Evaluation and Treatment of Recurrent Acute Pancreatitis

10.15279/kpb ◽  
2016 ◽  
Vol 21 (1) ◽  
pp. 1-10
Author(s):  
Dong Hui Cho ◽  
Tae Jun Song
Keyword(s):  
Acute Pancreatitis ◽  
Recurrent Acute Pancreatitis

Hypertriglyceridemia: An Infrequent, Difficult-to-predict, Severe Metabolic and Vascular Problem Associated with Estrogen Administration

2020 ◽  
Vol 18 (3) ◽  
pp. 254-261
Author(s):  
Thomas F. Whayne
Keyword(s):  
Acute Pancreatitis ◽  
Severe Side Effect ◽  
Recurrent Acute Pancreatitis ◽  
Postmenopausal Symptoms ◽  
Severe Hypertriglyceridemia ◽  
Short Period ◽  
Cv Disease ◽  
The Right ◽  
And Control ◽  
Transdermal Route

Supplementary estrogen plays important roles for female patients as convenient birth control, relief of postmenopausal symptoms, and in the management of other selected problems. However, as is the case for essentially all medications, there are side effects. Short of a major pulmonary embolus, the most severe side effect of estrogen would appear to be sporadic, rare, and severe hypertriglyceridemia associated with acute pancreatitis. The occurrence of this fortunately rare problem usually happens in the presence of some preexisting and usually mild increase in triglycerides (TG). A case of chronic and severe recurrent acute pancreatitis is described in the introduction and the management was complete estrogen avoidance. Started close to menopause and continued for a relatively short period, estrogens may have some cardiovascular (CV) benefit but the general recommendation is not to prescribe them for CV disease prevention. Estrogens may contribute to decreased diabetes mellitus (DM) risk and control. Administration of estrogens by the transdermal route may decrease some problems such as venous thromboembolism (VTE) and elevation of TG. Administration of estrogen in the right situation brings significant benefit to the female patient but skillful, careful, and knowledgeable use is essential.

scholarly journals The association of triglyceride levels with the incidence of initial and recurrent acute pancreatitis

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Robert J. Sanchez ◽  
Wenzhen Ge ◽  
Wenhui Wei ◽  
Manish P. Ponda ◽  
Robert S. Rosenson
Keyword(s):  
Acute Pancreatitis ◽  
Medical Records ◽  
Adult Population ◽  
Baseline Period ◽  
Prior History ◽  
Inclusion Criteria ◽  
Exclusion Criteria ◽  
Recurrent Acute Pancreatitis ◽  
History Of ◽  
Nationally Representative

Abstract Background This retrospective cohort study assessed the annualized incidence rate (IR) of acute pancreatitis (AP) in a nationally representative US adult population, as well as the variation in the risk of AP events across strata of triglyceride (TG) levels. Methods Data were obtained from IQVIA’s US Ambulatory Electronic Medical Records (EMR) database linked with its LRxDx Open Claims database. Inclusion criteria included ≥1 serum TG value during the overlapping study period of the EMR and claims databases, ≥1 claim in the 12-month baseline period, and ≥ 1 claim in the 12 months post index. All TG measurements were assigned to the highest category reached: < 2.26, ≥2.26 to ≤5.65, > 5.65 to ≤9.94, > 9.94, and > 11.29 mmol/L (< 200, ≥200 to ≤500, > 500 to ≤880, > 880, and > 1000 mg/dL, respectively). The outcome of interest was AP, defined as a hospitalization event with AP as the principal diagnosis. Results In total, 7,119,195 patients met the inclusion/exclusion criteria, of whom 4158 (0.058%) had ≥1 AP events in the prior 12 months. Most patients (83%) had TGs < 2.26 mmol/L (< 200 mg/dL), while < 1% had TGs > 9.94 mmol/L (> 880 mg/dL). Overall, the IR of AP was low (0.08%; 95% confidence internal [CI], 0.08–0.08%), but increased with increasing TGs (0.08% in TGs < 2.26 mmol/L [< 200 mg/dL] to 1.21% in TGs > 11.29 mmol/L [> 1000 mg/dL]). In patients with a prior history of AP, the IR of AP increased dramatically; patients with ≥2 AP events at baseline had an IR of 29.98% (95% CI, 25.1–34.9%). Conclusion The risk of AP increases with increasing TG strata; however, the risk increases dramatically among patients with a recent history of AP.

scholarly journals Clinical outcome of endoscopic therapy in patients with symptomatic pancreas divisum: a Dutch cohort study

2021 ◽  
Vol 09 (07) ◽  
pp. E1164-E1170
Author(s):  
David M. de Jong ◽  
Pauline M. Stassen ◽  
Jan Werner Poley ◽  
Paul Fockens ◽  
Robin Timmer ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Cohort Study ◽  
Endoscopic Therapy ◽  
Clinical Success ◽  
Pancreas Divisum ◽  
Univariate Analysis ◽  
Clinical Success Rate ◽  
Recurrent Acute Pancreatitis ◽  
Pancréas Divisum

Abstract Background and study aims Although the majority of patients with pancreas divisum (PDiv) are asymptomatic, a subgroup present with recurrent pancreatitis or pain for which endoscopic therapy may be indicated. The aim of this study was to evaluate success rates and long-term outcomes of endoscopic treatment in patients with symptomatic PDiv. Patients and methods A multicenter, retrospective cohort study was performed. Patients with symptomatic PDiv presenting with recurrent acute pancreatitis (RAP), chronic pancreatitis (CP), or chronic abdominal pancreatic-type pain (CAP) who underwent endoscopic retrograde cholangiopancreatography (ERCP) between January 2000 and December 2019 were included. The primary outcome was clinical success, defined as either no recurrent episode of acute pancreatitis (AP) for RAP patients, no flares for CP patients, or absence of abdominal pain for patients with CAP after technically successful ERCP. Results In 60 of 81 patients (74.1 %) a technically successful papilla minor intervention was performed. Adverse events were reported in 30 patients (37 %), with post-ERCP pancreatitis in 18 patients. The clinical success rate for patients with at least 3 months of follow-up was 42.6 %, with higher rates of success among patients presenting with RAP (44.4 %) as compared to those with CP (33.3 %) or CAP (33.3 %). Long-term sustained response was present in 40.9 % of patients with a technically successful intervention. In patients with RAP who did not completely respond to treatment, the mean number of AP episodes after treatment decreased significantly from 3.5 to 1.1 per year, and subsequently the interval between AP episodes increased from 278 to 690 days (P = 0.0006). A potential predictive factor of failure of clinical success after technically successful ERCP, at univariate analysis, was male sex (OR = 0.25, P = 0.02). Conclusions Endoscopic therapy in patients with symptomatic PDiv is moderately effective, with its highest yield in patients presenting with RAP. Future studies are needed to assess factors predictive for success of endoscopic therapy and potential risk factors for relapse after ERCP.

scholarly journals Endoscopic management of pancreaticopleural fistula after recurrent acute pancreatitis

2021 ◽  
pp. 1-2
Author(s):  
Abinash Subedi ◽  
Dragos Manta ◽  
Amrendra Mandal ◽  
Aakritee Sharma Subedi ◽  
Nuri Ozden
Keyword(s):  
Acute Pancreatitis ◽  
Endoscopic Management ◽  
Recurrent Acute Pancreatitis

Comparison of idiopathic recurrent acute pancreatitis [IRAP] and recurrent acute pancreatitis with genetic mutations

2021 ◽  
Author(s):  
Luisa M. Cruz ◽  
Joshua Y. Kwon ◽  
Sven P. Oman ◽  
Himesh Zaver ◽  
Gabriel A. Bolaños ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Genetic Mutations ◽  
Recurrent Acute Pancreatitis

A case of recurrent acute pancreatitis in an obese child

Nutrition ◽  
2014 ◽  
Vol 30 (10) ◽  
pp. 1213-1216 ◽  
Author(s):  
Byung Ok Kwak ◽  
Min Jung Lee ◽  
Hye Won Park ◽  
Kyo Sun Kim ◽  
Sochung Chung
Keyword(s):  
Acute Pancreatitis ◽  
Obese Child ◽  
Recurrent Acute Pancreatitis

Sa1503 Which Patients With Recurrent Acute Pancreatitis in the Setting of Pancreas Divisum Respond to Minor Sphincterotomy?

2016 ◽  
Vol 83 (5) ◽  
pp. AB275-AB276 ◽  
Author(s):  
Zachary A. Zator ◽  
Rohit Das ◽  
Rawad Mounzer ◽  
Arun Mannem ◽  
Dhiraj Yadav ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Pancreas Divisum ◽  
Recurrent Acute Pancreatitis ◽  
Pancréas Divisum

scholarly journals Primary Hyperparathyroidism due to Parathyroid adenoma presenting as recurrent acute pancreatitis

2017 ◽  
Vol 8 (1) ◽  
pp. 98-100
Author(s):  
Tarun J George ◽  
Pughazhendhi Thangavelu ◽  
S Zahir Hussain ◽  
MP Kumaran ◽  
Kini Ratnakar ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Primary Hyperparathyroidism ◽  
Parathyroid Adenoma ◽  
Elevated Serum ◽  
Surgical Excision ◽  
Medical Sciences ◽  
Thyroid Lobe ◽  
Recurrent Acute Pancreatitis ◽  
Hypoechoic Nodule ◽  
Left Thyroid Lobe

Primary hyperparathyroidism (PHPT) due to parathyroid adenoma presenting as recurrent acute pancreatitis is a rare entity. A 17-year-old male presented with recurrent attacks of pancreatitis and was found to have elevated serum calcium and Parathyroid hormone levels, 11.9mg/dL (8.5-10.2 mg/dL) and 396 pg/ml (10-65pg/ml) respectively. USG neck showed a 1.1 x 0.9 cm hypoechoic nodule in the superior aspect of left thyroid lobe. Parathyroid scintigraphy findings were consistent with parathyroid adenoma. After recovery of pancreatitis, surgical excision of the adenoma was done and the histopathological findings confirmed parathyroid adenoma. There were no further recurrence of pancreatitis following the excision.Asian Journal of Medical Sciences Vol.8(1) 2017 98-100

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