scholarly journals Enzymatic diagnosis of chronic pancreatitis

1986 ◽  
Vol 67 (6) ◽  
pp. 438-441
Author(s):  
V. V. Lukyanov ◽  
S. I. Rapoport ◽  
I. V. Lukyanov
Keyword(s):  
Chronic Pancreatitis ◽  
Digestive System ◽  
Clinical Manifestations ◽  
Initial Point ◽  
Pathological Process ◽  
Preliminary Diagnosis ◽  
Urgent Task ◽  
Pancreas Function

Chronic pancreatitis in the structure of diseases of the digestive system makes up from 5.1 to 9%. Severity of clinical manifestations and outcomes of this disease, frequent involvement of other organs and systems in the pathological process make diagnosis of chronic pancreatitis a very urgent task. Till now the anamnesis is the initial point of examination of the patient and further diagnosis. In a number of cases it allows to make a preliminary diagnosis without using complicated methods of pancreas function examination. In recent years radiological, gastroduodenoscopic, angiography and echography of pancreas are often used for recognition of chronic pancreatitis.

scholarly journals Modern aspects of diagnosis and treatment of chronic pancreatitis in children: experience of the center Center for the treatment of developmental anomalies and diseases of the hepatopancreatobiliary system in children

2022 ◽  
pp. 28-34
Author(s):  
B. O. Kulevich ◽  
A. Yu. Razumovsky ◽  
V. V. Kholostova ◽  
Z. B. Mitupov ◽  
A. I. Khavkin ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Clinical Manifestations ◽  
Treatment Method ◽  
Pathological Process ◽  
Diagnosis And Treatment ◽  
Developmental Anomalies ◽  
Enzyme Replacement ◽  
Effective Interventions ◽  
Endocrine Insufficiency ◽  
Long Time

Chronic pancreatitis is one of the most pressing problems of pediatric gastroenterology and surgery of hepatopancreatobiliary organs. Diagnosis and treatment of this category of patients requires a comprehensive examination using modern highly sensitive research methods and the collegial participation of a surgeon, gastroenterologist and endocrinologist. Due to the fact that the algorithm for managing these patients is not regulated, patients often receive enzyme replacement therapy for a long time, with indications for surgical treatment. In addition, the non-specificity of complaints and clinical manifestations of chronic pancreatitis, the asymptomatic course and the initial detection of exo- and endocrine insufficiency lead to a later choice of the optimal treatment method and increase the risk of complications. The key to effective care for children with chronic pancreatitis is the staging and continuity in research and treatment. At the Center for the Treatment of Developmental Anomalies and Diseases of the Hepatopancreatobiliary System in Children on the basis of the Filatov Hospital, highly effective interventions are carried out for chronic pancreatitis in children, the purpose of which is to ensure an adequate outflow of pancreatic juice using longitudinal pancreaticojejunostomy, which, in addition to draining the pancreas, allows to achieve clinical remission and stop the progression pathological process, including diabetes mellitus. The article reflects the experience of diagnosis and treatment of chronic pancreatitis in children.

Strengthening the pharmacological potential of drug therapy in treatment of patients with chronic pancreatitis by using therapeutic physical factors

2020 ◽  
pp. 8-14
Author(s):  
R. M. Mallaeva ◽  
A. N. Makhinko ◽  
M. B. Uzdenov
Keyword(s):  
Quality Of Life ◽  
Chronic Pancreatitis ◽  
Drug Therapy ◽  
Clinical Manifestations ◽  
Medical Rehabilitation ◽  
Control Group ◽  
Physical Factors ◽  
Standard Drug ◽  
Pharmacological Potential

The purpose of the study is to improve rehabilitation treatment of patients with chronic pancreatitis (CP) at inpatient stage by strengthening pharmacological potential of drug therapy due to inclusion of therapeutic physical factors (TPF) in therapeutic programs. Materials and methods. 159 patients with acute CP were observed. By simple randomization, 4 groups were formed: the control group (MG, 39 people) received standard drug therapy; 1st comparison group (GC1; 38 people) additionally received TPF; GC2 (40 people) in addition to treatment in GC1 had drinking mineral water «Slavyanovskaya»; in main group (42 people) in addition to the treatment in GC2 got preformed peloidotherapy on the cervical-collar zone. All the patients underwent the evaluation of clinical score and quality of life before and after medical rehabilitation. Results. In MG, clinical symptomatology leveling was by 78,2% (p<0,01), in GC1 — by 71,5% (p<0,01), GC2 — by 62,3% (p<0,01), CG — by 57,2% (p<0,01) on average immediately after the treatment, which was in a clear correlation with indicators of quality of life. In the long term (in 6 and 12 months), the advantage of combination therapy was noted with the same validity, the preservation of the achieved positive result was mostly noted in the MG: after 6 months the improvement in physical health compared to the initial values was noted by 34,4% (p<0,01), after 12 months — by 24,0% (p<0,05); mental — by 32,3% (p<0,01) and 22,5% (p<0,05), respectively. In both comparison groups, positive dynamics was 10–12% lower, and in the control group, after 6 months, there was only a tendency to improve quality of life indicators. Conclusion. The inclusion of TPF in the programs of the inpatient stage of medical rehabilitation of patients with chronic pancreatitis by strengthening the pharmacological potential of drug therapy contributes to the leveling of clinical manifestations (abdominal pain, dyspepsia and diarrhea), the result of which is an improvement in the quality of life of this category of patients.

scholarly journals Diagnostic value of research methods in diagnostics of chronic pancreatitis

2021 ◽  
Vol 102 (4) ◽  
pp. 528-536
Author(s):  
G R Aliyeva
Keyword(s):  
Chronic Pancreatitis ◽  
Early Stage ◽  
Imaging Modality ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Clinical History ◽  
Diagnostic Value ◽  
Diagnostic Tools ◽  
Invasive Approach ◽  
Pancreas Function ◽  
Function Testing

Chronic pancreatitis remains an unsolved problem for clinicians. One of the biggest dilemmas is to establish a clear diagnosis. Diagnosis can be particularly elusive in patients with early chronic pancreatitis. Many studies have been undertaken to improve diagnostics in chronic pancreatitis, but this has been significantly limited by the lack of a gold standard. The evaluation of patients with suspected chronic pancreatitis should follow a progressively non-invasive to more invasive approach. Computed tomography is the best primary imaging modality to obtain as it has good sensitivity for severe chronic pancreatitis and may exclude the need for other diagnostic tests. When ambiguous results are obtained, a magnetic resonance cholangiopancreatography may require for a more detailed evaluation of both the pancreatic parenchyma and ducts. If the diagnosis remains in doubt, endoscopic ultrasound with or without pancreas function testing becomes the preferred method. Endoscopic retrograde cholangiopancreatography remains a last line diagnostic test and generally should be used only for diagnostic purposes. Future researches in the field of diagnosis of early-stage chronic pancreatitis should purpose optimizing current diagnostic tools. A definitive diagnosis of chronic pancreatitis may not be made simply by clinical history, imaging or function testing alone, but rather by the data gathered by a combination of these diagnostic tools.

scholarly journals The substantiation of chronic pancreatitis surgical treatment method selection

2007 ◽  
Vol 6 (3) ◽  
pp. 43-50
Author(s):  
V. A. Koubyshkin ◽  
I. A. Kozlov ◽  
N. I. Yashina ◽  
T. V. Shevchenko
Keyword(s):  
Chronic Pancreatitis ◽  
Surgical Treatment ◽  
Gastric Resection ◽  
Clinical Manifestations ◽  
Pancreatic Head ◽  
Pain Syndrome ◽  
Treatment Method ◽  
Pancreas Head ◽  
Resection Of The Pancreas

The experience of surgical treatment of 154 patients having chronic pancreatitis with preferential injury of the pancreas head which underwent different operative interventions: isolated resection of pancreatic head ( based upon Berger surgery - 24, Frey surgery - 39), pancreatoduodenal resection ( with gastric resection - 22, with preserved pylorus - 43) and drainage surgeries - 26 is presented in the article. The surgery of isolated resection of pancreatic head has less number of nearest unfavorable results compared with pancretoduodenal resection with preserved pylorus. Proximal resection of the pancreas the variants of which are different isolated resection of pancreatic head is superior upon surgeries with full or partly resection of the duodenum due to fast normalization of the motor-evacuation function, less rate of the intestinal reflux and portion character of duodenal evacuation. In the follow-up period after pancreatoduodenal resection, atrophic processes occur in distal areas of the pancreas which are followed by clinical manifestations of exo- and endocrinous insufficiency. The surgery of longitudinal pancreatic jejunostomy does not avoid pathologic changes in the organ head and pain syndrome.

scholarly journals Hepatic involvement in sarcoidosis

2019 ◽  
Vol 91 (4) ◽  
pp. 4-12
Author(s):  
V V Fomin ◽  
M Yu Brovko ◽  
M V Kalashnikov ◽  
V I Sholomova ◽  
T P Rozina ◽  
...  
Keyword(s):  
Clinical Manifestations ◽  
Normal Liver ◽  
Liver Function Tests ◽  
Pathological Process ◽  
Unknown Etiology ◽  
Primary Biliary Cholangitis ◽  
Treatment Protocols ◽  
Hepatic Involvement ◽  
Wide Range ◽  
Hepatic Sarcoidosis

Sarcoidosis is a multisystem granulomatous disease of unknown etiology. Liver is frequently involved in the pathological process. Wide range of clinical manifestations can be seen: from asymptomatic lesion with normal liver function tests to cirrhosis with portal hypertension. Biopsy plays the key role in diagnosis of the hepatic sarcoidosis. It is essential for morphological diagnosis to exclude other causes of granulomatous liver disease, most often - primary biliary cholangitis. Nowadays there are no standard treatment protocols for patients with hepatic sarcoidosis.

scholarly journals The key role of pancreatic fibrosis severity in the surgical treatment algorithm of patients with chronic pancreatitis

2020 ◽  
Vol 73 (2) ◽  
pp. 235-238
Author(s):  
Oleh E. Kanikovskiy ◽  
Ihor V. Pavlyk ◽  
Iryna V. Oliinyk ◽  
Vasyl V. Mosondz
Keyword(s):  
Chronic Pancreatitis ◽  
Surgical Treatment ◽  
Treatment Algorithm ◽  
Pathological Process ◽  
The Body ◽  
Nutrition Status ◽  
Tissue Pressure ◽  
Surgical Interventions ◽  
Computer Morphometry ◽  
Definition Of

The aim of the work was to improve the results of surgical treatment of complicated forms of chronic pancreatitis. Materials and methods: The results of surgical treatment of 181 patients with complicated forms of chronic pancreatitis have been analyzed. All these patients were treated in surgical clinic of 2 nd medical faculty of National Pyrogov Memorial Medical University in Vinnytsya. Results: It is possible preoperative indirectly assess the severity of fibro- degenerative changes in pancreas, that includes 1 – the definition of pain type; 2 – CT or MRI (Marseilles- Rome classification); 3 – assessment of the stage of chronic pancreatitis (Büchler classification); 4 – patient&#39;s nutrition status and preoperative differential diagnosis with pancreatic cancer; 5 – assessment of the fibrosis severity (elastomers). The key point in treatment depended on intraoperative examination: detection of strictures of the main pancreatic duct (pacemaker of chronic pancreatitis); the tissue pressure resistance to the liquid, which is the maximum value&gt; 200 mmHg, in the region of stricture and falls in other parts of the pancreas; pressure in the main pancreas duct, which rises only in 59.5% of patients. The head of the pancreas was involved in the pathological process in 83.8%, in 16.2% it was isolated in the isthmus or the body and tail of the pancreas. In general, the distal pancreas was involved in 37.8%. At computer morphometry of histological samples, the area of connective tissue fields reached 81.4 ± 6.62%, preserved exocrine part in 4.87 ± 1.62%, endocrine – 1.92 ± 0.12%, total area of ducts – 6 , 47 ± 1.12%. Conclusions: The combined Frey-Izbickiy local resection provides a wide excision of the pacemaker (stricture) of chronic pancreatitis. In case of extrapancreatic complications or repeated surgical interventions on the pancreas due to chronic pancreatitis, this effect can be achieved by pancreatoduodenal resection.

scholarly journals Structural composition and clinical features of dermatological patients with keratinocytic skin tumors

2021 ◽  
Vol 67 (1) ◽  
pp. 91-96
Author(s):  
Rustem Khasanov ◽  
Elena Faizullina ◽  
Irina Khismatulina ◽  
Azat Murtazin
Keyword(s):  
Skin Cancer ◽  
Medical Care ◽  
Clinical Features ◽  
Basal Cell ◽  
Clinical Manifestations ◽  
Pathological Process ◽  
Skin Tumors ◽  
Long Period ◽  
Nasal Region ◽  
Common Malignancy

Basal cell skin cancer (BCС) is the most common malignancy that is found in dermatological practice. The purpose of the study: to determine the structure of clinical manifestations of BCС in ambulant dermatological patients. The study was conducted from 2015 to 2017 in a private clinic in Kazan, which has a license to provide medical care in the specialties "dermatovenerology" and "surgery". We studied the results of examination of 2730 patients with skin tumors available in outpatient cards. 101 patients with histologically verified BCС were examined, including 29% of men (n=29) and 71% of women (n=72), the average age was 59.7±14.9 years (median – 61.5 years). The percentage of patients with BCС among patients with all skin malignancies at the dermatological reception was 95.3% (n=101). Most often, patients aged 60-74 years suffered from BCС: women – in 21.0% (n=21) and men – in 16.0% (n=16), respectively. The proportion of women aged 45-59 years was significantly higher – 20.0%, than the proportion of men – 9.0% (p<0.05). Men were significantly more likely to see a dermatologist – 55.0% in less than a year from the onset of the disease, than women – 21.4% (p<0.01). The proportion of women (44.6%) who noted the appearance of a tumor over a long period (≥5 years) was significantly less than the proportion of men 15.0% (p<0.05). The most common variant of BCС was the nodular form n=77 (76.2%), in which the primary elements of 80.5% were identified by dermatologists as single 5-10 mm papules. The oculo-fronto-nasal region was involved in the pathological process in 47.5% (n=48) of cases, which is significantly more frequent than in other localisations (p<0.05). Dermatoscopy improved the visualization of the atypical vascular network.

scholarly journals Up-To-Date View on the Clinical Manifestations and Complications of Chronic Pancreatitis

Pancreatitis ◽  
2019 ◽  
Author(s):  
Mila Dimitrova Kovacheva-Slavova ◽  
Plamen Georgiev Getsov ◽  
Georgi Borislavov Vladimirov ◽  
Borislav Georgiev Vladimirov
Keyword(s):  
Chronic Pancreatitis ◽  
Clinical Manifestations

scholarly journals Spontaneous psoas abscess: presenting with phlegmasia cerulea dolens

2011 ◽  
Vol 93 (4) ◽  
pp. e15-e16 ◽  
Author(s):  
Jagwinder Dhaliwal ◽  
Ajanta Jayatunga
Keyword(s):  
Lower Extremity ◽  
Complete Resolution ◽  
Early Recognition ◽  
Psoas Abscess ◽  
Pathological Condition ◽  
Clinical Manifestations ◽  
Pathological Process ◽  
Successful Outcome ◽  
Life Threatening ◽  
Phlegmasia Cerulea Dolens

Phlegmasia cerulea dolens (PCD) is a limb-threatening venous disorder involving massive proximal venous thrombosis. The clinical manifestations are of oedema, cyanosis and pain of lower extremity. Patients presenting with PCD have an underlying pathological condition that predisposes to the thrombotic process. We report a diabetic patient who presented with PCD and septicaemia due to a spontaneous psoas abscess. Anticoagulation with heparin and treatment of the underlying psoas abscess led to complete resolution of symptoms. An understanding of the underlying pathological process responsible is vital to early recognition and successful outcome in this rare limb- and life-threatening venous disorder.

Combined minimaly invasive surgery of pancreaticolithiasis in combination with congenital stricture of the terminal sections of the pancreatic ducts

2017 ◽  
Vol 8 (5) ◽  
pp. 96-102
Author(s):  
Mikhail P. Korolev ◽  
Leonid E. Fedotov ◽  
Ruben G. Avanesyan ◽  
Elena A. Mikhailova ◽  
Georgiy M. Lepekhin ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Magnetic Resonance ◽  
Minimally Invasive ◽  
Pancreatic Duct ◽  
Correct Diagnosis ◽  
Clinical Manifestations ◽  
Pancreatic Ducts ◽  
Invasive Treatment ◽  
Percutaneous Access ◽  
Joint Application

Chronic pancreatitis with pancreatic hypertension is extremely rare in childhood. Chronic pancreatitis in this age is usually always associated with a сongenital defect of the pancreatic duct system. The article describes the case of long-term clinical observation and minimally invasive treatment of chronic calculous pancreatitis, first diagnosed in a girl at the age of 16 years. Despite the fact that clinical manifestations were observed from the age of 3 years, the correct diagnosis could be made only at the age of 16, by joint application of ultrasound, Magnetic Resonance Imaging (MRI) and Magnetic Resonance Cholangiopancreatography (MRCP). The cause of chronic pancreatitis were concrements and strictures of the main and additional pancreatic ducts that caused pancreatic hypertension. Attempt of endoscopic retrograde lithoextraction from the pancreatic ducts was impossible because of the presence of severe stricture. Therefore, it was decided to apply a combined approach using percutaneous access under ultrasound navigation. The patient underwent series of minimally invasive combined procedures including the lithoextraction, balloon dilatation and transcutaneous drainage of the pancreatic ducts with the endoscopic and percutaneous access with ultrasound and radiologic control. For the prevention of restenosis, the antegrade stenting of the main pancreatic duct with self-expanding coated nitinol stent was used with further removal of the stent. Due to the treatment, there was no pancreatitis within 5 years after stent removal.

Sign in / Sign up

Export Citation Format

Share Document