scholarly journals Computed Tomographic Evaluation of Pancreatitis and its Complications- Pictoral review

2012 ◽  
Vol 1 (2) ◽  
pp. 123-131
Author(s):  
S Ullal ◽  
KS Joshi ◽  
P Pant
Keyword(s):  
Chronic Pancreatitis ◽  
Helical Ct ◽  
Therapeutic Interventions ◽  
Imaging Modalities ◽  
College Hospital ◽  
Mortality And Morbidity ◽  
Computed Tomographic ◽  
Fluid Collections ◽  
Pseudocyst Formation ◽  
Ct Features

Pancreatitis is one of the commonest pancreatic pathology encountered in day to day clinical practice. Early detection of the entity and its complications can significantly reduce the mortality and morbidity. Various imaging modalities are now available including newer interventional techniques for the diagnosis and therapeutic interventions. For diagnostic purposes, Computed Tomography (CT) has long been regarded as one of the most efficient imaging modalities for evaluation of pancreatitis. This pictoral review is based on Helical CT scans performed in total 50 patients suspicious of having pancreatitis in Kasturba Medical College Hospital, Attavara, Mangalore, India between 2008-2009 and Dhulikhel Hospital, Dhulikhel, Nepal 2010. Various morphological features of both acute and chronic pancreatitis were found on helical CT abdomen. The CT features of acute pancreatitis were focal or diffuse enlargement of pancreas, areas of necrosis, peripancreatic fat strandings, extrapancreatic fluid collections, perinephric fat stranding, perirenal fascial thickening, ascites, pleural effusion, pseudocyst formation etc. The CT features of chronic pancreatitis were focal or diffuse atrophy of the gland, duct dilatation, pancreatic calcifications, ductal calculi etc. Various complications encountered were acute fluid collections, pseudocyst formation, necrosis, pseudoaneurysm, portal vein thrombosis, abscess formation etc. DOI: http://dx.doi.org/10.3126/njms.v1i2.6613 Nepal Journal of Medical Sciences. 2012;1(2): 123-31

scholarly journals Spontaneous pancreatic pseudocyst–portal vein fistula: a rare and potentially life threatening complication of pancreatitis

2013 ◽  
Vol 95 (1) ◽  
pp. e7-e9 ◽  
Author(s):  
SS Raza ◽  
A Hakeem ◽  
M Sheridan ◽  
N Ahmad
Keyword(s):  
Chronic Pancreatitis ◽  
Portal Vein ◽  
Pancreatic Pseudocyst ◽  
Conservative Approach ◽  
Fatal Complication ◽  
Life Threatening ◽  
Life Threatening Complication ◽  
Acute And Chronic Pancreatitis ◽  
Pseudocyst Formation

Pseudocyst formation following acute and chronic pancreatitis is a well known complication. A pancreatic pseudocyst fistulating into the portal vein is a rare and potentially fatal complication. We report a case of pancreatic pseudocyst – portal vein fistula, which was managed with a conservative approach.

scholarly journals Transgenic expression of cyclooxygenase-2 in pancreatic acinar cells induces chronic pancreatitis

2019 ◽  
Vol 316 (1) ◽  
pp. G179-G186
Author(s):  
Haojie Huang ◽  
Jiaxiang Chen ◽  
Lisi Peng ◽  
Yao Yao ◽  
Defeng Deng ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Transgenic Mice ◽  
Fibrous Tissue ◽  
Acinar Cells ◽  
Cyclooxygenase 2 ◽  
Therapeutic Interventions ◽  
Pancreatic Stellate Cells ◽  
Pancreatic Acinar Cells ◽  
Transgenic Expression ◽  
Cox 2

Replacement of the exocrine parenchyma by fibrous tissue is a main characteristic of chronic pancreatitis. Understanding the mechanisms of pancreatic fibrogenesis is critical for the development of preventive and therapeutic interventions. Cyclooxygenase-2 (COX-2), a rate-limiting enzyme for prostaglandin synthesis, is expressed in patients with chronic pancreatitis. However, it is unknown whether COX-2 can cause chronic pancreatitis. To investigate the roles of pancreatic acinar COX-2 in fibrogenesis and the development of chronic pancreatitis, COX-2 was ectopically expressed specifically in pancreatic acinar cells in transgenic mice. Histopathological changes and expression levels of several profibrogenic factors related to chronic pancreatitis were evaluated. COX-2 was expressed in the pancreas of the transgenic mice, as detected by Western blot analysis. Immunohistochemical staining showed COX-2 was specifically expressed in pancreatic acinar cells. COX-2 expression led to progressive changes in the pancreas, including pancreas megaly, persistent inflammation, collagen deposition, and acinar-to-ductal metaplasia. Quantitative RT-PCR and immunostaining showed that profibrogenic factors were upregulated and pancreatic stellate cells were activated in the COX-2 transgenic mice. Expression of COX-2 in pancreatic acinar cells is sufficient to induce chronic pancreatitis. Targeting this pathway may be valuable in the prevention of chronic pancreatitis. NEW & NOTEWORTHY COX-2 expression is observed in pancreatic tissues of human chronic pancreatitis. In this study, we showed that COX-2 expression caused the development of chronic pancreatitis in transgenic mice, supporting the idea that COX-2 inhibition may be an effective preventive and therapeutic strategy.

scholarly journals Causes and management of secondary postpartum haemorrhage in a tertiary medical college hospital in Bangladesh

2017 ◽  
Vol 6 (7) ◽  
pp. 2694
Author(s):  
Kamrun Nessa ◽  
Sumia Bari ◽  
Sanjida Khan ◽  
Ferdowsi Sultana ◽  
Tania Akbar
Keyword(s):  
Maternal Morbidity ◽  
Postpartum Haemorrhage ◽  
Mode Of Delivery ◽  
Wound Dehiscence ◽  
College Hospital ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Maternal Mortality And Morbidity ◽  
Postnatal Women ◽  
Low Incidence

Background: Globally postpartum haemorrhage remains a leading cause of maternal death. It affects only 1-2% of postnatal women. This low incidence of secondary PPH and linkage to maternal morbidity rather than mortality was the reason for the little attention among obstetricians, but it is recently gaining importance and interest with the increase morbidity and mortality related to secondary PPH.Methods: A retrospective study was conducted on the diagnosed patients of secondary PPH admitted in Enam Medical College and Hospital, Dhaka, Bangladesh, from January 2015 to December 2016. Among 33 cases of secondary PPH age of the patients, parity, mode of delivery, causes and management were noted from medical records. All data was analyzed by SPSS16.Results: Among 33 patients 14 (42.4%) were primi and 19 (57.6%) were multipara, age between 18 to 38 years, majority admitted 2nd and 3rd week after delivery. Among 33 patients 12% delivered vaginally at home and 30% vaginally at hospital and 58% undergone LUCS. We found 34% retained bits of placenta, 27% uterine wound dehiscence, 24% retained clots and 15% endometritis as causes. Less than 3 units blood needed in 22 (66.7%) patients and 11 (33.3%) needed more than 3 units. About 6 (18%) patients were treated conservatively, MVA were needed in 18 (55%) patients, repair of wound in 4 (12%) and TAH was in 5 (15%).Conclusions: Secondary PPH is increasing may result in significant maternal morbidity as well as mortality. More study needed to identify the risk factors and causes to reduce maternal mortality and morbidity.

scholarly journals Perinatal Findings in Pregnancy Induced Hypertension: A Study in a Tertiary Teaching Hospital in Dhaka City

2017 ◽  
Vol 2 (1) ◽  
pp. 10-13
Author(s):  
Zobaida Sultana Susan ◽  
Surayea Bulbul ◽  
Jannat Ara Ferdows ◽  
Abu Nayeem
Keyword(s):  
Cross Sectional Study ◽  
Fetal Mortality ◽  
Pregnancy Induced Hypertension ◽  
College Hospital ◽  
Cross Sectional ◽  
Mortality And Morbidity ◽  
Tertiary Teaching ◽  
Induced Hypertension ◽  
Questionnaire Result ◽  
In Pregnancy

Background: Hypertensive disorders are common complication occurring during pregnancy which are responsible for maternal and fetal mortality and morbidity. Objective: The purpose of the present study was to determine the perinatal outcome in pregnancy induced hypertension. Methodology: This study was designed as cross-sectional study and was conducted from April 2013 to September 2013 for a period of six (06) moths. Patients admitted in the Department of Obstetrics and Gynaecology at Shaheed SuhrawardyMedical College Hospital, Dhaka. Data were collected by interview, physical examintions (blood pressure, pulse rate, oedema, heart and lungs auscultation) and lab investigations using a structural questionnaire. Result: Majority of the women belonged to age group 21-25 year. Maximum were (56%) primigravida. The mean gestational age was 34.6 weeks with the range from 28 to 40 weeks. Hyperurecaemia was frequent among patients with pregnancy induced hypertension. Intrauterine growth retardation (IUGR) was secondary to pregnancy induced hypertension which was associated with significantly increased perinatalmortality. Conclusion: In this study, prematurity is frequent in pregnancy induced hypertension and convulsion in nonresponsive patients is associated with significantly increased perinatal mortality.Journal of National Institute of Neurosciences Bangladesh, January 2016;2(1): 10-13

scholarly journals Imaging of Fibrosis in Chronic Pancreatitis

2022 ◽  
Vol 12 ◽  
Author(s):  
Yasunobu Yamashita ◽  
Reiko Ashida ◽  
Masayuki Kitano
Keyword(s):  
Chronic Pancreatitis ◽  
Magnetic Resonance ◽  
Imaging Modality ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Imaging Modalities ◽  
Diagnostic Tools ◽  
Diagnostic Modality ◽  
Magnetic Resonance Imaging Mri ◽  
Initial Imaging ◽  
Eus Elastography

Chronic pancreatitis (CP) describes long-standing inflammation of the pancreas, which leads to irreversible and progressive inflammation of the pancreas with fibrosis. CP also leads to abdominal pain, malnutrition, and permanent impairment of exocrine/endocrine functions. However, it is difficult to assess CP pathologically, and imaging modalities therefore play an important role in the diagnosis and assessment of CP. There are four modalities typically used to assess CP. Pancreatic duct features are assessed with magnetic resonance cholangiopancreatography (MRCP) and endoscopic retrograde cholangiopancreatography (ERCP). However, ERCP is a rather invasive diagnostic modality for CP, and can result in adverse events such as post-ERCP pancreatitis. Computed tomography (CT) is often the most appropriate initial imaging modality for patients with suspected CP, and has high diagnostic specificity. However, CT findings typically only appear in advanced stages of CP, and it is difficult to detect early CP. Endoscopic ultrasonography (EUS) provides superior spatial resolution compared with other imaging modalities such as CT and magnetic resonance imaging (MRI), and is considered the most reliable and efficient diagnostic modality for pancreatic diseases. The EUS-based Rosemont classification plays an important role in diagnosing CP in clinical practice. Evaluation of tissue stiffness can be another option to assess the diagnosis and progression of CP, and MRI and EUS can be used to assess CP not only with imaging, but also with elasticity measurement. MR and EUS elastography are expected to provide new alternative diagnostic tools for assessment of fibrosis in CP, which is difficult to evaluate pathologically.

scholarly journals Risk factor Analysis and Angiographic Profiles in First 228 Cases Undergone Coronary Angiography in Cardiac Cath Lab of Dhaka Medical College Hospital

1970 ◽  
Vol 3 (2) ◽  
pp. 122-125 ◽  
Author(s):  
AEMM Islam ◽  
M Faruque ◽  
AW Chowdhury ◽  
HIR Khan ◽  
MS Haque ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Risk Factor ◽  
Coronary Angiography ◽  
Medical Therapy ◽  
Stable Angina ◽  
College Hospital ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Single Vessel

Background: Coronary artery diseases are one of the major challenges faced by cardiologists. Control of certain risk factors for CAD is associated with decrease in mortality and morbidity from myocardial infarction and unstable angina. So, identification and taking appropriate measures for primary and secondary prevention of such risk factors is, therefore, of great importance. This retrospective study was carried at the newly set up cath lab in Dhaka Medical college. Materials and Methods: Total 228 consecutive case undergone diagnostic coronary angiogram from 10th January 2007 to31st January 2009 out of which 194(80%) were male and 34 (20%) were female. In both sexes most of the patients were between 41 to 60 years of age. Risk factors of the patients were evaluated. Results: In females commonest risk factor was Diabetes (58.8%) followed by dyslipidaemia (35.3%). In males commonest risk factor was hypertension (30.9%) followed by smoking (29.9%) and diabetes (28.3%). In males 44.3% patients presented with acute myocardial infarction followed by stable angina (43.3%); but in females stable angina was the commonest presentation (50.0%) followed by myocardial infarction (38.2%).CAG findings revealed that in males 33.5% had double vessel disease 26.8% followed by single vessel 26.8% and multivessel disease 25.3%. In females normal CAG was found in 35.5% followed by double vessel 23.5%, multivessel 20.6% and single vessel 20.6%. On the basis of CAG findings; in males 41.8% patients were recommended for CABG, followed by PTCA & stenting 26.3% and medical therapy 30.0%; where as in females 55.9% were recommended for medical therapy , followed by CABG 32.4% and PTCA & stenting11.8%. Conclusion: The commonest presentation of CAD was 4th and 5th decades in both sexes. Diabetes and dyslipidaemia were more common in females whereas hypertension and smoking were more common in males. Myocardial infarction and stable angina were most common presentation in both sexes though in males myocardial infarction was more common. In males the angiographic severity of CAD was more and they were more subjected for CABG in comparison to females. Key words: Risk factors; Coronary angiography. DOI: http://dx.doi.org/10.3329/cardio.v3i2.9179 Cardiovasc. J. 2011; 3(2): 122-125

scholarly journals Practice Pattern, Diagnostic Yield, and Long‐Term Prognostic Impact of Coronary Computed Tomographic Angiography

2020 ◽  
Vol 9 (18) ◽  
Author(s):  
Min Soo Cho ◽  
Jae‐Hyung Roh ◽  
Hanbit Park ◽  
Sang‐Cheol Cho ◽  
Do‐Yoon Kang ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Diagnostic Yield ◽  
Computed Tomographic Angiography ◽  
Therapeutic Interventions ◽  
Coronary Cta ◽  
Coronary Computed Tomographic Angiography ◽  
Computed Tomographic ◽  
Asymptomatic Patients ◽  
Tomographic Angiography

Background Although guidelines recommend the use of coronary computed tomographic angiography (CTA) in patients with stable pain syndromes, the clinical benefits of the use of coronary CTA in a broad spectrum of patients is unknown. We evaluated the contemporary practice pattern and diagnostic yield of coronary CTA and their impact on the subsequent diagnostic‐therapeutic cascade and clinical outcomes. Methods and Results We identified 39 906 patients without known coronary artery disease (CAD) who underwent coronary CTA between January 2007 and December 2013. The patients' demographic characteristics, risk factors, symptoms, results of coronary CTA, the appropriateness of downstream diagnostic and therapeutic interventions, and long‐term outcomes (death or myocardial infarction) were evaluated. The number of coronary CTAs had increased over time, especially in asymptomatic patients. Coronary CTA revealed that 6108 patients (15.3%) had obstructive CAD (23.7% of symptomatic and 9.3% of asymptomatic patients). Subsequent cardiac catheterization was performed in 19.2% of symptomatic patients (appropriate, 80.6%) and in 3.9% of asymptomatic patients (appropriate, 7.9%). The 5‐year rate of death or myocardial infarction was significantly higher in patients with obstructive CAD on CTA than those without (7.2% versus 3.0%; P <0.001; adjusted hazard ratio [95% CI], 1.34 [1.17–1.54]). However, obstructive CAD on CTA had limited added value over conventional risk factors for predicting death or myocardial infarction. Conclusions Although the use of coronary CTA had substantially increased, CTA had a low diagnostic yield for obstructive CAD, especially in asymptomatic patients. The use of CTA in asymptomatic patients seemed to have led to inappropriate subsequent diagnostic or therapeutic interventions without clinical benefit.

Inflammation in Complicated Pregnancy and Its Outcome

2016 ◽  
Vol 33 (14) ◽  
pp. 1337-1356 ◽  
Author(s):  
Ram Kalagiri ◽  
Timothy Carder ◽  
Saiara Choudhury ◽  
Niraj Vora ◽  
Amie Ballard ◽  
...  
Keyword(s):  
Preterm Labor ◽  
Maternal Obesity ◽  
Normal Pregnancy ◽  
Adverse Outcomes ◽  
Therapeutic Interventions ◽  
Inflammatory Factors ◽  
Diagnostic Tools ◽  
Inflammatory Reactions ◽  
Mortality And Morbidity

Background Normal pregnancy relies on a careful balance between immune tolerance and suppression. It is known that strict regulation of maternal immune function, in addition to components of inflammation, is paramount to successful pregnancy, and any imbalance between proinflammatory and anti-inflammatory cytokines and chemokines can lead to aberrant inflammation, often seen in complicated pregnancies. Inflammation in complicated pregnancies is directly associated with increased mortality and morbidity of the mother and offspring. Aberrant inflammatory reactions in complicated pregnancies often lead to adverse outcomes, such as spontaneous abortion, preterm labor, intrauterine growth restriction, and fetal demise. The role of inflammation in different stages of normal pregnancy is reviewed, compared, and contrasted with aberrant inflammation in complicated pregnancies. The complications addressed are preterm labor, pregnancy loss, infection, preeclampsia, maternal obesity, gestational diabetes mellitus, autoimmune diseases, and inflammatory bowel disease. Aim This article examines the role of various inflammatory factors contributing to aberrant inflammation in complicated pregnancies. By understanding the aberrant inflammatory process in complicated pregnancies, novel diagnostic tools and therapeutic interventions for modulating it appropriately can be identified.

scholarly journals Management of chronic pancreatitis: Role of endoscopic therapy

2012 ◽  
Vol 03 (S 05) ◽  
pp. 048-052 ◽  
Author(s):  
Manu Tandan ◽  
D. Nageshwar Reddy
Keyword(s):  
Chronic Pancreatitis ◽  
Plastic Stents ◽  
Minor Papilla ◽  
Good Pain Relief ◽  
Long Term Follow Up ◽  
Short And Long Term ◽  
Fluid Collections ◽  
The Tropics

AbstractChronic pancreatitis (CP), a disease of varied etiology can, from the endoscopists perspective present as ductal strictures, stones, ductal leaks and fluid collections, biliary strictures or duodenal narrowing. This article deals with role of ERCP in the management of CP associated strictures and calculi. ERCP has a limited role in the diagnosis CP, though we feel that it is better at identifying small ductal calculi or leaks as compared to MRCP. Major and minor papilla sphincterotomy gives relief from pain in patients with mild or moderate ductal changes. Pancreatic ductal strictures are best managed by stenting. Use of multiple plastic stents (8.5-11Fr diameter) gives relief from pain in 84% and strictures resolution in 95% on follow up of over 3 years. CP associated CBD strictures are also managed by placement of multiple stents. Covered SEMS are increasingly being used in these strictures. Surgery is often the best option for CP associated CBD strictures which recur after adequate endotherapy. ESWL is the standard of therapy for pancreatic ductal calculi which are large, as seen in the tropics and the non alcoholic form of CP. Our experience has shown complete or partial clearance with ESWL in over 90% of patients with large PD calculi. Good pain relief was seen in both on short and long term follow up. In selected patients of CP, ERCP and endotherapy should be offered as first line of treatment, as the results are comparable to surgery. Prior endotherapy also does not interfere with subsequent surgical procedures.

Surgical Endoscopy: Future Directions

2018 ◽  
Vol 02 (04) ◽  
pp. 383-387
Author(s):  
Megan Sippey ◽  
Wanda Lam ◽  
Ahmed Ali ◽  
Jeffrey Marks
Keyword(s):  
Endoscopic Surgery ◽  
Diagnostic Tool ◽  
Therapeutic Interventions ◽  
Surgical Endoscopy ◽  
Imaging Modalities ◽  
Natural Orifice ◽  
Endoscopic Imaging ◽  
Future Directions ◽  
Therapeutic Tools ◽  
Made In

AbstractSince the introduction of the modern endoscope in 1957, numerous advances have been made in its use. The endoscope has transitioned from a primarily diagnostic tool at its inception, to now offering a plethora of therapeutic interventions including Natural Orifice Transluminal Endoscopic Surgery (NOTES). Advances in the endoscope, endoscopic imaging modalities, and therapeutic tools and platforms have contributed to recent, and upcoming, progression in NOTES. Current states of these advancements are reviewed.

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