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Pancreatitis

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29 papers 1000+ followers Prevention and management
By Faye Kehler Family Physician and GP Anesthetist since 1987 interested in all aspects of Medicine
https://www.readbyqxmd.com/read/27007094/clinical-practice-guideline-management-of-acute-pancreatitis
#1
REVIEW
Joshua A Greenberg, Jonathan Hsu, Mohammad Bawazeer, John Marshall, Jan O Friedrich, Avery Nathens, Natalie Coburn, Gary R May, Emily Pearsall, Robin S McLeod
There has been an increase in the incidence of acute pancreatitis reported worldwide. Despite improvements in access to care, imaging and interventional techniques, acute pancreatitis continues to be associated with significant morbidity and mortality. Despite the availability of clinical practice guidelines for the management of acute pancreatitis, recent studies auditing the clinical management of the condition have shown important areas of noncompliance with evidence-based recommendations. This underscores the importance of creating understandable and implementable recommendations for the diagnosis and management of acute pancreatitis...
April 2016: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/25770706/recent-advances-in-autoimmune-pancreatitis
#2
REVIEW
Phil A Hart, Yoh Zen, Suresh T Chari
Autoimmune pancreatitis (AIP) is a form of chronic pancreatitis that is characterized clinically by frequent presentation with obstructive jaundice, histologically by a dense lymphoplasmacytic infiltrate with fibrosis, and therapeutically by a dramatic response to corticosteroid therapy. Two distinct diseases, type 1 and type 2 AIP, share these features. However, these 2 diseases have unique pancreatic histopathologic patterns and differ significantly in their demographic profiles, clinical presentation, and natural history...
July 2015: Gastroenterology
https://www.readbyqxmd.com/read/26650175/images-in-clinical-medicine-cullen-s-and-grey-turner-s-signs-in-acute-pancreatitis
#3
Xavier Valette, Damien du Cheyron
A 63-year-old man with no history of alcohol abuse presented with sudden, severe epigastric pain. The serum lipase level was elevated (1380 U per liter; normal range, 22 to 51 U per liter), a finding consistent with acute pancreatitis. Abdominal ultrasonography revealed cholelithiasis without..
December 10, 2015: New England Journal of Medicine
https://www.readbyqxmd.com/read/25642743/acute-pancreatitis-extrapancreatic-necrosis-volume-as-early-predictor-of-severity
#4
Olivier Meyrignac, Séverine Lagarde, Barbara Bournet, Fatima Zohra Mokrane, Louis Buscail, Hervé Rousseau, Philippe Otal
PURPOSE: To determine the volume of extrapancreatic necrosis that predicts severe acute pancreatitis and to assess the reliability of this threshold in predicting severe acute pancreatitis compared with current scoring systems and C-reactive protein (CRP) levels. MATERIALS AND METHODS: This institutional review board-approved, HIPAA-compliant retrospective study included patients with acute pancreatitis who were examined with computed tomography (CT) 2-6 days after disease onset...
July 2015: Radiology
https://www.readbyqxmd.com/read/25286967/new-diagnosis-of-chronic-pancreatitis-risk-of-missing-an-underlying-pancreatic-cancer
#5
Satish Munigala, Fasiha Kanwal, Hong Xian, Banke Agarwal
OBJECTIVES: Patients with pancreatic cancer (PaCa) sometimes present with symptoms suggestive of chronic pancreatitis (CP). We evaluated the prevalence of undiagnosed PaCa in patients with new CP diagnosis. METHODS: This is a retrospective study with data from Veterans Health Administration national medical care data sets from fiscal year 1998-2007. A 3-year washout period was used to identify patients with preexisting PaCa and preexisting CP diagnosis. RESULTS: Among 471,992 veterans included, 917 (0...
November 2014: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/25269432/current-knowledge-of-hypertriglyceridemic-pancreatitis
#6
REVIEW
Pedro Valdivielso, Alba Ramírez-Bueno, Nils Ewald
Severe hypertriglyceridemia (HTG) is a well established and the most common cause of acute pancreatitis (AP) after alcohol and gall stone disease. It is alleged to account for up to 10% of all pancreatitis episodes. Studies suggest that in patients with triglyceride (TG) levels>1000 mg/dL (>11.3 mmol/L), hypertriglyceridemia-induced acute pancreatitis (HTGP-AP) occurs in approximately 15-20% of all subjects referred to Lipid Clinics. Until now, there is no clear evidence which patients with severe HTG will develop pancreatitis and which will not...
October 2014: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/25276114/the-simultaneous-incidence-of-acute-pancreatitis-and-autoimmune-hemolytic-anemia-a-rare-duo-in-a-patient-with-sle
#7
Ibrahim Masoodi
A young female presented with acute abdominal pain of two days duration consistent with acute pancreatitis. During her stay in the hospital she had a sudden drop in hemoglobin to 6 g/dl without any overt blood loss. On evaluation, it was evident that she had acute pancreatitis, in addition to displaying features of autoimmune hemolytic anemia. She had been a known case of systemic lupus erythematosus (SLE) and had discontinued her treatment. She was managed with methylprednisolone pulse therapy. Her clinical condition improved, and she has been regularly attending our clinic for the last 2 years...
2014: German Medical Science: GMS E-journal
https://www.readbyqxmd.com/read/25254514/pathophysiology-classification-and-available-guidelines-of-acute-pancreatitis
#8
REVIEW
Ali Tüzün Ince, Birol Baysal
Acute pancreatitis (AP) constitutes the majority of cases requiring hospital admission in gastroenterology. We are yet to know many things about its pathophysiology which is a certain drawback for the progress in its treatment. Prediction of severity is necessary for the plan of the management. The existing scoring systems are yet to be satisfactory. However our progress in the field was significant in the recent decade and a leap forward is expected in this cumbersome-to-manage condition which has many unmet needs...
August 2014: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/25239388/does-early-ed-ct-scanning-of-afebrile-patients-with-first-episodes-of-acute-pancreatitis-ever-change-management
#9
Robert J Dachs, Luke Sullivan, Preshanthini Shanmugathasan
Rising utilization of computed tomography (CT) imaging early in the course of acute pancreatitis (AP) has been recently reported. However, radiographic demonstration of the degree of necrosis or the presence of complications is not fully apparent within the first days of an acute attack. The objective of this study was to examine if CT scanning early in the course of disease (<48 h of symptoms) in afebrile patients with an emergency department (ED) diagnosis of first episode of AP revealed any unanticipated pathology that altered clinical management...
June 2015: Emergency Radiology
https://www.readbyqxmd.com/read/25226062/standardization-of-management-in-acute-pediatric-pancreatitis-a-tertiary-centre-perspective
#10
LETTER
Christine S Quinlan, Ronan McDermott, Neil Moran, Brian Sweeney, Ganapathy Lakshmanadass, Kevin C Conlon, Paul F Ridgway
No abstract text is available yet for this article.
December 2014: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/25216326/urgent-ercp-with-pancreatic-stent-placement-or-replacement-for-salvage-of-post-ercp-pancreatitis
#11
Tossapol Kerdsirichairat, Rajeev Attam, Mustafa Arain, Yan Bakman, David Radosevich, Martin Freeman
BACKGROUND AND STUDY AIMS: Urgent placement or replacement of pancreatic stents shortly after endoscopic retrograde cholangiopancreatography (ERCP) might attenuate the course of evolving post-ERCP pancreatitis (PEP). PATIENTS AND METHODS: Salvage ERCP with de novo pancreatic stent placement or replacement of outwardly migrated stents was performed within 2 - 48 hours in patients with evolving PEP accompanied by severe pain, systemic inflammatory response syndrome (SIRS), and major elevations in serum amylase and lipase...
December 2014: Endoscopy
https://www.readbyqxmd.com/read/25214831/analysis-of-the-power-of-common-diagnostic-tools-in-the-management-of-acute-pancreatitis
#12
Markus Nistal, Malai Zoltani, Ansgar W Lohse, Nicola Di Daniele, Manfredi Tesauro, Andrea Pace
Acute pancreatitis (AP) is a serious medical condition usually associated with severe upper abdominal pain. The purpose of our study is to assess the therapeutic consequences of contrast-enhanced computed tomography (CE-CT) and the predictive value of CRP for severe pancreatitis. We included patients with a threefold increase of plasma lipase who had received a CE-CT or had a CRP of =150 mg/dl. A total of 74 out of 283 patients got a contrast-enhanced CT scan; in 11 cases the CT was followed by endoscopic or surgical interventions as therapeutic consequences compared with 19 out of 50 control cases...
2014: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/25180322/old-age-is-associated-with-increased-severity-of-complications-in-endoscopic-biliary-stone-removal
#13
Takao Nishikawa, Toshio Tsuyuguchi, Yuji Sakai, Harutoshi Sugiyama, Dai Sakamoto, Masato Nakamura, Osamu Yokosuka
BACKGROUND AND AIM: Various techniques are required in endoscopic biliary stone removal. Because the presence of biliary stones is a benign disease, it is essential to minimize procedure-related complications. Having a sound knowledge of the risk factors can help reduce the number and severity of complications. We determined the risk factors for complications in patients undergoing endoscopic biliary stone removal. METHODS: This was a retrospective observational cohort study...
July 2014: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/25208277/necrotizing-pancreatitis-diagnosis-imaging-and-intervention
#14
Jeffrey Y Shyu, Nisha I Sainani, V Anik Sahni, Jeffrey F Chick, Nikunj R Chauhan, Darwin L Conwell, Thomas E Clancy, Peter A Banks, Stuart G Silverman
Acute necrotizing pancreatitis is a severe form of acute pancreatitis characterized by necrosis in and around the pancreas and is associated with high rates of morbidity and mortality. Although acute interstitial edematous pancreatitis is diagnosed primarily on the basis of signs, symptoms, and laboratory test findings, the diagnosis and severity assessment of acute necrotizing pancreatitis are based in large part on imaging findings. On the basis of the revised Atlanta classification system of 2012, necrotizing pancreatitis is subdivided anatomically into parenchymal, peripancreatic, and combined subtypes, and temporally into clinical early (within 1 week of onset) and late (>1 week after onset) phases...
September 2014: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/25155229/type-1-autoimmune-pancreatitis-and-igg4-related-sclerosing-cholangitis-is-associated-with-extrapancreatic-organ-failure-malignancy-and-mortality-in-a-prospective-uk-cohort
#15
Matthew T Huggett, E L Culver, M Kumar, J M Hurst, M Rodriguez-Justo, M H Chapman, G J Johnson, S P Pereira, R W Chapman, George J M Webster, E Barnes
OBJECTIVES: Type I autoimmune pancreatitis (AIP) and IgG4-related sclerosing cholangitis (IgG4-related SC) are now recognized as components of a multisystem IgG4-related disease (IgG4-RD). We aimed to define the clinical course and long-term outcomes in patients with AIP/IgG4-SC recruited from two large UK tertiary referral centers. METHODS: Data were collected from 115 patients identified between 2004 and 2013, and all were followed up prospectively from diagnosis for a median of 33 months (range 1-107), and evaluated for response to therapy, the development of multiorgan involvement, and malignancy...
October 2014: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/25155846/are-we-meeting-the-british-society-of-gastroenterology-guidelines-for-cholecystectomy-post-gallstone-pancreatitis
#16
Lee R Creedon, Chris Neophytou, Paul C Leeder, Altaf K Awan
BACKGROUND: The aim of this study was to audit the current management of patients suffering with gallstone pancreatitis (GSP) at a university teaching hospital for compliance with the British Society of Gastroenterology (BSG) guidelines regarding cholecystectomy post-GSP. METHODS: Data were collected on all patients identified via the hospital coding department that presented with GSP between January 2011 and November 2013. Patients with alcoholic pancreatitis were excluded...
December 2016: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/25139414/etiology-clinical-features-and-management-of-acute-recurrent-pancreatitis
#17
Yi Yun Deng, Rui Wang, Hao Wu, Cheng Wei Tang, Xin Zu Chen
OBJECTIVE: To study the etiology and clinical features of acute recurrent pancreatitis (ARP) and to determine its optimal management and outcomes. METHODS: ARP cases among acute pancreatitis patients who were admitted to the West China Hospital, Sichuan University from January 2008 to December 2012 were retrospectively collected. Their etiology, clinical features, treatments and outcomes were analyzed. RESULTS: Of all pancreatitis patients, 8...
October 2014: Journal of Digestive Diseases
https://www.readbyqxmd.com/read/25133018/early-phase-of-acute-pancreatitis-assessment-and-management
#18
REVIEW
Veit Phillip, Jörg M Steiner, Hana Algül
Acute pancreatitis (AP) is a potentially life-threatening disease with a wide spectrum of severity. The overall mortality of AP is approximately 5%. According to the revised Atlanta classification system, AP can be classified as mild, moderate, or severe. Severe AP often takes a clinical course with two phases, an early and a late phase, which should both be considered separately. In this review article, we first discuss general aspects of AP, including incidence, pathophysiology, etiology, and grading of severity, then focus on the assessment of patients with suspected AP, including diagnosis and risk stratification, followed by the management of AP during the early phase, with special emphasis on fluid therapy, pain management, nutrition, and antibiotic prophylaxis...
August 15, 2014: World Journal of Gastrointestinal Pathophysiology
https://www.readbyqxmd.com/read/25112526/successful-use-of-octreotide-as-a-chemoprotectant-for-prevention-of-peg-asparaginase-induced-pancreatitis
#19
Larry W Buie, Joseph Moore, Hank van Deventer
l-asparaginase is an aminohydrolase that deprives leukemia cells of l-asparagine required for protein synthesis. Although studies in patients with acute lymphoblastic leukemia have shown that the addition of l-asparaginase improved the overall remission rate, life-threatening acute pancreatitis has occurred in 0.5-4% of patients. We describe the first adult case report, to our knowledge, of the successful use of octreotide as a chemoprotectant for the prevention of recurrent pegylated asparaginase (PEG-ASP)-induced pancreatitis in a 21-year-old man with Philadelphia chromosome-negative acute lymphoblastic leukemia...
August 2014: Pharmacotherapy
https://www.readbyqxmd.com/read/25113041/the-role-of-endoscopy-in-the-management-of-pancreatic-necrosis
#20
REVIEW
Aaron Lewis, Brett Partridge, Oleh Haluszka
The management of acute pancreatitis has seen many advances over the past three decades. Attempts to improve care have led to new definitions, classification systems, and treatment strategies. Despite those efforts, considerable morbidity and mortality result from complications of severe acute pancreatitis. Much attention has been given to new ways to treat these complications, including inflammatory pancreatic fluid collections and associated infections. Endoscopy has become one of the established modalities for the treatment of these complications in many expert centers...
September 2014: Current Gastroenterology Reports
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