scholarly journals Acute Pancreatitis and Diabetic Ketoacidosis following L-Asparaginase/Prednisone Therapy in Acute Lymphoblastic Leukemia

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Dania Lizet Quintanilla-Flores ◽  
Miguel Ángel Flores-Caballero ◽  
René Rodríguez-Gutiérrez ◽  
Héctor Eloy Tamez-Pérez ◽  
José Gerardo González-González
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Acute Lymphoblastic Leukemia ◽  
Diabetic Ketoacidosis ◽  
Lymphoblastic Leukemia ◽  
Remission Induction ◽  
Contrast Enhanced ◽  
Enhanced Computed Tomography ◽  
Hispanic Male ◽  
Contrast Enhanced Computed Tomography

Acute pancreatitis and diabetic ketoacidosis are unusual adverse events following chemotherapy based on L-asparaginase and prednisone as support treatment for acute lymphoblastic leukemia. We present the case of a 16-year-old Hispanic male patient, in remission induction therapy for acute lymphoblastic leukemia on treatment with mitoxantrone, vincristine, prednisone, and L-asparaginase. He was hospitalized complaining of abdominal pain, nausea, and vomiting. Hyperglycemia, acidosis, ketonuria, low bicarbonate levels, hyperamylasemia, and hyperlipasemia were documented, and the diagnosis of diabetic ketoacidosis was made. Because of uncertainty of the additional diagnosis of acute pancreatitis as the cause of abdominal pain, a contrast-enhanced computed tomography was performed resulting in a Balthazar C pancreatitis classification.

scholarly journals Computed Tomography Evaluation of Acute Pancreatitis and Its Complications – A Prospective Study at a Tertiary Referral Center

2021 ◽  
Vol 8 (11) ◽  
pp. 643-647
Author(s):  
Rama Krishna Narra ◽  
Manjeera Boddepalli ◽  
Narasimhachary Munjuwanpalli ◽  
Bhimeswarao Pasupaleti
Keyword(s):  
Computed Tomography ◽  
Acute Pancreatitis ◽  
Prospective Study ◽  
Pancreatic Necrosis ◽  
Contrast Enhanced ◽  
Necrotising Pancreatitis ◽  
Enhanced Computed Tomography ◽  
A Prospective Study ◽  
Contrast Enhanced Computed Tomography ◽  
Score Index

BACKGROUND Acute pancreatitis (AP) is described as acute inflammation of the pancreas with or without peripancreatic abnormalities. The present study describes the role of computed tomography in the evaluation and grading of acute pancreatitis. Acute pancreatitis is a dynamic disease having biphasic mortality peaks due to two overlapping phases, which include early and late due to increased obesity, ageing of population, alcohol abuse, increased gall stone incidence, the worldwide AP incidence is increasing. Most important causes of AP in developing countries such as India include increased alcohol consumption. Contrast enhanced computed tomography plays an important role in diagnosis of the disease and helps in determining the prognosis of the disease. Modified CT severity index scoring system is the most commonly used scoring system for assessment of the severity of the disease. METHODS The present study is a prospective study of patients presenting with signs and symptoms of acute pancreatitis referred to the Department of Radio Diagnosis at Katuri medical college. This study comprised of 50 patients with clinical suspicion / diagnosis of acute pancreatitis, raised pancreatic biochemical parameters like serum amylase and serum lipase. Contrast enhanced computed tomography was performed in these patients, findings reported, and the disease was classified using modified CT scoring index system (MCTSI). RESULTS The mean age of the patients in the present study was 42.3 ± 12.28 years. Most of the patients presented with abdominal epigastric pain, abdominal distension. Acute pancreatitis was divided into acute oedematous pancreatitis and necrotising pancreatitis, the former being common. Complications included, ascites, pleural effusions, splenic vein thrombosis, portal venous thrombosis, and haemorrhages. CONCLUSIONS Contrast enhanced CT is useful to differentiate between oedematous and necrotising types of pancreatitis. The MCTSI helps in better evaluation of pancreatic necrosis grading. The modified computed tomography score index correlation with the development of local and systemic complications in acute pancreatitis is well established. Ideally, conducting contrast enhanced computed tomography (CECT) after 48 - 72 hours of acute attack, increases the probability of identifying necrotising pancreatitis. CT in particular has an overall accuracy of about 87 % and sensitivity and specificity of 100 % in the recognition of pancreatic necrosis. KEYWORDS Computed Tomography, Acute Pancreatitis, Pseudocyst, Modified CT Score Index

scholarly journals Midgut malrotation with volvulus - a case report

2013 ◽  
Vol 02 (02) ◽  
pp. 082-085
Author(s):  
Pradipta Ray Choudhury ◽  
Prasant Sarda ◽  
Shobhit Singh ◽  
Prabahita Baruah ◽  
K. L. Talukdar
Keyword(s):  
Abdominal Pain ◽  
Mesenteric Artery ◽  
Acute Abdominal Pain ◽  
Abdominal Cavity ◽  
Recurrent Abdominal Pain ◽  
Midgut Malrotation ◽  
Contrast Enhanced ◽  
Whirlpool Sign ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

AbstractMidgut malrotation is a rare anatomic anomaly that complicates the diagnosis and management of acute abdominal pain. It is a congenital anomaly that arises from incomplete rotation or abnormal position of the midgut during embryonic development. A two years old boy was brought with recurrent abdominal pain and vomiting. On ultrasonography, the intestinal malrotation was suspected and thus contrast enhanced computed tomography (CECT) was done. On CECT, abnormal relationship between the superior mesenteric artery (SMA) and superior mesenteric vein (SMV), colon on the left side of the abdominal cavity, 'Whirlpool sign' etc., were found. All findings were suggestive of midgut malrotation with volvulus. Detection of uncomplicated malrotation should not be trivialized because such patients might experience a future complication.

SMALL INTESTINAL CARCINOID TUMOR-A CASE REPORT

2021 ◽  
pp. 36-37
Author(s):  
B. Santhi ◽  
S. Savitha ◽  
V. G. Vikraman
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Exploratory Laparotomy ◽  
Wall Thickening ◽  
Lower Quadrant ◽  
Polypoidal Lesion ◽  
Contrast Enhanced ◽  
Intraluminal Mass ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

Carcinoid tumors are neuroendocrine tumours, the most common tumour of the small bowel and its incidence is rising. Most carcinoid tumours grow slowly and mostly asymptomatic or may present with nonspecic abdominal pain or carcinoid syndrome. We had a 38 year old, female patient presented with generalized, intermittent, dull aching abdominal pain accompanied with distension and obstipation for 2 days with associated vomiting. She complained of weight loss and constipation during this period. On examination abdomen showed deep tenderness in periumbilical, right lower quadrant regions. No guarding, rigidity, mass or free uid. On per-rectal examination, there was no tenderness and the rectum was empty. Contrast enhanced computed tomography scan showed enhancing polypoidal lesion noted in distal ileum causing proximal dilatation of small bowel with air uid levels and circumferential wall thickening in dilated ileum proximal to polypoidal lesion, strongly enhancing nodal mass with specs of calcication, multiple mesentric lymph nodes and no liver metastasis. As the conservative management for 48 hours showed no improvement in symptoms, an emergency exploratory laparotomy was performed, and an intraluminal mass was identied from ileocecal junction causing obstruction with dilated loops of ileum and jejunum. Local resection of terminal ileum was performed and a side to side anastomoses was done using GI stapler. Histopathology showed diagnosis of neuroendocrine tumor

scholarly journals Prognostic Indicators in Acute Pancreatitis

2003 ◽  
Vol 17 (5) ◽  
pp. 325-328 ◽  
Author(s):  
Clement W Imrie
Keyword(s):  
Acute Pancreatitis ◽  
Organ Dysfunction ◽  
Pancreatic Necrosis ◽  
Prognostic Indicators ◽  
Radiological Findings ◽  
Severe Pancreatitis ◽  
Contrast Enhanced ◽  
Threshold Score ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

Several approaches have been used in an attempt to predict the severity and prognosis of attacks of acute pancreatitis. The Ranson and Glasgow criteria include a variety of simple laboratory parameters that are measured on admission and again within 48 h. They are the most widely used indices in clinical practice. The Acute Physiological and Chronic Health Evaluation II system is more complicated, but can be applied to a wide variety of conditions, especially in intensive care settings. The usefulness of this system depends on the threshold score for defining severe pancreatitis; a score of eight appears to be the most appropriate. The finding of nonperfused areas in the pancreas at contrast-enhanced computed tomography is indicative of pancreatic necrosis and portends an unfavourable prognosis. Other clinical and laboratory indices have been proposed, but the most important predictive factor of early mortality seems to be the presence and persistance of a Marshall organ failure score of two or more. This is especially true if organ dysfunction persists beyond 36 h. Radiological findings do not always correlate well with the presence of organ dysfunction, and more investigations are required.

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