Presentation
They present with either severe upper abdominal pain radiating to back requiring narcotic analgesics, or may present as diabetes or foul smelling loose sticky stools called steatorrhoea. [practo.com]
To the best of our knowledge this was the first case of its kind presented to our hospital in recent past. A 25-year-old female presented to the emergency department of our hospital with an acute episode of pancreatitis. [ncbi.nlm.nih.gov]
A 59-year-old male with chronic calcific pancreatitis secondary to alcohol and smoking presented with chronic abdominal pain and acute recurrent pancreatitis. [endoscopedia.com]
This work was presented in part at the 1994 Annual Meeting of the American Society for Gastrointestinal Endoscopy (Digestive Disease Week, New Orleans). [journals.lww.com]
Gastrointestinal
- Abdominal Pain
They present with either severe upper abdominal pain radiating to back requiring narcotic analgesics, or may present as diabetes or foul smelling loose sticky stools called steatorrhoea. [practo.com]
This paper reports 2 women aged 27 and 40 with histories of chronic abdominal pain, and who, by abdominal X-ray and endoscopic retrograde cholangiopancreatography (ERCP), were shown to have multiple calcifications in the main and accessory pancreatic [karger.com]
Abstract A 53-year-old woman with chronic alcoholic pancreatitis had abdominal pain due to a pancreatic stone in the main pancreatic duct of the pancreatic head. [jstage.jst.go.jp]
After the modified Puestow procedure, abdominal pain was reduced in patients with complete or incomplete stone clearance (P>0.05). Steatorrhea and diabetes mellitus developed in several patients during a long-term follow-up. [ncbi.nlm.nih.gov]
However, the patient visited the emergency room for severe abdominal pain three days after discharge. Vital signs were stable. [kjpbt.org]
- Epigastric Pain
This can be a major factor causing pain in patients with CP. This hypothesis is supported by the observation that symptoms may improve following pancreatic duct drainage. Method A 62-year-old woman presented with persistent epigastric pain. [nzma.org.nz]
CASE A 65-year-old woman presented with postprandial epigastric pain that lasted for several days. Twenty years ago, the patient had undergone a subtotal gastrectomy with Billroth II for gastric ulcer and a cholecystectomy. Vital signs were stable. [kjpbt.org]
Case 1 A 22-year-old male with idiopathic chronic pancreatitis and pancreatic stones (the first implementation of EPDBD at our hospital) with epigastric pain prompting was hospitalized. [oatext.com]
Liver, Gall & Pancreas
- Pancreatic Pain
Pseudocysts of the Pancreas Pseudocysts of the pancreas are abnormal collections of fluid, dead tissue, pancreatic enzymes, and blood that can lead to a painful mass in the pancreas. [massgeneral.org]
Costamagna, G, Tringali, A 2005 Endoscopic treatment of pain in chronic pancreatitis: really useful or only feasible? Dominguez-Munoz, JE eds. [link.springer.com]
Pancreatic enzymes Can be considered in all patients with pain. Randomized trials of pancreatic enzymes for pain show mixed results. A meta-analysis of these trials did not show benefit for treating pain. [clinicaladvisor.com]
The use of pancreatic enzymes was not considered to indicate pancreatic insufficiency, because they had also been prescribed as part of pain management. [nejm.org]
Musculoskeletal
- Back Pain
Back pain at the same opposite spot of the abdomen pain Indigestion Unexplained weight loss Nausea and vomiting are other common symptoms Diagnosis: An ultrasound and sonography is done to detect the pancreatic duct stones. [drwanisgastrocare.com]
[…] below your breastbone Back pain between your shoulder blades Pain in your right shoulder Nausea or vomiting Gallstone pain may last several minutes to a few hours. [mayoclinic.org]
Additional symptoms of severe acute pancreatitis include upper abdominal or back pain and fever. Pain is usually described as sharp and stabbing, typically radiating to the back, with occasional throbbing. [nyulangone.org]
Sudden severe abdominal pain. Pain usually begins in the upper abdomen and radiates s to your back. [allps.co.uk]
Symptoms of chronic pancreatitis include abdominal pain, nausea, vomiting, weight loss, diarrhea, and diabetes. Abdominal pain is the most common presenting symptom. The abdominal pain is typically epigastric and radiates to the back. [pancreapedia.org]
Workup
X-Ray
- Pancreatic Calcification
Imaging evidence usually reveals far advanced structural injury (e.g., pancreatic calcifications). [clinicaladvisor.com]
CT examination is the most appropriate method for identifying pancreatic calcifications, while for very small calcifications non-enhanced CT is preferred. [emedicine.medscape.com]
In 1995, Yoshida et al. first proposed a concept of AIP that did not include pancreatic calcification [ 4 ]. [bmcgastroenterol.biomedcentral.com]
These calcifications are like stones that are within the tissue itself, or within the pancreatic duct (Figure 1). [pancreapedia.org]
Treatment
Several days after treatment, symptoms of pancreatitis improved with conservative treatment. [oatext.com]
In contrast, in the study of Kozarek and colleagues from the United States, patients received general or epidural anesthesia and received a single treatment session, with repeat treatment at a later time, if the initial treatment was unsuccessful. [bcidaho.com]
Incorporate the latest findings and improvements in care for liver disease patients —from diagnosis and treatment through post-treatment strategies and management of complications. Expert Consult eBook version included with purchase. [books.google.com]
Since the pancreatic stone was not destroyed by extracorporeal shock wave lithotripsy, endoscopic treatment was carried out. [jstage.jst.go.jp]
Prognosis
Tsuji T, Shiratori K, Katoh M, Yamafuji K, Okamoto N (2009) Treatment of 225 cases of chronic pancreatitis and pancreatic stone-the effect of ESWL + endoscopy therapy and its prognosis. Pancreas 24: 62-73. [oatext.com]
However, these criteria for predicting prognosis and outcome of therapy in patients with chronic pancreatitis is unknown. [9, 10] EUS, in which the probe can approach the pancreas, is capable of yielding high-resolution visualization of abnormal pancreatic [emedicine.medscape.com]
Treatment and prognosis of AIP. J Gastroenterol. 2010;45(5):471–7. PubMed View Article Google Scholar Hart PA, Kamisawa T, Brugge WR, Chung JB, Culver EL, Czako L, et al. [bmcgastroenterol.biomedcentral.com]
Etiology
Article / Publication Details First-Page Preview Abstract Several experimental and clinical studies have shown that citrates are useful in dissolving calcifications and proteic plug in pancreatic ducts both of alcoholic etiology and in patients with chronic [karger.com]
Keywords : Catheter, Common bile duct, Stone, Pancreatitis INTRODUCTION Acute pancreatitis is caused by various etiologies, although the pathogenic mechanisms are not fully understood [ 1 ]. [kjpbt.org]
Specific etiologies may have specific associated conditions. [clinicaladvisor.com]
Irrespective of the etiology majority of patients of CP present with pain as the dominant symptom. From an endoscopists perspective CP is a challenge. [jdeonline.in]
Distinct classification systems have been developed for CP, but only the Toxic/metabolic, Idiopathic, Genetic, Autoimmune, Recurrent acute pancreatitis, and Obstructive (TIGAR-O) and the M-ANNHEIM classification systems take the etiology of CP into account [emedicine.medscape.com]
Epidemiology
Epidemiology of alcohol-related liver and pancreatic disease in the United States. Arch Intern Med 168:649–656, 2008. PMID: 18362258 [pancreapedia.org]
Epidemiology and outcome of acute pancreatitis. Br J Surg 1987; 74: 398-401. Tandon M, Tropaziam M, Pezilli R et al. Endoscopic ultrasound in idhiopatic acute pancreatitis. Am J Gastroenterol 2001; 96:705-709. Wilcox CM, Varadarajulu S, Eloubeidi M. [sapd.es]
The epidemiology and impact of pancreatic diseases in the United States. Curr Gastroenterol Rep 2005;7:90-5. [ PUBMED ] 9. Ochiai K, Kaneko K, Kitagawa M, Ando H, Hayakawa T. [saudisurgj.org]
E., (2007) Mastery of surgery, 5th edition, Editura Lippincott Williams & Wilkins, New York Lowenfels, A., B., Maisonneuve, P., (2004) Epidemiology and prevention of pancreatic cancer, Jpn J Clin Oncol 2004;34(5) 9 Revista Româneasc pentru Educa ie Multidimensional [healthdocbox.com]
Author Affiliations From the Departments of Gastroenterology and Hepatology (D.L.C., E.A.J.R., K.H., M.J.B.), Surgery (D.J.G., M.A.B., O.R.B.), Radiology (Y.N., J.S., J.S.L.), and Clinical Epidemiology, Biostatistics, and Bioinformatics (M.G.W.D.), Academic [nejm.org]
Pathophysiology
Unlike others on this topic, this text demonstrates how the endoscope incorporates pathophysiology, diagnostic, and treatment modalities into endoscopic practice. [books.google.com]
Pancreatic physiology, pathophysiology, acute and chronic pancreatitis. Gastrointestinal Teaching Project, American Gastroenterological Association. 2003. [pancreapedia.org]
In: Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 10th ed. Philadelphia, Pa.: Saunders Elsevier; 2016. http://www.clinicalkey.com. Accessed June 16, 2016. Picco MF (expert opinion). [mayoclinic.org]
The reason for this difference may be pathophysiological differences that require further study. In our cohort, ESWL was performed on AIP patients mainly to preserve pancreas function. [bmcgastroenterol.biomedcentral.com]
Pathophysiological mechanisms in acute pancreatitis: Current understanding. Indian J Gastroenterol. 2016; 35 :153–166. [ PubMed ] [ Google Scholar ] 3. Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD, Sarr MG, Tsiotos GG, Vege SS. [ncbi.nlm.nih.gov]
Prevention
The stones block the duct of pancreas and prevent this organ from releasing the enzymes needed for food digestion. [practo.com]
Special chapters, such as the Designing Clinical Research in Gastrointestinal Endoscopy, The Prevention of Infection Following Gastrointestinal Endoscopy, Complications of Peptic Ulcer Disease, and Credentialing for Gastrointestinal Endoscopy, help make [books.google.com]
It is also recommended that EPS should be placed just after EPDBD to prevent re-stenosis [11,12]. [oatext.com]
This incision is made with an electrical current (you can not feel) that also cauterizes the tissues to prevent bleeding. [medicine.iupui.edu]