scholarly journals Posttraumatic Pancreatitis Four Days after Renal Injury with Massive Retroperitoneal Hematoma

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Masamichi Kiriyama ◽  
Kei Jitsuiki ◽  
Ken-ichi Muramatsu ◽  
Hoshiko Furusawa ◽  
Soshi Moriya ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Vital Signs ◽  
Retroperitoneal Hematoma ◽  
Amylase Level ◽  
Shock State ◽  
Causative Factors ◽  
Enhanced Ct ◽  
Direct Injury ◽  
Social Drinker ◽  
Enhanced Computed Tomography

A 25-year-old man accidentally fell from a cliff and hit his right flank on the ground while camping. Initially, he was able to barely walk, but he ultimately became unable to walk at all due to severe flank pain. He had no remarkable personal or family history and was a social drinker. Upon arrival, he showed clear consciousness but was in a hemorrhagic shock state. Enhanced computed tomography (CT) revealed extravasation of contrast medium from the injured right kidney with massive retroperitoneal hematoma. He underwent massive blood transfusion and tracheal intubation followed by renal embolization. His vital signs stabilized on hospital day 2, and he was extubated on day 3. On days 4 and 5, a blood examination revealed increased levels of amylase (360 and 904 IU/L, respectively). Enhanced CT on day 5 did not show signs of severe acute pancreatitis. The maximum amylase level was 1041 IU/L on day 6 and decreased day by day without deterioration of the severity of his acute pancreatitis. He was discharged on day 14. The subacute phase of posttraumatic acute pancreatitis in the present case may have been induced not by direct injury to the pancreas but by several causative factors, such as shock, increased pressure of the retroperitoneal space, or the release of inflammatory mediators from injured tissues or hematoma.

scholarly journals Clinical and therapeutic correlations in patients with slight acute pancreatitis

2015 ◽  
Vol 28 (1) ◽  
pp. 24-27 ◽  
Author(s):  
Clewis Henri MUNHOZ-FILHO ◽  
Fernando BATIGÁLIA ◽  
Hamilton Luiz Xavier FUNES
Keyword(s):  
Acute Pancreatitis ◽  
Intensive Care ◽  
Vital Signs ◽  
Positive Association ◽  
Multiple Organ ◽  
Glutamic Oxaloacetic Transaminase ◽  
Serum Glutamic Oxaloacetic Transaminase ◽  
Early Return ◽  
Lower Spectrum ◽  
Mild Acute Pancreatitis

BACKGROUND: Acute pancreatitis is an inflammatory disease of the pancreas due to enzymatic autodigestion which can cause necrosis or multiple organ failure; its pathophysiology is not fully known yet. AIM: To evaluate the correlation between clinical and therapeutic data in patients with mild acute pancreatitis. METHODS: A retrospective study in 55 medical records of patients admitted with acute mild pancreatitis was realized to analyze the association between age, leukocytosis, serum glutamic-oxaloacetic transaminase and lactate dehydrogenase, glucose, antibiotics, time admission and Ranson´s scores. RESULTS: There was a positive association between less intensive care (strict hydration, analgesia and monitoring of vital signs), early antibiotic therapy (monotherapy), early return to diet after 48 hours and laboratory control of the serum amylase and lipase (high in the first week and decreasing after 10 days, without any prognostic value). CONCLUSIONS: Changes in the management of patients with mild acute pancreatitis, such as enteral nutrition, rational use of lower spectrum antibiotics and intensive care, have contributed significantly to the reduction of hospitalization time and mortality.

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 The Effect of Contrast-enhanced Computed Tomography (CT) Scans on the Calculated Dose of Radiotherapy in a Thorax Phantom

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Athar Ehtiati ◽  
Payman Hejazi ◽  
Mohsen Bakhshandeh ◽  
Ali Jabbary Arfaee ◽  
Eftekhar Rajab Bolookat ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Contrast Media ◽  
Ct Scan ◽  
Treatment Planning ◽  
Tumor Volume ◽  
Ct Scans ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

Background: Despite the benefits of contrast-enhanced computed tomography (CT) scans in better tumor volume delineation, it can affect the accuracy of dose calculation in radiation therapy. This study examined this effect on a thorax phantom. Objectives: The influence of different variables including the concentrations of the Visipaque contrast media, tumor sizes, and CT scan energies on the dose measurement was examined. Methods: Transparent cylinders containing the contrast media were inserted in the lung area of the phantom and the CT scans were made. Non-enhanced CT scans were also acquired. Treatment planning using 2 opposite fields was performed on the CT scans and the doses were calculated in the treatment planning system. The results of the 2 sets of enhanced and non-enhanced CT scans were compared. Results: The correlation between concentration and the percentage of mean dose of the tumor volume was significant in 2 of the tumor sizes. The differences in the mean doses of the 2 plans were examined and more than 3% increase was observed in higher concentrations of the contrast media. Conclusions: According to this study, the suitable concentration of the contrast media administered and the CT scan energy should be considered. This would help to decrease the discrepancies between the calculated and delivered dose in radiotherapy treatments to a clinically acceptable level. The importance of time delays for CT scans after administration of the contrast media is emphasized.

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 Quantitative Analysis of Enhanced Computed Tomography in Differentiating Cystitis Glandularis and Bladder Cancer

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Hui Hua ◽  
Yuanxiang Gao ◽  
Jizheng Lin ◽  
Feng Hou ◽  
Jun wei Wang ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Quantitative Analysis ◽  
Sensitivity And Specificity ◽  
Arterial Phase ◽  
Relative Enhancement ◽  
Enhanced Ct ◽  
Venous Phase ◽  
Enhanced Computed Tomography ◽  
Quantitative Indicators ◽  
Delayed Phase

Objective. This study was performed to assess the value of quantitative analysis of enhanced computed tomography (CT) values in the differential diagnosis of bladder cancer and cystitis glandularis (CG). Methods. Eighty patients with bladder masses (39 with CG and 41 with bladder cancer) who underwent enhanced CT were retrospectively reviewed. The CT enhancement values of the lesion and normal bladder wall in the arterial phase, venous phase, and delayed phase were measured. The relative enhancement CT values (relative enhancement CT value=enhancement CT value of lesion−enhancement CT value of normal bladder) in the arterial phase, venous phase, and delayed phase were also calculated. The pathological results were used as the gold standard, and the area under the curve (AUC), sensitivity, and specificity were calculated for the six groups of quantitative indicators (enhanced CT values and relative enhanced CT values of CG and bladder cancer in the arterial, venous, and delayed phases). We performed the leave-group-out cross-validation method to validate the accuracy, AUC, sensitivity, and specificity. The differences in accuracy, AUC, sensitivity, and specificity among the six groups of quantitative indicators were compared by the t-test. Results. In a combined analysis of the AUC, sensitivity, and specificity performance, the best indicator was the arterial-phase relative enhancement CT value with a cut-off of 25.85 HU (AUC, 0.966; sensitivity, 95.1%; specificity, 92.3%). We used the 100-times leave-group-out cross-validation method to validate the accuracy, AUC, sensitivity, and specificity. Arterial-phase relative enhancement CT values showed the highest AUC and accuracy among the six groups, with statistical significance (P<0.05). Conclusion. Quantitative analysis of enhanced CT is of great clinical value in the differential diagnosis of CG and bladder cancer.

scholarly journals Morphometric analysis of the splenic artery using contrast-enhanced computed tomography (CT)

2020 ◽  
Author(s):  
David J. Brinkman ◽  
Stephanie Troquay ◽  
Wouter J. de Jonge ◽  
Eric D. Irwin ◽  
Margriet J. Vervoordeldonk ◽  
...  
Keyword(s):  
Immune Modulation ◽  
Splenic Artery ◽  
Experimental Studies ◽  
Pancreatic Tissue ◽  
Branching Pattern ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
And Gender ◽  
Enhanced Computed Tomography

Abstract Purpose To evaluate the morphology and course of the splenic artery, which might impact the surgical implantation of systems that stimulate the nerves surrounding the splenic artery. Experimental studies indicate that these nerves play an important part in immune modulation, and might be a potential target in the treatment of autoimmune diseases. Methods This retrospective cohort study made use of contrast-enhanced CT images from 40 male and 40 female patients (age 30–69) that underwent a CT examination of the aorta, kidneys or pancreas. Anatomic features were described including total splenic artery length, calibers, tortuosity, the presence of arterial loops and the branching pattern of the splenic artery. Results No age-gender-related differences could be found related to tortuosity or branching pattern. The length of splenic artery in contact with pancreatic tissue decreased with increasing age, but was not different between genders. Artery diameters were wider in male compared to female subjects. Loops of variable directions, that represent a part of the artery that curls out of the pancreatic tissue, were identified in each age-gender category and were present in nearly all subjects (86%). Conclusion This study suggests that although some anatomic features of the splenic artery are subject to factors as age and gender, the tortuosity of the splenic artery is not age dependent. Most subjects had one or multiple loops, which can serve as a target for neuromodulatory devices. Future studies should investigate whether splenic nerve stimulation is safe and feasible.

Possible Sulfamethoxazole/Trimethoprim-Induced Pancreatitis in a Complicated Adolescent Patient Posttraumatic Injury

2015 ◽  
Vol 28 (4) ◽  
pp. 419-424 ◽  
Author(s):  
Susan E. Dickey ◽  
William A. Mabry ◽  
Leslie A. Hamilton
Keyword(s):  
Acute Pancreatitis ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Pediatric Population ◽  
Pancreatic Enzyme ◽  
Amylase Level ◽  
African American Female ◽  
Adolescent Patient ◽  
Drug Induced ◽  
Causative Agents

Introduction: Multiple medications have been associated with pancreatitis, however, data in the pediatric population are scarce secondary to the nonspecific presentation and infrequent diagnosis. The aim of this report is to characterize drug-induced pancreatitis in an adolescent patient. Case Presentation: A 16-year-old African-American female presented with a surgical site infection 8 weeks after a motor vehicle accident with multiple traumas. Two weeks prior to the admission, the patient was hospitalized for a urinary tract infection (UTI) and was initiated on sulfamethoxazole/trimethoprim (TMP/SMX) daily for UTI prophylaxis. On day 13, the patient was diagnosed with acute pancreatitis with an amylase level of 187 units/L (normal = 30-110) and a lipase level of 987 units/L (normal = 23-208). TMP/SMX was discontinued, and pancreatic enzyme levels decreased but did not reach normal. The patient was asymptomatic at discharge. Discussion: TMP/SMX was identified as the likely etiology of pancreatitis by the medical team. Evaluation with the Naranjo algorithm indicated a “possible” adverse drug reaction. Conclusion: Acute pancreatitis can have significant morbidity and mortality in the pediatric population but can go undiagnosed due to its lower incidence. Pediatric patients presenting with idiopathic abdominal pain should be evaluated for pancreatitis and drug therapy should be reviewed for potential causative agents.

scholarly journals Local Cerebral Blood Flow Measured by Xenon-Enhanced CT during Cryogenic Brain Edema and Intracranial Hypertension in Monkeys

1993 ◽  
Vol 13 (5) ◽  
pp. 763-772 ◽  
Author(s):  
Joseph M. Darby ◽  
Edwin M. Nemoto ◽  
Howard Yonas ◽  
Liping Yao ◽  
John A. Melick ◽  
...  
Keyword(s):  
Blood Flow ◽  
Brain Edema ◽  
Rhesus Monkeys ◽  
Vasogenic Edema ◽  
Ct Scans ◽  
Local Cerebral Blood Flow ◽  
Skull Model ◽  
Enhanced Ct ◽  
Enhanced Computed Tomography ◽  
Over Time

We developed a closed-skull model of freeze injury-induced brain edema, a model classically thought to produce vasogenic edema, and observed the natural course of changes in edema and blood flow using xenon-enhanced computed tomography (CT) in five rhesus monkeys before and for up to 6 h post insult. Intracranial pressure (ICP) gradually rose throughout the duration of the experiment. CT scans and CBF images permitted direct observation of the evolution of the lesion and revealed early ischemia in the periphery of the injury zone that progressed over time in association with edema. Frequency histogram analysis of local CBF (lCBF) demonstrated subtle but potentially important changes in distribution of lCBF between and within hemispheres at various times post insult. Changes in lCBF distribution were phasic and dissociated from increases in ICP in the latter stages of injury. The Xe/CT CBF method can be used to evaluate the effects of injury and therapy on CBF in this and other models of acute brain injury.

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