Pikas, Tanya George
No abstract text is available yet for this article.
July 2017: American Journal of Therapeutics
https://www.readbyqxmd.com/read/28609373/multiorgan-failure-predicts-mortality-in-emphysematous-pancreatitis-a-case-report-and-systematic-analysis-of-the-literature
#9
Vadim Bul, Cemal Yazici, Jonas J Staudacher, Barbara Jung, Brian R Boulay
Emphysematous pancreatitis (EP) is a subtype of acute necrotizing pancreatitis (ANP) characterized by the presence of gas in and around the pancreas. Although investigators have studied prognostic factors in ANP, less is known about EP. We aimed to determine predictors of mortality and identify changes in management strategies for EP. A PubMed search was performed to identify EP cases. Data were gathered about patient demographics, clinical findings, laboratory results, radiological studies, procedures, outcomes, and mortality...
July 2017: Pancreas
https://www.readbyqxmd.com/read/28609366/visceral-adiposity-predicts-severity-of-acute-pancreatitis
#10
Ashwinee Natu, Tyler Stevens, Lorna Kang, Scott Yasinow, Emad Mansoor, Rocio Lopez, Brooke Glessing, Erick Remer, Tyler Richards, Amit Gupta, Amitabh Chak, Peter J W Lee
OBJECTIVES: The aim of this study was to determine the association of visceral adiposity with severe outcomes in acute pancreatitis (AP). METHODS: This retrospective study included consecutive patients with AP admitted to a tertiary care hospital between January 2010 and January 2015 who underwent a computed tomography scan. The visceral adipose tissue (VAT) volume was estimated using the method of Linder and colleagues. Multivariable logistic regression analysis was conducted to assess VAT as a predictor of severe AP compared with other validated predictors of severity...
July 2017: Pancreas
https://www.readbyqxmd.com/read/28593784/abdominal-compartment-syndrome-secondary-to-acute-necrotizing-pancreatitis
#11
Ismael Mora-Guzmán, Juan Antonio Del Pozo Jiménez, Elena Martín-Pérez
Severe acute pancreatitis occurs in around 20% of patients and is associated with mortality rates between 8-40%. Abdominal compartment syndrome is a fatal complication that is associated with new organ failure or acute worsening of existing organ failure and has an associated mortality of around 60%. Intra-abdominal pressure measurements are recommended in patients with risk factors for intra-abdominal hypertension or abdominal compartment syndrome. Management should be based on a step-up method and surgical intervention may be indicated when conservative treatment fails...
July 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28587348/hepatoprotective-effects-of-litchi-litchi-chinensis-procyanidin-a2-on-carbon-tetrachloride-induced-liver-injury-in-icr-mice
#12
Lih-Geeng Chen, Cheng-Wei Chang, Jwu-Guh Tsay, Brian Bor-Chun Weng
Drug tolerance, lacking liver regenerative activity and inconclusive inhibition of steatosis and cirrhosis by silymarin treatment during chronic liver injury have increased the demand for novel alternative or synergistic treatments for liver damage. Litchi fruit is abundant in polyphenolic compounds and is used in traditional Chinese medicine for treatments that include the strengthening of hepatic and pancreatic functions. Unique polyphenolic compounds obtained from litchi pericarp extract (LPE) were studied in vitro and in vivo for hepatoprotection...
June 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28586010/resveratrol-protects-against-l-arginine-induced-acute-necrotizing-pancreatitis-in-mice-by-enhancing-sirt1-mediated-deacetylation-of-p53-and-heat-shock-factor-1
#13
Nian Wang, Fen Zhang, Liu Yang, Jiang Zou, Hao Wang, Ke Liu, Meidong Liu, Huali Zhang, Xianzhong Xiao, Kangkai Wang
Acute necrotizing pancreatitis (ANP) is a common severe critical illness with a high mortality rate. Resveratrol, a polyphenol compound derived from various plants such as grape skin, peanut, berry and veratrum, exhibits multiple biological activities, especially potent anti‑inflammatory activity, but its effect on ANP has not yet been fully elucidated. The present study aimed to investigate the effects of resveratrol on L-arginine-induced ANP and the possible mechanisms. A mouse model of ANP was established by 2 hourly intraperitoneal injections of 8% L-arginine (4 g/kg)...
June 6, 2017: International Journal of Molecular Medicine
https://www.readbyqxmd.com/read/28576129/treatment-with-long-acting-lanreotide-autogel-in-early-infancy-in-patients-with-severe-neonatal-hyperinsulinism
#14
Heike Corda, Sebastian Kummer, Alena Welters, Norbert Teig, Dirk Klee, Ertan Mayatepek, Thomas Meissner
BACKGROUND: Treatment of severe diffuse congenital hyperinsulinism (CHI) without sufficient response to diazoxide is complicated by the lack of approved drugs. Therefore, patients are often hospitalized long-term or have to undergo pancreatic surgery if episodes of severe hypoglycaemia cannot be prevented. A long-acting somatostatin analogue, octreotide, has been reported to be an effective treatment option that prevents severe hypoglycaemia in children with CHI, and its off-label use is common in CHI...
June 2, 2017: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/28522995/dysbiosis-of-intestinal-microbiota-and-decreased-antimicrobial-peptide-level-in-paneth-cells-during-hypertriglyceridemia-related-acute-necrotizing-pancreatitis-in-rats
#15
Chunlan Huang, Jing Chen, Jingjing Wang, Hui Zhou, Yingying Lu, Lihong Lou, Junyuan Zheng, Ling Tian, Xingpeng Wang, Zhongwei Cao, Yue Zeng
Hypertriglyceridemia (HTG) aggravates the course of acute pancreatitis (AP). Intestinal barrier dysfunction is implicated in the pathogenesis of AP during which dysbiosis of intestinal microbiota contributes to the dysfunction in intestinal barrier. However, few studies focus on the changes in intestine during HTG-related acute necrotizing pancreatitis (ANP). Here, we investigated the changes in intestinal microbiota and Paneth cell antimicrobial peptides (AMPs) in HTG-related ANP (HANP) in rats. Rats fed a high-fat diet to induce HTG and ANP was induced by retrograde injection of 3...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/28522361/clostridium-perfringens-a-bacterial-pathogen-gaining-recognition-in-necrotizing-pancreatitis
#16
Rakhi Biswas, Deepika K, Sujatha Sistla, Sarath Chandra Sistla, Anandhi Amaranathan
We report an interesting case of necrotizing pancreatitis due to Clostridium perfringens in an elderly man who came to the hospital with complaints of severe abdominal pain. The infection further worsened with the dissemination to other internal organs. The patient did not show any improvement despite intensive care and treatment. This emphasizies the fact that early diagnosis and appropriate treatment would reduce the morbidity associated with necrotizing pancreatitis.
May 15, 2017: Anaerobe
https://www.readbyqxmd.com/read/28516758/necrotizing-pancreatitis-current-management-and-therapies
#17
Christine Boumitri, Elizabeth Brown, Michel Kahaleh
Acute necrotizing pancreatitis accounts for 10% of acute pancreatitis (AP) cases and is associated with a higher mortality and morbidity. Necrosis within the first 4 weeks of disease onset is defined as an acute necrotic collection (ANC), while walled off pancreatic necrosis (WOPN) develops after 4 weeks of disease onset. An infected or symptomatic WOPN requires drainage. The management of pancreatic necrosis has shifted away from open necrosectomy, as it is associated with a high morbidity, to less invasive techniques...
May 16, 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/28514287/concurrent-igg4-related-tubulointerstitial-nephritis-and-igg4-myeloperoxidase-anti-neutrophil-cytoplasmic-antibody-positive-crescentic-glomerulonephritis-a-case-report
#18
Tao Su, Li Yang, Zhao Cui, Su-Xia Wang, Ming-Hui Zhao
RATIONALE: IgG4-related disease (IgG4-RD) is a newly recognized systemic disease. The typical pathological finding in the kidney is abundant IgG4-positive plasma cell infiltration with characteristic storiform fibrosis in the interstitium. Antibodies of the IgG4 subclass have been linked to certain autoimmune diseases including antiproteinase 3 (PR3) anti-neutrophil cytoplasmic antibody (ANCA) of the IgG4 subclass. Here, we report a rare case of kidney injury with concurrent typical IgG4-related tubulointerstitial nephritis and IgG4 subclass of myeloperoxidase (MPO) ANCA-positive necrotizing crescentic glomerulonephritis...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28503840/a-critical-note-on-treatment-of-a-severe-diltiazem-intoxication-high-dose-calcium-and-glucagon-infusions
#19
Mathilde Van Veggel, Gijs Van der Veen, Tim Jansen, Elsbeth Westerman
The morbidity and mortality of a severe calcium channel blocker intoxication is high due to serious toxic cardiac effects. Its treatment is supported by low-quality evidence from the heterogeneous literature. We describe a case of a severe diltiazem intoxication and critically appraise the efficacy and role of high-dose calcium and glucagon infusions. A 53-year-old woman was admitted to the emergency department with a cardiogenic shock with complete AV block, not responding to atropine, isoprenaline and an external pacemaker...
May 15, 2017: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28489122/minimally-invasive-endoscopic-treatment-of-necrotizing-pancreatitis-a-case-report-with-images-and-review-of-the-literature
#20
Cassia Lemos Moura, Priscila Pulita Azevedo Barros, Cristiane Mota Oliveira, Rogerio Colaiácovo, Juliana Marques Drigo, Augusto Pincke Cruz Carbonari, Tercio de Campos, Lucio Giovani Batista Rossini
Necrotizing pancreatitis with fluid collections can occur as a complication of acute pancreatitis. The management of these patients depends on the severity and involves multiple medical treatment modalities, as clinical intensive care and surgical intervention. In this article, we show a severe case of walled-off pancreatic necrosis that was conducted by endoscopic drainage with great clinical outcome.
March 2017: Revista da Associação Médica Brasileira
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