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Calcific Pancreatitis


Presentation

  • Pyogenic liver abscess is a rare presentation of common bile duct stenosis secondary to chronic calcific pancreatitis. Two cases are described in this report; in both cases, biliary obstruction was present in the absence of jaundice.[ncbi.nlm.nih.gov]
Leg Edema
  • A 19-year-old Thai male, who was a regular drinker, presented with massive ascites, back pain and leg edema for four months. On examination there was obvious clinical evidence of an inferior vena cava obstruction.[ncbi.nlm.nih.gov]
Epigastric Tenderness
  • Physical examination revealed epigastric tenderness. Results of laboratory testing, including serum lipase and liver-function tests, were within normal limits.[nejm.org]
Macroglossia
  • Our patientpresented with weight loss, anorexia, anemia due to upper gastrointestinal bleeding, macroglossia, periorbital purpura.[medresearch.in]

Workup

  • The workup for secondary causes of autoimmune hemolytic anemia such as SLE was negative. SLE is an autoimmune disease with multiorgan involvement which may involve one or several organ systems and over time additional manifestations may occur.[webmedcentral.com]
Pancreatic Calcification
  • Vanishing pancreatic calcifications. AJR 1967; 99: 642–644. Google Scholar 16. Donowitz M, Stein SA, Keohande MF. Vanishing pancreatic calcifications, a nonspecific finding in chronic pancreatitis. JAMA 1974; 228: 1575–1577.[springerlink.com]
  • All had pancreatic calcification and ERCP changes typical of chronic pancreatitis, the most predominant being ductal dilatation which was detected in all patients by both ERCP and by ultrasonography.[ncbi.nlm.nih.gov]
  • Chronic alcoholic pancreatitis is a common cause of pancreatic calcification. Treatment of chronic pancreatitis typically includes pain management and correction of exocrine pancreatic insufficiency.[nejm.org]
Hyperviscosity
  • The hyperviscosity of serum in Waldenstrom's macroglobulinemia may be associated with a viscous pancreatic juice that leads to stone formation.[ncbi.nlm.nih.gov]
Anisopoikilocytosis
  • Presence of Nucleated RBCs, polychromasia, anisopoikilocytosis and left shift of neutrophils were noted in the Peripheral Smear. The serum LDH was 677, urine for Hemoglobin was negative and Serum Iron Profile was normal.[webmedcentral.com]
Nodular Glomerulosclerosis
  • This is only the fourth recorded case of histologically documented nodular glomerulosclerosis occurring in a patient with pancreatogenic diabetes. Accepted April 22, 1976.[diabetes.diabetesjournals.org]
Bone Marrow with Decreased Iron Stores
  • Bone marrow aspiration showed mature bone marrow with decreased iron store. X ray skull was normal. 2D-Echo revealed features of diastolic dysfunction.[medresearch.in]

Treatment

  • […] did not need insulin before trimethadione treatment.[ncbi.nlm.nih.gov]
  • In the original treatment group, pain reduction persisted at six months.[empr.com]

Prognosis

  • But its diagnosis and differentiation from metastatic disease is important as their management and prognosis is different.[omicsonline.org]
  • To keep learning about pancreatitis: Overview Causes Genetics Symptoms Diagnosis Treatment Auto Islet Transplants Diet Prognosis FAQ[columbiasurgery.org]
  • Prognosis of abdominal aortic aneurysms: a population-based study. N Engl J Med 1989; 321:1009-1014. ‎[books.google.de]
  • Pain, exocrine and endocrine pancreatic insufficiency and prognosis of the disease. Digestion 1993; 54:148-155. 13. Chronic pancreatitis: diagnosis and management of complications.[webmedcentral.com]
  • The prognosis is good relative to other causes of chronic pancreatitis.[diapedia.org]

Etiology

  • The etiology of villous atrophy could not be established. The pathophysiological significance of this association is discussed.[ncbi.nlm.nih.gov]
  • DISCUSSION The etiology of tropical calcific pancreatitis in tropical countries has generally remained obscure [ 10 , 11 ].[pancreas.imedpub.com]

Epidemiology

  • Epidemiology, natural history, and predictors of disease outcome in acute and chronic pancreatitis. Gastrointest Endosc. 2002;56:S226–S230. 8.[webmedcentral.com]
  • Epidemiology Tropical chronic pancreatitis has been reported from many parts of Africa, South America and South-East Asia. Its highest prevalence is in Southern India.[diapedia.org]
  • An interim report from a prospective epidemiological multicentre study. Scand J Gastroenterol 1981;16:305–312.[karger.com]
  • […] present diffusely in dilated ducts Micro description: pancreatic ducts with denuded epithelium, squamous metaplasia, periductal lymphoplasmacytic infiltrate, acinar and islets atrophy, fibrosis Infectious pancreatitis: In immunocompromised patients Epidemiology[pathologyoutlines.com]
  • Epidemiology of alcohol-related liver and pancreatic disease in the United States. Arch Intern Med 168:649–656, 2008. PMID: 18362258[pancreapedia.org]
Sex distribution
Age distribution

Pathophysiology

  • The pancreatic ductal changes in CCPT seems to be different from that seen in chronic alcoholic pancreatitis and may be due to the difference in the pathophysiology of the underlying disease.[ncbi.nlm.nih.gov]
  • Because the pathophysiology of pseudocyst formation is by enzymatic destruction, pathology will not be confined to surrounding anatomical spaces in retroperitoneum [ 4 ].[npplweb.com]
  • Pancreatic physiology, pathophysiology, acute and chronic pancreatitis. Gastrointestinal Teaching Project, American Gastroenterological Association. 2003.[pancreapedia.org]

Prevention

  • This, coupled with the brisk output of catecholamines, may have prevented the heightened sensitivity to insulin anticipated because of their hypoglucagonemia.[ncbi.nlm.nih.gov]
  • The stones block the duct of pancreas and prevent this organ from releasing the enzymes needed for food digestion.[practo.com]
  • Abstinence from alcohol and greasy or fried foods is important in helping to prevent malnutrition and pain.[columbiasurgery.org]
  • Treatment is, therefore, directed towards preventing attacks, controlling the pain and treating the complications. Preventing symptoms worsening Patients with chronic pancreatitis should avoid alcohol altogether.[netdoctor.co.uk]
  • Can Pancreatitis Be Prevented? Because most cases of pancreatitis are caused by alcohol abuse, prevention is directed at responsible drinking or no drinking at all.[webmd.com]

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