scholarly journals Pancreaticoportal Fistula in Association with Antiphospholipid Syndrome Presenting as Ascites and Portal System Thrombosis

2002 ◽  
Vol 16 (9) ◽  
pp. 601-605 ◽  
Author(s):  
Li-Hsin Chang ◽  
Luc Francoeur ◽  
Franzjosef Schweiger
Keyword(s):  
Abdominal Pain ◽  
Chronic Pancreatitis ◽  
Medical Therapy ◽  
Antiphospholipid Syndrome ◽  
Portal System ◽  
Pancreatic Pseudocysts ◽  
Portal Venous System ◽  
Laboratory Studies ◽  
Endoscopic Retrograde ◽  
Computed Tomographic

Fistulous communication between the pancreas and the portal venous system is extremely rare and is usually a complication of chronic pancreatitis or pancreatic pseudocysts. A patient who presented with abdominal pain and ascites secondary to a pancreaticoportal fistula and portal system thrombosis is described. The diagnosis was made by endoscopic retrograde cholangiopancreatography and confirmed by immediate postprocedure computed tomographic scanning. Laboratory studies identified concomitant antiphospholipid syndrome. The patient responded favourably to supportive medical therapy.

scholarly journals Clinical and Epidemiologic Profile of Chronic Pancreatitis, A Retrospective Study in Eastern Nepal

2018 ◽  
Vol 7 (2) ◽  
pp. 30-33
Author(s):  
Rabin Sharma ◽  
Bikram Pradhan ◽  
Prahlad Karki ◽  
Manish Subedi
Keyword(s):  
Chronic Pancreatitis ◽  
Retrospective Study ◽  
Alcohol Use ◽  
Medical Therapy ◽  
Statistical Power ◽  
Retrospective Chart Review ◽  
Study Data ◽  
Idiopathic Pancreatitis ◽  
Computed Tomographic ◽  
Epidemiologic Profile

Background and Aims: Chronic pancreatitis is a condition characterized by chronic inflammatory and fibrotic changes in the pancreas leading to irreversible parenchymal damage and loss of glandular function. This retrospective study was conducted to study the clinic-epidemiologic profile of chronic pancreatitis in eastern Nepal. Methods: All adult patients admitted with chronic pancreatitis from June 2014 to June 2016 were included in this study. Data pertaining to demographics and clinical profile was obtained by retrospective chart review. Results: A total of (n=55) patients were enrolled in the study with a median age of 28 years. Idiopathic pancreatitis was the most common form of chronic pancreatitis (n= 37, 67.3%) and alcoholic chronic pancreatitis accounted for about a third of cases (n=18, 32.7%). Abdominal pain was a presenting symptom in all the cases (n=55,100%). Thirty-seven patients (67.3%) had diabetes mellitus. Ductal dilatation (n=55,100%) and calculi (n=43, 83.6%) were the most common findings on imaging using ultrasonography and Computed tomographic scan of abdomen). All the patients were receiving medical therapy. Most patients receiving medical therapy were on opioids (n=37, 67.3%) or pancreatic supplements (n=18, 32.7%). Complications were seen in only nine patients (16.4%). All of them had pseudocyst. Conclusions: In this study, idiopathic chronic pancreatitis (CP) was observed as the most common etiologic form of CP unlike CP related to alcohol use in other similar studies. CP related to alcohol use was seen as the second most common etiologic form. Diabetes was the most commonly associated comorbidity in our CP cohort. This study was performed in a small study population and is limited by several factors including statistical power. Larger studies are warranted to study the etiologic forms and outcomes of CP in Nepalese population.

scholarly journals Extensive Investigation of Patients with Mild Elevations of Serum Amylase and/or Lipase Is ‘Low Yield’

2002 ◽  
Vol 16 (12) ◽  
pp. 849-854 ◽  
Author(s):  
Michael F Byrne ◽  
Robert M Mitchell ◽  
Helen Stiffler ◽  
Paul S Jowell ◽  
Malcolm S Branch ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Chronic Pancreatitis ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Serum Amylase ◽  
Diagnostic Yield ◽  
Extensive Investigation ◽  
Endoscopic Retrograde ◽  
Abdominal Symptoms ◽  
Upper Limit ◽  
Pancreatic Pathology

BACKGROUND: Serum amylase and lipase levels are widely used as markers of pancreatic inflammation. However, it would seem that mild elevations of amylase and lipase rarely predict significant pancreatic pathology. Pancreatic imaging tests are expensive. The gold standard, endoscopic retrograde cholangiopancreatography, carries risk of morbidity and mortality.OBJECTIVE: To determine whether extensive investigation of patients with mild, nonspecific abdominal symptoms and mild elevations of amylase and/or lipase results in a significant diagnostic yield.METHODS: Outpatient evaluations were retrospectively analyzed over 12 months. Inclusion criteria were nonspecific abdominal pain, and mild elevations (less than three times the upper limit of normal) of serum amylase or lipase, or both. Exclusion criteria included a history of chronic pancreatitis, elevation of liver tests and acute pain syndromes.RESULTS: Nineteen patients over the study period met the criteria. Of the nineteen patients, 58% had elevation of lipase alone, 21% amylase alone and 21% had elevations of both. In addition, 89.5% of the patients had nonspecific abdominal pain. After imaging with one or more of ultrasound, computed tomography, magnetic resonance cholangiopancreatography, endoscopic ultrasound and endoscopic retrograde cholangiopancreatography, small bowel follow through or hepatobiliary scanning, 78.9% patients were thought to have a normal pancreas. Of the remaining patients, 15.8% had mild or equivocal changes of chronic pancreatitis, and one patient was found to have a pancreatic tail pseudocyst. The average cost of investigation was US$2,255, taking only direct procedural costs into account. No patient was found to have malignancy.CONCLUSIONS: The majority of patients with nonspecific abdominal pain and isolated elevations of amylase and/or lipase (less than three times the upper limit of normal) had no identifiable pancreatic pathology. The diagnostic yield in patients with mild elevations of lipase alone was particularly poor. The cost effectiveness and risk-benefit ratio of extensive investigation of this group of patients warrants further study.

scholarly journals Case Report: Pancreatic adenocarcinoma presenting as acute obstructive suppurative pancreatic ductitis

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 199
Author(s):  
Taha Sheikh ◽  
Syed Hamza Bin Waqar ◽  
Jordan Burlen ◽  
Toseef Javaid ◽  
Ali Nawras
Keyword(s):  
Abdominal Pain ◽  
Chronic Pancreatitis ◽  
Alcohol Use Disorder ◽  
Pancreatic Head ◽  
Advanced Dementia ◽  
Past Medical History ◽  
Endoscopic Retrograde ◽  
Rare Form ◽  
Rare Presentation ◽  
History Of

Acute obstructive suppurative pancreatic ductitis (AOSPD) is a rare form of infection primarily arising within the pancreatic duct in the setting of chronic pancreatitis. We present a case of AOSPD precipitated by obstructive adenocarcinoma of pancreatic head in an elderly woman with a past medical history of chronic pancreatitis, alcohol use disorder and, advanced dementia, who developed progressive abdominal pain during her hospital admission for urinary tract infection. Endoscopic retrograde cholangiopancreatography (ERCP) with balloon sweep of pus and stent placement resulted in prompt abdominal pain resolution. Our case highlights a rare presentation of AOSPD as a harbinger of pancreatic malignancy.

Comparison of Endoscopic Retrograde Pancreatography with Functional and Histologic Changes in Chronic Pancreatitis

1987 ◽  
Vol 28 (3) ◽  
pp. 289-293 ◽  
Author(s):  
H. A. Heij ◽  
H. Obertop ◽  
M. van Blankenstein ◽  
G. A. J. J. Nix ◽  
D. L. Westbroek
Keyword(s):  
Chronic Pancreatitis ◽  
Discriminant Analysis ◽  
Test Data ◽  
Pancreatic Surgery ◽  
Pancreatic Disease ◽  
Pancreatic Tissue ◽  
Endoscopic Retrograde Pancreatography ◽  
Endoscopic Retrograde ◽  
The Relationship ◽  
Histologic Changes

The findings from endoscopic retrograde pancreatography (ERP) and secretin-CCK test data were compared in 69 patients: 36 with chronic pancreatitis, 9 with possible chronic pancreatitis, and 24 without chronic pancreatic disease. The ERP findings were also compared with the histologic changes in pancreatic tissue in 18 patients who underwent pancreatic surgery for chronic pancreatitis. ERP films were reviewed according to the criteria proposed by Kasugai et coll. (8) with special attention paid to the side branches. Secretin-CCK test data were interpreted using the discriminant analysis. A good correlation between bicarbonate and chymotrypsin output and ductular changes at ERP was found. The results of ERP and the secretin-CCK test were compatible in 86 per cent of the patients. The relationship between ERP findings and histologic changes was not straightforward. It was concluded that ERP and the secretin-CCK test are complementary in the diagnosis of chronic pancreatitis. ERP does not necessarily represent the histology in chronic pancreatitis.

An endoscopic pancreatic function test with synthetic porcine secretin for the evaluation of chronic abdominal pain and suspected chronic pancreatitis

2003 ◽  
Vol 57 (1) ◽  
pp. 37-40 ◽  
Author(s):  
Darwin L. Conwell ◽  
Gregory Zuccaro ◽  
John J. Vargo ◽  
Patricia A. Trolli ◽  
Frederick VanLente ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Chronic Pancreatitis ◽  
Chronic Abdominal Pain ◽  
Pancreatic Function ◽  
Pancreatic Function Test ◽  
Function Test

Abdominal Pain Secondary to Pylephlebitis: An Uncommon Disease of the Portal Venous System, Treated with Local Thrombolytic Therapy

2005 ◽  
Vol 50 (5) ◽  
pp. 983-987 ◽  
Author(s):  
Rathnakara Sherigar ◽  
Khalil A. Amir ◽  
Ravi K. Bobba ◽  
Edward L. Arsura ◽  
Narain Srinivas
Keyword(s):  
Abdominal Pain ◽  
Thrombolytic Therapy ◽  
Venous System ◽  
Portal Venous System ◽  
Uncommon Disease ◽  
Local Thrombolytic Therapy

scholarly journals Sex-Related Differences of Acute and Chronic Pancreatitis in Adults

2021 ◽  
Vol 10 (2) ◽  
pp. 300
Author(s):  
Madeline Drake ◽  
Shah-Jahan M. Dodwad ◽  
Joy Davis ◽  
Lillian S. Kao ◽  
Yanna Cao ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
The United States ◽  
Prevention Strategies ◽  
Endoscopic Retrograde ◽  
Effective Prevention ◽  
Type 1 Autoimmune Pancreatitis ◽  
Acute And Chronic Pancreatitis ◽  
Effective Prevention Strategies

The incidence of acute and chronic pancreatitis is increasing in the United States. Rates of acute pancreatitis (AP) are similar in both sexes, but chronic pancreatitis (CP) is more common in males. When stratified by etiology, women have higher rates of gallstone AP, while men have higher rates of alcohol- and tobacco-related AP and CP, hypercalcemic AP, hypertriglyceridemic AP, malignancy-related AP, and type 1 autoimmune pancreatitis (AIP). No significant sex-related differences have been reported in medication-induced AP or type 2 AIP. Whether post-endoscopic retrograde cholangiopancreatography pancreatitis is sex-associated remains controversial. Animal models have demonstrated sex-related differences in the rates of induction and severity of AP, CP, and AIP. Animal and human studies have suggested that a combination of risk factor profiles, as well as genes, may be responsible for the observed differences. More investigation into the sex-related differences of AP and CP is desired in order to improve clinical management by developing effective prevention strategies, diagnostics, and therapeutics.

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