Pancreatic disease

2018 ◽  
Author(s):  
Satish Keshav ◽  
Alexandra Kent
Keyword(s):  
Acute Pancreatitis ◽  
Inflammatory Process ◽  
Pancreatic Disease ◽  
Pancreatic Enzymes ◽  
Surrounding Tissue ◽  
Systemic Effects

Acute pancreatitis is an acute inflammatory process of the pancreas and is potentially reversible. It is characterized by oedema and necrosis of peripancreatic fat and may progress to necrosis of glandular and surrounding tissue. Activation of pancreatic enzymes leads to pancreatic autodigestion and systemic effects.

scholarly journals Asymptomatic and Persistent Elevation of Pancreatic Enzymes in an Ulcerative Colitis Patient

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Elisa Liverani ◽  
Filippo Leonardi ◽  
Lucia Castellani ◽  
Carla Cardamone ◽  
Andrea Belluzzi
Keyword(s):  
Ulcerative Colitis ◽  
Acute Pancreatitis ◽  
Serum Amylase ◽  
Drug Dosage ◽  
Pancreatic Disease ◽  
Pancreatic Enzymes ◽  
Pancreatic Damage ◽  
Bowel Diseases ◽  
One Year ◽  
Asymptomatic Elevation

Azathioprine has been extensively used in the management of inflammatory bowel diseases. It might cause pancreatic damage in the form of either asymptomatic elevation in serum amylase/lipase or overt acute pancreatitis. Here we report the case of a 61-year-old patient with ulcerative colitis who had been treated with azathioprine for three years, achieving clinical remission. During treatment he presented an asymptomatic elevation of serum pancreatic enzymes, without any signs of pancreatitis at imaging. This evidence brought us to reassess the drug dosage, without achieving a normalization of biochemical analysis. Autoimmune pancreatitis was excluded. One year after the suspension of azathioprine, we still face persistent high levels of amylase/lipase. Normalization of enzymatic values in patients who develop intolerance to azathioprine, in the form of either asymptomatic elevation in serum amylase/lipase or overt acute pancreatitis, is usually achieved in about two months after stopping drug intake. Asymptomatic elevation in serum pancreatic enzymes in the absence of pancreatic disease is reported in the literature and defined as “Gullo’s syndrome,” but nobody of the subjects studied had been treated in the past with pancreatotoxic drugs. Might this case be defined as “benign pancreatic hyperenzymemia”?

scholarly journals Bilobular pancreas: another variant of the divided pancreas?

2006 ◽  
Vol 63 (10) ◽  
pp. 902-904 ◽  
Author(s):  
Dragana Zivanovic ◽  
Vojislav Perisic
Keyword(s):  
Acute Pancreatitis ◽  
Pancreatic Disease ◽  
Recurrent Pancreatitis ◽  
Adequate Diet ◽  
Dorsal Pancreas ◽  
Full Control ◽  
Endoscopic Cholangiopancreatography ◽  
Key Factor ◽  
Ventral And Dorsal Pancreas ◽  
Possible Cause

Background. Pancreas divisum is the most common anomaly of the pancreas. This anomaly has been known as a possible cause of recurrent pancreatitis. Case report. We performed computerized tomography (CT) of the abdomen in 5 children in whom a divided pancreas was confirmed using endoscopic cholangiopancreatography. In a girl, who had three episodes of severe acute pancreatitis, a CT examination confirmed a completely divided embryonal dorsal and ventral primordium. We named this variant of the divided pancreas the "bilobular pancreas". Contrary to the remaining 4 children in whom the control of the number and severity of attacks, as well as the control of pancreatic pain were achieved by pharmacotherapeutics and an adequate diet, in the reported patient sphincteroplasty of the papilla duodeni minor resulted in a full control of the disease. Conclusion. The paper discussed the possibility that the variant of the divided pancreas, with anatomically completely separated ventral and dorsal pancreas and their ductal systems, is the key factor that determines the severity of pancreatic disease and an indication for sphincteroplasty of the papilla duodeni minor as the major therapeutic method.

scholarly journals A Rare Cause of Acute Pancreatitis: Intramural Duodenal Hematoma

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Hemant Goyal ◽  
Umesh Singla ◽  
Roli R. Agrawal
Keyword(s):  
Acute Pancreatitis ◽  
Emergency Room ◽  
Outlet Obstruction ◽  
Interesting Case ◽  
Pancreatic Enzymes ◽  
Initial Evaluation ◽  
Healthy Male ◽  
Imaging Studies ◽  
Acute Gastritis ◽  
Duodenal Hematoma

We describe an interesting case of intramural duodenal hematoma in an otherwise healthy male who presented to emergency room with gradually progressive abdominal pain, nausea, and vomiting. This condition was missed on initial evaluation and patient was discharged from emergency room with diagnosis of acute gastritis. After 3 days, patient came back to emergency room and abdominal imaging studies were conducted which showed that patient had intramural duodenal hematoma associated with gastric outlet obstruction and pancreatitis. Hematoma was the cause of acute pancreatitis as pancreatic enzymes levels were normal at the time of first presentation, but later as the hematoma grew in size, it caused compression of pancreas and subsequent elevation of pancreatic enzymes. We experienced a case of pancreatitis which was caused by intramural duodenal hematoma. This case was missed on initial evaluation. We suggest that physicians should be more vigilant about this condition.

Determination of Plasma Glycoprotein 2 Levels in Patients With Pancreatic Disease

2004 ◽  
Vol 128 (6) ◽  
pp. 668-674 ◽  
Author(s):  
Ying Hao ◽  
Jing Wang ◽  
Ningguo Feng ◽  
Anson W. Lowe
Keyword(s):  
Pancreatic Cancer ◽  
Acute Pancreatitis ◽  
Chronic Pancreatitis ◽  
Tertiary Care ◽  
Pancreatic Disease ◽  
Pancreatic Acinar Cell ◽  
Enzyme Linked Immunosorbent Assay ◽  
Assay Sensitivity ◽  
Acute And Chronic Pancreatitis

Abstract Context.—Blood tests possessing higher diagnostic accuracy are needed for all the major pancreatic diseases. Glycoprotein 2 (GP2) is a protein that is specifically expressed by the pancreatic acinar cell and that has previously shown promise as a diagnostic marker in animal models of acute pancreatitis. Objective.—This study describes the development of an assay for GP2, followed by the determination of plasma GP2 levels in patients with acute pancreatitis, chronic pancreatitis, and pancreatic cancer. Design.—Rabbit polyclonal antisera and mouse monoclonal antibodies were generated against human GP2 and used to develop an enzyme-linked immunosorbent assay. The assay was tested in patients with an admitting diagnosis of pancreatic disease at 2 tertiary care facilities. The diagnosis of acute or chronic pancreatitis and pancreatic cancer was determined using previously established criteria that incorporated symptoms, radiology, pathology, and serology. Plasma GP2 levels were determined in 31 patients with acute pancreatitis, 16 patients with chronic pancreatitis, 36 patients with pancreatic cancer, and 143 control subjects without pancreatic disease. Amylase and lipase levels were also determined in patients with acute pancreatitis. Results.—The GP2 assay's sensitivity values were 0.94 for acute pancreatitis, 0.81 for chronic pancreatitis, and 0.58 for pancreatic cancer, which were greater than the 0.71 for acute pancreatitis and 0.43 for chronic pancreatitis (P = .02) observed for amylase. The lipase assay sensitivity for acute pancreatitis was 0.66. The accuracy of the GP2 assay was greater than that of the amylase or lipase assays for acute pancreatitis (GP2 vs lipase, P = .004; GP2 vs amylase, P = .003) when analyzed using receiver operator characteristic curves. When daily serial blood samples were obtained for 13 patients with acute pancreatitis, GP2 levels remained abnormally elevated for at least 1 day longer than the amylase or lipase levels. Conclusion.—The GP2 assay is a useful new marker for acute and chronic pancreatitis.

Pancreatic disease

2011 ◽  
pp. 611-618
Keyword(s):  
Pancreatic Cancer ◽  
Acute Pancreatitis ◽  
Chronic Pancreatitis ◽  
Enzyme Replacement Therapy ◽  
Replacement Therapy ◽  
Pancreatic Enzyme ◽  
Pancreatic Disease ◽  
Enzyme Replacement ◽  
Pancreatic Enzyme Replacement Therapy ◽  
Pancreatic Disorders

Pancreatic disorders 612 Pancreatic enzyme replacement therapy 616 See Table 27.1. The major pancreatic disorders include pancreatitis and pancreatic cancer. Pancreatitis results from the auto-digestion of the pancreas by activated pancreatic enzymes. It can be categorized as: • Chronic pancreatitis (CP). • Acute pancreatitis: •...

scholarly journals Polyphenols as Possible Agents for Pancreatic Diseases

Antioxidants ◽  
2020 ◽  
Vol 9 (6) ◽  
pp. 547
Author(s):  
Uroš Gašić ◽  
Ivanka Ćirić ◽  
Tomislav Pejčić ◽  
Dejan Radenković ◽  
Vladimir Djordjević ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Acute Pancreatitis ◽  
Early Diagnosis ◽  
Pancreatic Disease ◽  
Biologically Active ◽  
Cytostatic Agents ◽  
Inhibitory Effects ◽  
Pancreatic Diseases ◽  
Anticancer Effects ◽  
Significant Data

Pancreatic cancer (PC) is very aggressive and it is estimated that it kills nearly 50% of patients within the first six months. The lack of symptoms specific to this disease prevents early diagnosis and treatment. Today, gemcitabine alone or in combination with other cytostatic agents such as cisplatin (Cis), 5-fluorouracil (5-FU), irinotecan, capecitabine, or oxaliplatin (Oxa) is used in conventional therapy. Outgoing literature provides data on the use of polyphenols, biologically active compounds, in the treatment of pancreatic cancer and the prevention of acute pancreatitis. Therefore, the first part of this review gives a brief overview of the state of pancreatic disease as well as the procedures for its treatment. The second part provides a detailed overview of the research regarding the anticancer effects of both pure polyphenols and their plant extracts. The results regarding the antiproliferative, antimetastatic, as well as inhibitory effects of polyphenols against PC cell lines as well as the prevention of acute pancreatitis are presented in detail. Finally, particular emphasis is given to the polyphenolic profiles of apples, berries, cherries, sour cherries, and grapes, given the fact that these fruits are rich in polyphenols and anthocyanins. Polyphenolic profiles, the content of individual polyphenols, and their relationships are discussed. Based on this, significant data can be obtained regarding the amount of fruit that should be consumed daily to achieve a therapeutic effect.

scholarly journals Man with epigastric pain and persistently elevated serum lipase

2019 ◽  
Vol 12 (4) ◽  
pp. e229208
Author(s):  
Caroline Annette Erika Bachmeier ◽  
Adam Morton
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Epigastric Pain ◽  
Elevated Serum ◽  
Pancreatic Disease ◽  
Radiological Assessment ◽  
Serum Lipase ◽  
Persistent Elevation ◽  
Assay Interference ◽  
Laboratory Assay

Serum lipase and amylase are commonly requested in individuals presenting with abdominal pain for investigation of acute pancreatitis. Pancreatic hyperenzymaemia is not specific for acute pancreatitis, occurring in many other pancreatic and non-pancreatic conditions. Where persistent elevation of serum lipase and amylase occurs in the absence of a diagnosed cause or evidence of laboratory assay interference, ongoing radiological assessment for pancreatic disease is required for 24 months before a diagnosis of benign pancreatic hyperenzymaemia can be made. We report a case of a 71-year-old man with epigastric pain and elevated serum lipase levels. He was extensively investigated, but no pancreatic disease was detected. He is asymptomatic, but serum lipase levels remain elevated 18 months after his initial presentation.

scholarly journals Critical Review of Diagnostic Methods Used in Chronic Pancreatic Disease

1995 ◽  
Vol 9 (1) ◽  
pp. 51-60
Author(s):  
Ivan T Beck
Keyword(s):  
Endoscopic Ultrasound ◽  
Imaging Techniques ◽  
Pancreatic Disease ◽  
Dietary Lipids ◽  
Pancreatic Enzymes ◽  
Diagnostic Methods ◽  
Screening Tests ◽  
Malignant Tumours ◽  
Curative Surgery ◽  
Function Tests

This paper provides a balanced assessment of the various pancreatic function tests and imaging techniques used in the differential diagnosis of chronic pancreatic disease. Function tests that study the digestive capacity of the pancreas (fat absorption of dietary lipids, fluorescein- or radiolabelled fats, bentiromide test, etc) have high specificity, but very low sensitivity. This is because 90% of pancreas has to be destroyed before steatorrhea or creatorrhea occurs. Tests that directly measure pancreatic bicarbonate and protein secretion (secretin test, etc) are more accurate and may detect pancreatic dysfunction even before anatomical changes occur. Measurement of pancreatic enzymes in serum or urine, or the decreased decline of serum amino acids during their incorporation into pancreatic enzymes, are not sufficiently sensitive or specific to help diagnose pancreatic disease. Sensitive and specific tumour markers are not yet available. Thus screening tests are not cost-effective - if they are negative, they do not exclude pancreatic disease; and if positive, they have to be confirmed by more specific tests. Imaging techniques are the most commonly used methods of investigation. The usefulness of abdominal survey films, barium studies, percutaneous transhepatic cholangiography, endoscopic retrograde cholangiopancreatography (ERCP), ultrasonography, computed tomographic scan, magnetic resonance imaging and endoscopic ultrasonography is critically reviewed. Most of the radiological methods can be combined with cytology or biopsy. Histology demonstrating malignancy establishes this diagnosis, but negative biopsies do not exclude malignant tumours. Presently only ERCP and endoscopic ultrasound can diagnose cancers sufficiently early to allow for possible `curative' surgery, and only endoscopic ultrasound is capable to stage tumours for the assessment of resectability.

Sign in / Sign up

Export Citation Format

Share Document