1/465. The development of a pancreatic abscess, suppurative pylethrombosis, and multiple hepatic abscesses after a pancreatojejunostomy for chronic pancreatitis: report of a case.We present herein an autopsy case of 63-year-old Japanese man who died as a result of pancreatic abscess, suppurative pylethrombosis, and multiple liver abscesses that had developed 10 years after a pancreato- and cystojejunostomy with side-to-side anastomosis for chronic pancreatitis. Even after this operation, the patient had continued to consume excessive amounts of alcohol. He had first experienced back pain with leukocytosis 9 years after the operation, which relapsed the following year. Despite percutaneous transhepatic gallbladder drainage, his icterus had deteriorated into hepatic insufficiency. Computed tomographic scans of the abdomen had disclosed multiple liver abscesses. At autopsy, a pancreatic abscess and suppurative pylethrombosis as well as multiple liver abscesses were found. There have been few reported cases of such lethal complications developing after a pancreato- and cystojejunostomy for chronic pancreatitis. As the consumption of alcohol would have exacerbated the chronic pancreatitis, such patients should be strongly advised to abstain from drinking alcohol.- - - - - - - - - - ranking = 1keywords = pain, back pain, back (Clic here for more details about this article) |
2/465. hyperparathyroidism and chronic pancreatitis.hyperparathyroidism is a rare cause of pancreatitis. The nature of the relationship between the two entities is not well defined, i.e. is it casual or causal? We describe 2 patients with chronic pancreatitis and hyperparathyroidism who presented with epigastric pain and were initially treated unsuccessfully by surgical drainage of the pancreatic ducts. In 1 case the hyperparathyroidism was only recognised after the pancreatic surgery. In both the symptoms of chronic pancreatitis responded well to parathyroidectomy. We believe that our cases add support to a causal relationship between pancreatitis and hyperparathyroidism. Whatever the true relationship, management of these patients should initially be directed at the hyperparathyroidism, followed by appropriate treatment of the pancreatitis.- - - - - - - - - - ranking = 0.83998001898722keywords = pain (Clic here for more details about this article) |
3/465. Acute hemorrhage into the peritoneal cavity--a complication of chronic pancreatitis with pseudocyst: a case report from clinical practice.Acute hemorrhage due to a pseudocyst of the pancreas is a dangerous complication of chronic pancreatitis (CP). Without operative treatment, mortality is as high as 90%. Immediate recognition of this complication as well as urgent operative treatment allowing the survival of 70% of patients is imperative. Described is the case of a patient with CP and pseudocyst in which hyperamylasemia and unclarified anemia developed following sudden abdominal pain. The suspicion of hemorrhage into the peritoneal cavity was confirmed by selective visceral angiography showing hemorrhage from the splenic artery in the region of the hilus of the spleen. Operative treatment was successful. During the procedure, a ligature was applied to the hemorrhaging splenic artery and a splenectomy was carried out with 2500 ml of bloody contents being removed from the abdominal cavity. Acute hemorrhage into the peritoneal cavity as a complication of chronic pancreatitis with pseudocyst (CPP) requires immediate identification, confirmation by visceral angiography, and urgent operative treatment.- - - - - - - - - - ranking = 10.497361855631keywords = abdominal pain, pain (Clic here for more details about this article) |
4/465. pancreatitis caused by duodenal duplication.The authors present the investigations and surgical treatment of two cases of duodenal cystic duplication. abdominal pain and gastroesophageal reflux were the most important symptoms and signs associated with an history of recurrent acute pancreatitis. Computed tomography scan, ultrasound examination, and cholangiography confirmed preoperatively the diagnosis, and a transduodenal surgical approach was carried out in both children. A simple marsupialization of the cyst was performed in the former, and a sphincterotomy with papillosphincteroplasty was associated in the latter. The diagnosis was confirmed by microscopy, and both the children are asymptomatic after a 14 and 18 months of follow-up. This report focuses on the importance of the cholangiopancreatography for every child presenting with recurrent, unexplained bouts of acute pancreatitis, and underlines the technical surgical aspects on the basis of the anatomic identification of the malformation.- - - - - - - - - - ranking = 0.83998001898722keywords = pain (Clic here for more details about this article) |
5/465. Childhood pancreatitis.Acute pancreatitis is a rare finding in childhood but probably more common than is generally realized. This condition should be considered in the evaluation of children with vomiting and abdominal pain, because it can cause significant morbidity and mortality. Clinical suspicion is required to make the diagnosis, especially when the serum amylase concentration is normal. Recurrent pancreatitis may be familial as a result of inherited biochemical or anatomic abnormalities. patients with hereditary pancreatitis are at high risk for pancreatic cancer.- - - - - - - - - - ranking = 10.497361855631keywords = abdominal pain, pain (Clic here for more details about this article) |
6/465. edwardsiella tarda bacteraemia--complicated by acute pancreatitis and pyomyoma.edwardsiella tarda (E. tarda) has recently become recognized as a pathogen in humans. Here we report a new case of E. tarda bacteraemia complicated by acute pancreatitis and pyomyoma. A 46-year-old female came to our emergency room complaining of sudden onset of left upper quadrant pain and vomiting for the previous few hours after drinking three bottles of wine. An abdominal computed tomography (CT) scan revealed multiple biliary stones, acute pancreatitis with extensive inflammatory change, and a large uterine myoma. fever, watery diarrhoea, and mild suprapubic discomfort with vaginal spotting were noted soon after admission. The patient's blood cultures yielded E. tarda and symptoms subsided after antibiotic therapy. fever and severe suprapubic pain with rebound tenderness developed 12 days later. Repeat abdominal CT scan revealed an enlarged uterine myoma with central necrosis. The patient subsequently underwent anterior total hysterectomy and bilateral salpingo-oophorectomy, revealing a uterine myoma with infarction and abscess formation. The patient recovered uneventfully and was discharged 1 week later.- - - - - - - - - - ranking = 1.6799600379744keywords = pain (Clic here for more details about this article) |
7/465. Three generations of hereditary chronic pancreatitis.The patient was a 22 year-old male. Hereditary chronic pancreatitis was suspected as a diagnosis since his mother's uncle had been operated on for chronic pancreatitis 14 years previously at the age of 64 years and his mother had been operated on for chronic pancreatitis with calculi 5 years previously at the age of 40 years. Surgery was needed, since: 1) he had experienced abdominal pain for 8 years; 2) endoscopic retrograde cholangiopancreatography (ERCP) revealed a marked irregular dilatation in the main pancreatic duct and a marked irregular dilatation and protein plugs in the ductule of the tail of the pancreas; and, 3) pancreatic functional diagnostic (PFD) test examination showed a 75% decrease in exocrine function. If a surgical procedure had not been performed, the patient would likely have experienced calculi formation in the pancreas and a further decrease in exocrine function. Since the patient was very young and had many protein plugs in the dilated ductule of the tail of the pancreas, we decided to perform a spleen-preserving Puestow's procedure with removal of the tail of the pancreas. Clinical and pathological findings of hereditary pancreatitis are reviewed.- - - - - - - - - - ranking = 10.497361855631keywords = abdominal pain, pain (Clic here for more details about this article) |
8/465. multiple myeloma presenting as acute pancreatitis.Acute pancreatitis is a very uncommon presenting feature of multiple myeloma. We report an elderly non-alcoholic man presenting with acute abdominal pain and rapidly progressing renal failure. Investigations revealed lytic lesions in the vertebrae and skull, M band on urine electrophoresis, and radiological and biochemical evidence of acute pancreatitis. The patient died despite conservative management of the pancreatitis.- - - - - - - - - - ranking = 10.497361855631keywords = abdominal pain, pain (Clic here for more details about this article) |
9/465. Management of chylothorax after thoracoscopic splanchnicectomy.Thoracoscopic splanchnicectomy is a minimally invasive procedure used in the treatment of recalcitrant abdominal pain in patients with chronic pancreatitis or pancreatic carcinoma. chylothorax, an uncommon complication of thoracoscopic splanchnicectomy, may lead to a protracted, costly hospital course of treatment usually consisting of central venous hyperalimentation, restricted oral intake, and tube thoracostomy. In our series of 25 patients who underwent thoracoscopic splanchnicectomy, 2 developed postoperative chylothorax. Both patients failed conservative management and ultimately underwent operative reintervention, at which time, leaking lymphatics were easily identified and closed using minimally invasive techniques. On the basis of this experience, we advocate early thoracoscopic reintervention in patients with chylothorax after thoracoscopic splanchnicectomy.- - - - - - - - - - ranking = 10.497361855631keywords = abdominal pain, pain (Clic here for more details about this article) |
10/465. Gestational hyperlipidemic pancreatitis without non-gestational hyperlipidemia.A 27 year-old pregnant woman was referred to our department with nausea, abdominal pain, and hypertriglyceridemia (5500 mg/dl). A diagnosis of acute gestational hyperlipidemic pancreatitis was made. She had no history of nongestational hyperlipidemia. Subsequently, she underwent pancreatic drainage and Caesarean section. Our experience suggests that gestational hyperlipidemic pancreatitis may occur in pregnant women without nongestational hyperlipidemia. Intensive monitoring of serum lipid levels is mandatory when managing pregnant women who develop or show gestational worsening of hypertriglyceridemia.- - - - - - - - - - ranking = 10.497361855631keywords = abdominal pain, pain (Clic here for more details about this article) |
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