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1.
Rev. méd. Panamá ; 42(1): 24-24, mayo 2022.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1371950

ABSTRACT

Introducción: La intoxicación con organofosforados se ha descrito como causa poco frecuente de pancreatitis aguda. En la literatura, son escasos los reportes de casos de esta asociación y el mecanismo fisiopatológico que lleva al desarrollo de necrosis en esta situación, está aún menos estudiada. Por esta razón presentamos este caso de esta inusual asociación. Presentación de caso: masculino de 45 años que es llevado por familiares a hospital de segundo nivel por cuadro clínico compatible con intoxicación por organofosforados. Desde el ingreso con niveles elevados de amilasa y ultrasonido abdominal sin datos sugestivos de pancreatitis, sin embargo, con dolor abdominal típico que mejora progresivamente con el manejo conservador instaurado. A pesar de esto, inicia con datos de disfunción pancreática y en la tomografía computarizada se reporta necrosis de >90% de la estructura pancreática, compatible con pancreatitis aguda necrótica. Al no haber datos de infección sistémica, se ofrece manejo conservador con adecuada respuesta. Conclusión: la pancreatitis es una complicación que debe ser buscada en pacientes con intoxicación por organofosforados, ya que el tratamiento oportuno mejora significativamente el pronóstico. (provisto por Infomedic International)


Introduction: Organophosphate poisoning has been described as a rare cause of acute pancreatitis. In the literature, case reports of this association are scarce and the pathophysiological mechanism that leads to the development of necrosis in this situation is even less studied. For this reason, we present this case of this unusual association. Case presentation: 45-year-old male who was taken by family members to a second level hospital with clinical symptoms compatible with organophosphate poisoning. Since admission, he had elevated amylase levels and abdominal ultrasound with no data suggestive of pancreatitis, however, with typical abdominal pain that improved progressively with conservative management. Despite this, he started with data of pancreatic dysfunction and the CT scan showed necrosis of >90% of the pancreatic structure, compatible with acute necrotic pancreatitis. Since there was no evidence of systemic infection, conservative management was offered with adequate response. Conclusion: pancreatitis is a complication that should be sought in patients with organophosphate poisoning since timely treatment significantly improves prognosis. (provided by Infomedic International)

2.
Pediatr Panamá ; 51(1): 19-23, May2022.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1368294

ABSTRACT

La pancreatitis crónica (PC) es una enfermedad de incidencia creciente en la población pediátrica, aunque desconocida, y conlleva una importante comorbilidad. La clínica inicial suele ser la propia de un episodio de pancreatitis aguda pero la importancia recae en el desarrollo, al cabo de meses o años, de insuficiencia pancreática. Para su diagnóstico será necesario tener un alto índice de sospecha clínica y realizar pruebas de imagen que demuestren cambios propios de la PC. El manejo de esta entidad deberá ser multidisciplinar y consistirá en controlar de forma adecuada el dolor e iniciar tratamiento sustitutivo cuando se constate la presencia de insuficiencia pancreática exocrina y endocrina. El caso que se reporta a continuación es un buen ejemplo de un caso de PC con presencia de insuficiencia exocrina y endocrina. Se documenta el proceso diagnóstico de la PC, en cuanto a pruebas de imagen y pruebas que demuestren la presencia de insuficiencia pancreática. Se exponen también las diferentes pruebas que se realizan para llegar a la etiología del cuadro. Se intenta reflejar el manejo que se debe llevar a cabo en estos pacientes y el seguimiento estricto que requieren.


Chronic pancreatitis (CP) is a disease with increasing incidence, though unknown, in the last years in the pediatric population which entails important comorbidities. The initial symptomatology is similar to the clinical scenario of acute pancreatitis, but its importance relies on the development, in months to years, of pancreatic insufficiency. For its diagnosis a high clinical suspicion and typical image findings are necessary. The management of this entity is held by a multidisciplinary team and the main goal is to assure an optimal pain control and start substitutive treatment once the pancreatic insufficiency is diagnosed. The clinical case that follows is a good example of CP with stablished pancreatic exocrine and endocrine insufficiency. It documents the diagnostic process of CP, regarding the imaging tools used and other laboratory test that manifested the pancreatic insufficiency. We expose the different etiologic tests that were performed in order to get to the etiologic diagnosis. It intends to reflect on the management needed for these patients and the strict follow-up that must be done.

3.
Arq. gastroenterol ; 59(1): 71-74, Jan.-Mar. 2022. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1374438

ABSTRACT

ABSTRACT Background Viral infections can cause acute pancreatitis. Idiopathic pancreatitis has an important proportion in the etiology of acute pancreatitis. Objective To investigate the rate of development of acute pancreatitis (AP) in COVID-19 patients and to determine the rate of idiopathic pancreatitis in the etiology of this pancreatitis. Methods A total of 6.467 patients hospitalized with the COVID-19 diagnosis were included in the study. Patients diagnosed with AP based on the Atlanta criteria were identified. Etiological factors were determined in patients who developed acute pancreatitis and compared with the etiological factors in 315 patients with non-COVID-19, hospitalized with the diagnosis of AP before the COVID-19 pandemic. AP was detected in 0.1% of patients with COVID-19. While gallstone was the etiologic factor in 2 (28.6%) of seven patients who developed acute pancreatitis during COVID-19, hyperlipidemia was the factor for 1 (14.3%) patient. Moreover, the etiologic factor could not be determined in 4 (57.1%) patients, and they were regarded as idiopathic pancreatitis patients. Biliary pancreatitis was the most common etiologic factor in 315 (78.4%) patients admitted to the hospital for AP before the COVID-19 pandemic. Idiopathic pancreatitis was ranked second with 16.8%. Conclusion It was observed that there was a significant difference in the incidence of idiopathic pancreatitis between patients with COVID-19 and non-COVID-19 (P=0.015). Results suggest that the SARS-Cov-2 virus may be among the factors leading to AP.


RESUMO Contexto Infecções virais podem causar pancreatite aguda (PA). A pancreatite idiopática tem uma proporção importante na etiologia da pancreatite aguda. Objetivo Investigar a taxa de desenvolvimento de pancreatite aguda em pacientes com COVID-19 e determinar a taxa de pancreatite idiopática na etiologia desta pancreatite. Métodos No estudo foram incluídos 6.467 pacientes internados com o diagnóstico de COVID-19. Foram identificados pacientes diagnosticados com PA com base nos critérios de Atlanta. Fatores etiológicos foram determinados em pacientes que desenvolveram pancreatite aguda e comparados com os fatores etiológicos em 315 pacientes sem COVID-19, hospitalizados com o diagnóstico de PA antes da pandemia COVID-19. A PA foi detectada em 0,1% dos pacientes com COVID-19. Enquanto o cálculo biliar foi o fator etiológico em 2 (28,6%) dos sete pacientes que desenvolveram pancreatite aguda durante o COVID-19, a hiperlipidemia foi o fator para 1 (14,3%) paciente. Além disso, o fator etiológico não pôde ser determinado em 4 (57,1%) pacientes, sendo considerados pacientes com pancreatite idiopática. A pancreatite biliar foi o fator etiológico mais comum em 315 (78,4%) pacientes internados no hospital para PA antes da pandemia COVID-19. A pancreatite idiopática ficou em segundo lugar com 16,8%. Conclusão Observou-se que houve diferença significativa na incidência de pancreatite idiopática entre pacientes com COVID-19 e não COVID-19 (P=0,015). Os resultados sugerem que o vírus SARS-Cov-2 pode estar entre os fatores que levam à pancreatite aguda.

4.
Rev. Assoc. Med. Bras. (1992) ; 68(3): 395-399, Mar. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1376125

ABSTRACT

SUMMARY OBJECTIVE: The aim of this study was to explore the efficacy of imipenem combined with glutamine in the treatment of severe acute pancreatitis with abdominal infection in mainland China using meta-analysis. METHODS: We searched China National Knowledge Network, Wanfang Medical Network, Chinese Science Citation Database, PubMed, and Embase Databases for publications of imipenem combined with glutamine in the treatment of severe acute pancreatitis abdominal infection. The search time limit was from the establishment of the database to April 10, 2021. Stata software version 12.0 was used for statistical analysis; the combined effect size odds ratio and standardized mean difference values were calculated for the count data and measurement data, respectively; and the heterogeneity test was performed in this study. RESULTS: A total of five randomized controlled trials were included. A total of 499 cases were included, with 251 in the observation group and 248 in the control group. Meta-analysis results showed that the efficacy of imipenem combined with glutamine in the treatment of severe acute pancreatitis with abdominal infection was significantly better than that of imipenem alone (odds ratio=0.78, 95%CI 0.71-0.86, p=0.040). CONCLUSION: Imipenem combined with glutamine can significantly improve the efficacy in the treatment of severe acute pancreatitis with abdominal cavity infection.

5.
Rev. colomb. gastroenterol ; 37(1): 58-64, Jan.-Mar. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1376906

ABSTRACT

Abstract Introduction: Pancreatitis is a frequent pathology in our environment, mostly related to benign biliary pathology. It can progress to severe forms in 10-15 % of cases, where the pancreatic tissue becomes necrotic and forms large collections with risk of infection. We do not have epidemiological data about the incidence or management of this complication in Colombia. Aim: This study aims to study the prevalence of infected pancreatic necrosis and describe the cases identified in a quaternary care hospital between 2014 and 2021. Materials and methods: A cross-sectional observational study. We analyzed records of patients diagnosed with stage 2 pancreatitis. Those cases with infected pancreatic necrosis that underwent debridement plus laparoscopic and open surgical drainage at Hospital Universitario Mayor Méderi in Bogotá, Colombia, between January 2014 and January 2021 were studied. A convenience sampling was carried out without calculating the sample size. We collected the patients' demographic and clinical variables, performing a descriptive statistical analysis in Excel. Qualitative variables were described through absolute and relative frequencies, while quantitative ones were expressed through measures of central tendency and dispersion based on their distribution. Results: We analyzed 1020 episodes of pancreatitis, finding pancreatic necrosis in 30 patients, i.e., a period prevalence of 2.9 %. Of the patients, 83 % (n = 25) underwent open drainage, with 48 % (n = 12) mortality. About laparoscopic management, the reduction in postoperative organ failure was 40 % (n = 2), with a 30 % shorter hospital stay than the open drainage approach. Those patients with a level of procalcitonin (PCT) lower than 1.8 ng/mL had less mortality. Conclusions: The laparoscopic approach shows promising results regarding final morbidity and mortality.


Resumen Introducción: la pancreatitis es una patología frecuente en nuestro medio, mayormente relacionada con la patología biliar benigna. Esta puede progresar a formas severas en 10 %-15 % de los casos, en donde el tejido pancreático se necrosa y forma grandes colecciones, con riesgo de infección. En Colombia no conocemos los datos epidemiológicos acerca de la incidencia de este tipo de complicaciones, ni del manejo de las mismas. Objetivo: este estudio tiene como objetivo estudiar la prevalencia de la necrosis pancreática infectada y describir los casos identificados en un hospital de alto nivel de complejidad entre 2014 y 2021. Métodos: estudio observacional de corte transversal. Se analizaron los registros de pacientes diagnosticados con pancreatitis en segunda etapa. Se estudiaron aquellos casos que presentaron necrosis pancreática infectada y se sometieron a desbridamiento más drenaje quirúrgico por vía laparoscópica y abierta en el Hospital Universitario Mayor Méderi de Bogotá, Colombia, entre enero de 2014 y enero de 2021. Se realizó un muestreo por conveniencia, sin cálculo de tamaño de muestra. Se recolectaron variables demográficas y clínicas de los pacientes. Se realizó un análisis estadístico descriptivo de las variables obtenidas en Excel. Las variables cualitativas se describieron a través de frecuencias absolutas y relativas; mientras que las cuantitativas se expresaron mediante medidas de tendencia central y de dispersión en función de su distribución. Resultados: se analizaron 1020 episodios de pancreatitis y se evidenció necrosis pancreática en 30 pacientes, es decir, una prevalencia de período de 2,9 %. De los pacientes, 83 % (n = 25) se llevó a drenajes por vía abierta, con un 48 % (n = 12) de mortalidad. En relación con el manejo por vía laparoscópica, la reducción en la falla orgánica posoperatoria fue de 40 % (n = 2), con un 30 % menos de duración en la estancia hospitalaria, comparado con la vía abierta. Aquellos pacientes que presentaron un nivel de procalcitonina (PCT) menor de 1,8 ng/mL tuvieron menos mortalidad. Conclusiones: el abordaje laparoscópico muestra resultados prometedores en cuanto a la morbilidad y mortalidad final observada.

6.
Einstein (Säo Paulo) ; 20: eRW6667, 2022. tab, graf
Article in English | LILACS | ID: biblio-1360402

ABSTRACT

ABSTRACT This review aimed to investigate whether SARS-CoV-2 is capable of infecting the gland and causing acute pancreatitis, and the peculiarities in the management of these cases. The research was conducted through PubMed® database, and 62 articles were systematically selected for analysis. Differences were found in the literature; however, there are important warnings, such as the presence of hyperlipasemia, clinical and imaging findings suggestive of acute pancreatitis in the presence and even in the absence of respiratory symptoms. Attention should be paid to clinical and imaging findings during this virus infection, since it is possible to identify these two diseases early. Therefore, it is possible to detect and isolate these patients more quickly, providing the correct care and decreasing the morbidity and mortality of two potentially severe diseases.


Subject(s)
Humans , Pancreatitis/etiology , Pancreatitis/diagnostic imaging , COVID-19 , Acute Disease , SARS-CoV-2
7.
Neuroscience Bulletin ; (6): 342-358, 2022.
Article in English | WPRIM | ID: wpr-929097

ABSTRACT

Central sensitization is essential in maintaining chronic pain induced by chronic pancreatitis (CP), but cortical modulation of painful CP remains elusive. Here, we examined the role of the anterior cingulate cortex (ACC) in the pathogenesis of abdominal hyperalgesia in a rat model of CP induced by intraductal administration of trinitrobenzene sulfonic acid (TNBS). TNBS treatment resulted in long-term abdominal hyperalgesia and anxiety in rats. Morphological data indicated that painful CP induced a significant increase in FOS-expressing neurons in the nucleus tractus solitarii (NTS) and ACC, and some FOS-expressing neurons in the NTS projected to the ACC. In addition, a larger portion of ascending fibers from the NTS innervated pyramidal neurons, the neural subpopulation primarily expressing FOS under the condition of painful CP, rather than GABAergic neurons within the ACC. CP rats showed increased expression of vesicular glutamate transporter 1, and increased membrane trafficking and phosphorylation of the N-methyl-D-aspartate receptor (NMDAR) subunit NR2B and the α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid receptor (AMPAR) subunit GluR1 within the ACC. Microinjection of NMDAR and AMPAR antagonists into the ACC to block excitatory synaptic transmission significantly attenuated abdominal hyperalgesia in CP rats, which was similar to the analgesic effect of endomorphins injected into the ACC. Specifically inhibiting the excitability of ACC pyramidal cells via chemogenetics reduced both hyperalgesia and comorbid anxiety, whereas activating these neurons via optogenetics failed to aggravate hyperalgesia and anxiety in CP rats. Taken together, these findings provide neurocircuit, biochemical, and behavioral evidence for involvement of the ACC in hyperalgesia and anxiety in CP rats, as well as novel insights into the cortical modulation of painful CP, and highlights the ACC as a potential target for neuromodulatory interventions in the treatment of painful CP.


Subject(s)
Animals , Anxiety/etiology , Chronic Pain/etiology , GABAergic Neurons , Gyrus Cinguli/metabolism , Hyperalgesia/metabolism , Pancreatitis, Chronic/pathology , Rats , Rats, Sprague-Dawley , Receptors, N-Methyl-D-Aspartate/metabolism , Trinitrobenzenesulfonic Acid/toxicity
8.
Article in English | WPRIM | ID: wpr-929016

ABSTRACT

Pancreatic panniculitis (PP) is a necrotizing inflammation of subcutaneous fat that is a rare complication of pancreatic disease appearing in 2% to 3% of all patients. It is more common in the elderly and often affects the extremities. It presents as skin inflammation with pain and erythema nodules. We report a case of acute pancreatitis associated with PP in an old female. She was admitted for vomiting and abdominal pain for 3 days and presented with a 2-week history of erythematous subcutaneous nodules on her legs. Laboratory and ultrasonic findings revealed acute pancreatitis. High frequency ultrasound showed hypoechoic foci in subcutaneous soft tissue layer and adipose layer. Histopathological examination confirmed the diagnosis of PP. Nodules disappeared with the resolution of acute pancreatic inflammation. PP may be the first manifestation of pancreatic disease. Imaging features of this pathology are seldom described and ultrasonic diagnosis experience is worth to be accumulated.


Subject(s)
Acute Disease , Aged , Female , Humans , Inflammation/complications , Pancreatic Diseases/diagnostic imaging , Pancreatitis/diagnostic imaging , Panniculitis/etiology , Ultrasonography
9.
Journal of Clinical Hepatology ; (12): 1198-1202, 2022.
Article in Chinese | WPRIM | ID: wpr-924807

ABSTRACT

Abnormal activation and secretion of pancreatic enzymes in pancreatic acinar cells is one of the important pathogeneses of acute pancreatitis (AP) and can directly damage the pancreatic tissue to accelerate disease progression and induce severe AP. At present, the drugs inhibiting the abnormal activation and secretion of pancreatic enzymes tend to have an unsatisfactory effect in clinical practice, and therefore, it is of great importance to search for new therapeutic targets. This article summarizes the pathological events of abnormal activation and secretion of pancreatic enzymes (cytoplasmic calcium overload, colocalization of lysosomes and zymogen granules, organelle injury, obstructed apical secretion of trypsin, and increased basal secretion of trypsin), collects the molecular mechanisms of related events, and discusses the role of abnormal activation and secretion of pancreatic enzymes in the early stage of AP, so as to provide ideas for the development of targeted drugs in the future.

10.
Journal of Clinical Hepatology ; (12): 1192-1197, 2022.
Article in Chinese | WPRIM | ID: wpr-924806

ABSTRACT

Acute pancreatitis (AP) is one of the common acute abdominal diseases of the digestive system, and early treatment to avoid aggravation to severe pancreatitis (SAP) is the key to guaranteeing prognosis. AP with acute kidney injury (AKI) can significantly increase the mortality rate of pancreatitis. Early diagnosis of AP with AKI is a top priority to reduce mortality rate. This article reviews the current studies on the early predictors for AKI in AP and briefly describes commonly used indicators (neutrophil-to-lymphocyte ratio, cystatin C, renal vascular resistance index, and neutrophil gelatinase-associated lipocalin) and other valuable indicators. It is pointed out that a combination of various markers based on their sensitivity and specificity has a promising future in the diagnosis of AKI in AP.

11.
Journal of Clinical Hepatology ; (12): 1351-1355, 2022.
Article in Chinese | WPRIM | ID: wpr-924709

ABSTRACT

Objective To investigate the value of ultrasound and contrast-enhanced ultrasound (CEUS) in the differential diagnosis of mass-type autoimmune pancreatitis (AIP) and pancreatic ductal adenocarcinoma (PDAC). Methods A retrospective analysis was performed for the clinical data, ultrasound findings, and CEUS findings of 11 patients with mass-type AIP who were diagnosed in Tangshan Workers' Hospital from January 2015 to December 2020, and their characteristic manifestations were analyzed and compared with the data of 23 patients with PDCA. The chi-square test was used for comparison of categorical data between two groups. Results For the 11 patients with mass-type AIP, CEUS had a diagnostic accuracy of 63.64%, and all of these patients had hypoechoic single lesions; the patients with clear boundaries, regular morphology, pancreatic duct dilatation or cutoff, and blood flow signal accounted for 54.55%, 63.64%, 18.18%, and 36.36%, respectively, while in the PDCA group, such patients accounted for 30.43%, 34.78%, 78.26%, and 21.74%, respectively, and there was a significant difference in the presence or absence of pancreatic duct dilatation or cutoff between the two groups( χ 2 =11.089, P 0.05). For the 11 patients with mass-type AIP, CEUS showed that 7 patients (63.64%) had hyperenhancement and 4 (36.36%) had iso-enhancement in the arterial phase, and 5 patients (45.45%) had hyperenhancement in the arterial phase and 6 (54.55%) had iso-enhancement in the venous phase; for the 23 patients with PDCA, 22 (95.65%) had hypoenhancement of lesions in both arterial and venous phases, and there were significant differences in the enhancement pattern in arterial and venous phases between the two groups ( χ 2 =30.345 and 30.084, both P < 0.05). Conclusion The enhancement pattern of CEUS and the presence or absence of pancreatic duct dilatation or cutoff have a relatively high value in the differential diagnosis of mass-type AIP and PDCA.

12.
Journal of Clinical Hepatology ; (12): 762-766, 2022.
Article in Chinese | WPRIM | ID: wpr-923274

ABSTRACT

IgG4-related hepatobiliary and pancreatic diseases are a part of the IgG4-related disease multiorgan fibroinflammatory disorder, including IgG4-related autoimmune pancreatitis, IgG4-related sclerosing cholangitis, and IgG4-related hepatic involvement. The main pathological features include IgG4 + plasma cell/lymphocyte infiltration, storiform fibrosis, obliterative phlebitis, and eosinophil infiltration. The diagnosis of this disease is often based on the comprehensive diagnostic criteria for IgG4-related diseases and organ-specific diagnostic criteria. However, it is difficult to differentiate IgG4-related hepatobiliary and pancreatic diseases from neoplastic diseases, and novel diagnostic biomarkers are expected to improve the sensitivity and specificity of diagnosis. To date, glucocorticoids remain the first-line drug for this disease, and biological agents, especially anti-CD20 monoclonal antibody, may be an alternative therapy for patients with corticosteroid contraindication/intolerance or recurrent/refractory disease.

13.
Ciênc. rural (Online) ; 52(2): e20210041, 2022. tab
Article in English | LILACS, VETINDEX | ID: biblio-1286049

ABSTRACT

Eurytrema coelomaticum is a trematode reported in the pancreatic ducts of ruminants. It is conjectured that may cause disorders in the pancreas, as well as digestive and metabolic processes dependent on them. This study, determined if there is an impairment of exocrine pancreatic function, and correlated it with parasite burden. Pancreas, blood, and fecal samples were collected from 119 bovines at a abattoir. Stool samples were subjected to the gelatin and x-ray film digestion tests (to detect the presence of trypsin in feces). Using blood samples, the following biochemical tests were performed: amylase, lipase, glucose, fructosamine, cholesterol, triglycerides, total protein, albumin, and globulins. Analyses were correlated with pancreatic parasite burden. Cattle with a high parasitic load presented higher incidence of negative tests in both gelatin digestion and x-ray film digestion tests (P < 0.001) when compared to non-parasitized animals and those with a low parasitic load. Changes in those tests only occurred if the parasitemia was moderate or severe. The activity of the amylase and lipase enzymes was significantly higher in animals with low parasitemia (P < 0.05), compared to non-parasitized animals and with a high parasitic burden. In this study, in cases of high parasitemia, negative results were observed in both gelatin and x-ray film in the feces digestion tests. However, the low infection of E. coelomaticum, higher levels of serum amylase and lipase that also indicated loss of pancreatic exocrine functions were reported.


Eurytrema coelomaticum, um trematódeo de ductos pancreáticos de ruminantes. Conjectura-se que possa ocasionar transtornos nas funções pancreáticas, mais especificamente nos processos digestivos e metabólicos dependentes destas. Neste estudo, o objetivo foi determinar se há comprometimento da função pancreática exócrina, correlacionado-a a carga parasitária. Foram utilizados pâncreas e respectivas amostras de sangue e fezes de 119 bovinos. As amostras de fezes foram submetidas aos testes de digestão da gelatina em tubo e digestão de filme radiográfico, ambos para detecção de tripsina nas fezes. Foram realizados os seguintes exames bioquímicos em amostras de sangue: amilase, lipase, glicemia, frutosamina, colesterol, triglicerídeos, proteínas totais, albumina e globulinas. Após isto, as análises bioquímicas foram correlacionadas com a quantidade numérica de parasitas encontrados no pâncreas (post-mortem). Houve maior quantidade de testes negativos (digestão do filme radiográfico e prova de digestão da gelatina) nos animais com alta carga parasitária (P < 0.001), quando comparados aos animais não parasitados e com baixa carga parasitária. Portanto, os exames supracitados se alteram somente se a quantidade de parasitas for moderada ou severa. As atividades das enzimas amilase e lipase foram significativamente maiores nos animais que apresentavam baixa parasitemia (P < 0.05), em comparação com os animais com alta carga parasitária e não parasitados. Conclui-se que em quadros de alta parasitemia há alteração significativa nos testes de digestão nas fezes, e que em quadros de baixa parasitemia há alterações significativas nos valores de amilase e lipase séricas, ambos comprovando alterações pancreáticas importantes, de acordo com o quadro de parasitemia.


Subject(s)
Animals , Cattle , Exocrine Pancreatic Insufficiency/parasitology , Pancreatitis/parasitology , Trematode Infections/complications , Trematode Infections/veterinary , Amylases/blood , Lipase/blood , Trematoda , Parasite Load/veterinary
14.
CES med ; 35(3): 316-324, sep.-dic. 2021. graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1374772

ABSTRACT

Resumen Las complicaciones de la pancreatitis aguda se dividen en sistémicas y locales, y entre estas últimas se encuentran las colecciones líquidas pancreáticas agudas, la colección necrótica aguda, el pseudoquiste y la necrosis amurallada pancreática. Se reporta el caso de niña de nueve años con pancreatitis aguda idiopática severa, quien desarrolló una necrosis pancreática amurallada de 75 x 45 mm. Por la persistencia del dolor abdominal y la intolerancia a la vía oral, a pesar del manejo médico, se indicó un abordaje percutáneo transgástrico para su tratamiento. Se obtuvo éxito técnico y terapéutico a través del drenaje de la colección, permitiendo iniciar la vía oral y disminuyendo los requerimientos de analgesia. La paciente evolucionó satisfactoriamente, con alta quirúrgica a los 13 días y retiro del catéter a los 30 días. A los cuatro meses de seguimiento se evidenció una colección recidivante asintomática, manejándose de manera conservadora. Lo anterior permite considerar que el abordaje percutáneo transgástrico es una técnica segura y eficaz; sin embargo, evaluar la efectividad y morbimortalidad en población pediátrica requiere de otros estudios que posibiliten llegar conclusiones que generen mayor evidencia científica.


Abstract The complications of acute pancreatitis are divided into systemic and local such as acute pancreatic fluid collections, acute necrotic collection, pseudocyst and pancreatic walled necrosis. The case of a nine-year-old girl with idiopathic severe acute pancreatitis who developed a pancreatic walled necrosis of 75 x 45mm is reported. Due to the persistence of abdominal pain and intolerance to the oral route, despite medical treatment, a trans gastric percutaneous approach was indicated for the treatment of pancreatic walled necrosis. Technical and therapeutic success was obtained through the drainage of the collection, allowing to start the oral route and decreasing the analgesia requirements. The patient evolved satisfactorily, with surgical discharge after 13 days and removal of the catheter after 30 days. After 4 months of follow-up, a recurrent asymptomatic collection was evidenced, being handled in a conservative manner. The above mentioned allows considering that the trans-gastric percutaneous approach is a safe and effective technique; however, evaluating the effectiveness and morbimortality in pediatric population requires other studies that make possible to reach conclusions that generate more scientific evidence.

15.
Rev. colomb. cir ; 37(1): 146-150, 20211217. fig, tab
Article in Spanish | LILACS | ID: biblio-1357602

ABSTRACT

Introducción. En las hernias paraesofágicas tipo IV se produce la herniación del estómago junto a otros órganos abdominales. La herniación del páncreas es muy infrecuente.Caso clínico. Varón de 57 años que acude por dolor torácico, disnea e intolerancia al decúbito. En la tomografía computarizada toracoabdominal se observa hernia diafragmática que contiene colon transverso, intestino delgado y páncreas, con reticulación de la grasa alrededor del mismo, compatible con pancreatitis aguda. Conclusión. La asociación de hernia hiatal con páncreas herniado y pancreatitis es extremadamente infrecuente. El diagnóstico se estableció mediante tomografía computarizada y el tratamiento fue conservador, con cirugía diferida de la hernia de hiato.


Introduction. In type IV paraesophageal hernias, the stomach is herniated along with other abdominal organs. Herniation of the pancreas is very rare. Clinical case. A 57-year-old man presented with chest pain, dyspnea, and intolerance to decubitus. The thoracoabdominal computed tomography shows a diaphragmatic hernia containing the transverse colon, small intestine and pancreas, with reticulation of fat around it, compatible with acute pancreatitis. Conclusion. The association of hiatal hernia with herniated pancreas and pancreatitis is extremely rare. The diagnosis was established by computerized tomography and the treatment was conservative, with delayed surgery for the hiatal hernia.


Subject(s)
Humans , Pancreatitis, Acute Necrotizing , Hernia, Hiatal , Pancreas , Pancreatectomy , Pancreatitis , General Surgery
16.
Rev. colomb. gastroenterol ; 36(4): 480-484, oct.-dic. 2021. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1360972

ABSTRACT

Resumen Se presentan 6 pacientes con disrupción ductal del páncreas (DDP) tratados mediante drenaje percutáneo guiado por imágenes con apoyo de la endoscopia. Inicialmente, los pacientes presentaron necrosis pancreática infectada tratada con drenaje percutáneo transgástrico y luego de resolver la infección desarrollaron DDP. En el estudio por imágenes se diagnosticaron 4 pacientes con disrupción ductal parcial y 2 con disrupción total, a quienes se les indicó la colocación de una prótesis transgástrica percutánea para lograr el drenaje del líquido pancreático hacia el estómago. La duración promedio de la prótesis fue de 183 días; no hubo casos de mortalidad. Se pudo evidenciar que esta opción terapéutica mínimamente invasiva tiene baja morbimortalidad, por lo que se plantea el abordaje percutáneo transgástrico apoyado por la endoscopia como posible tratamiento de la DDP.


Abstract A total of six patients with pancreatic ductal disruption (PDD), treated with image-guided endoscopy percutaneous drainage were enrolled. Initially, patients had infected pancreatic necrosis, treated with transgastric percutaneous drainage, and after the infection was controlled, they developed PDD. In the imaging study process, four patients were diagnosed with partial duct disruption and two patients with complete duct disruption. In both cases the placement of a percutaneous transgastric prosthesis to drain the pancreatic fluids to the stomach was indicated. The prosthesis remained 183 days on average and there were no mortality cases. This therapeutic minimally invasive alternative has low rates of morbimortality and thus, the endoscopy percutaneous transgastric approach is considered as a viable treatment in PPD.

17.
Rev. colomb. gastroenterol ; 36(4): 514-518, oct.-dic. 2021. graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1360977

ABSTRACT

Resumen La necrosis en la pancreatitis aguda muestra una mortalidad muy alta a pesar de los avances en cuidados críticos. Después de la etiología biliar y alcohólica, la tercera causa más común de pancreatitis es la idiopática, con un 10 % de los casos secundarios a parásitos, y el áscaris es el parásito más común implicado en la necrosis e inflamación del páncreas. Teniendo en cuenta la alta mortalidad que representa la pancreatitis necrotizante, se describe un reporte de caso por ascariasis, destacando su creciente epidemiología, sus causas, su diagnóstico clínico e imagenológico, y su tratamiento antiparasitario según la evidencia actual.


Abstract Necrosis in acute pancreatitis presents a high mortality rate despite advances in critical care. After biliary and alcoholic etiology, the third most common cause of pancreatitis is idiopathic etiology, with 10% of cases related to parasites, being Ascaris the most common parasite involved in pancreas necrosis and inflammation. Considering the high rates of mortality related to necrotizing pancreatitis, a case of ascariasis is analyzed, including its growing epidemiology, its causes, its clinical and imaging diagnosis, and its antiparasitic treatment based on current evidence.

18.
Rev. méd. Maule ; 36(2): 60-68, dic. 2021.
Article in Spanish | LILACS | ID: biblio-1378505

ABSTRACT

Immunoglobulin G4 (IgG4-RD) -related disease is a regional or systemic fibroinflammatory disease of unknown etiology. It has a characteristic histopathological appearance of dense lymphoplasmacytic infiltrates with abundant IgG4 positive plasma cells, storiform fibrosis and obliterative phlebitis with the appearance of inflammatory swelling or swollen lesions. This entity frequently affects the pancreas, salivary glands, and lymph nodes, but it can compromise almost any structure in the human anatomy. This new disease entity includes a wide variety of diseases such as Mikulicz disease, autoimmune pancreatitis, Riedel's thyroiditis, interstitial nephritis, and retroperitoneal fibrosis. Glucocorticoid therapy can resolve clinical and pathologic abnormalities and impaired organ function. IgG4-RD was internationally recognized in 2011, and new evidence has accumulated on its pathogenesis, clinical characteristics, and treatment. However, much is still unknown about the behavior of IgG4 in vivo, the participation of this molecule in disease, and whether its role in IgG4-related disease is primary or secondary. The text below is based on a brief review of the most recent literature on this entity in relation to a clinical case.


Subject(s)
Humans , Male , Aged , Autoimmune Diseases/immunology , Immunoglobulin G4-Related Disease/diagnosis , Immunoglobulin G4-Related Disease/therapy , Autoimmune Diseases/pathology , Aftercare , Immunoglobulin G4-Related Disease , Immunoglobulin G4-Related Disease/physiopathology , Immunoglobulin G4-Related Disease/epidemiology , Autoimmune Pancreatitis , Mikulicz' Disease
19.
Rev. Fed. Centroam. Ginecol. Obstet. ; 25(2): 15-19, oct 2021.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1373595

ABSTRACT

La pancreatitis aguda es una causa rara de dolor abdominal durante el embarazo, puede ser potencialmente mortal para la madre y el feto. Se presenta con mayor frecuencia durante el tercer trimestre debido a un aumento progresivo de los triglicéridos y el colesterol como cambios fisiológicos del embarazo. Sin embargo, estos niveles no logran sobrepasar los 300 mg/dL; pacientes con niveles de triglicéridos por encima de 1000 mg/dL están en riesgo incrementado de desarrollar pancreatitis severa. Los criterios diagnósticos y protocolos de manejo no son específicos para esta patología durante el embarazo. El Tratamiento con aféresis puede ser usado como manejo primario durante el embarazo logrando una disminución rápida y segura de los niveles plasmáticos de triglicéridos. (provisto por Infomedic International)


Acute pancreatitis is a rare cause of abdominal pain during pregnancy, it can be life threatening for the mother and fetus. It occurs more frequently during the third trimester due to a progressive increase in triglycerides and cholesterol as physiological changes in pregnancy. However, these levels do not exceed 300 mg / dL; patients with triglyceride levels above 1000 mg / dL are at increased risk of developing severe pancreatitis. The diagnostic criteria and management protocols are not specific for this pathology during pregnancy. Treatment with apheresis can be used as primary management during pregnancy, achieving a rapid and safe decrease in plasma triglyceride levels. (provided by Infomedic International)

20.
Arq. gastroenterol ; 58(3): 402-404, July-Sept. 2021. tab
Article in English | LILACS | ID: biblio-1345303

ABSTRACT

ABSTRACT BACKGROUND: There is controversy about the initiation of gastric or oral feeding in patients with severe acute pancreatitis (SAP) because they could increase pancreatic stimulation and exacerbate symptoms and complications. OBJECTIVE: To describe the clinical characteristics and results of patients with SAP who underwent gastric tube or oral feeding versus parenteral or jejunal feeding. METHODS: A retrospective study was carried out on patients over 18 years old with SAP diagnostic, who had been treated in critical care units. We excluded patients coming from other hospitals and those with incomplete medical records. RESULTS: Thirty patients with SAP were included, fifty three percent of them tolerated the gastric tube or oral feeding, and most of them were females and older than patients who received parenteral or jejunal feeding. Other clinical characteristics and outcomes were similar in both groups. Conclusion: Gastric tube or oral feeding is no absolute contraindication for SAP.


RESUMO CONTEXTO Há controvérsias sobre o início da alimentação gástrica ou oral em pacientes com pancreatite aguda grave (PAG), pois elas podem aumentar a estimulação pancreática e exacerbar os sintomas e complicações. OBJETIVO Descrever as características clínicas e os resultados de pacientes com PAG submetidos à alimentação por sonda gástrica ou via oral versus alimentação parenteral ou jejunal. MÉTODOS Foi realizado um estudo retrospectivo em pacientes maiores de 18 anos com diagnóstico de PAG, atendidos em unidades de terapia intensiva. Excluímos pacientes procedentes de outros hospitais e aqueles com prontuário incompleto. RESULTADOS Trinta pacientes com PAG foram incluídos, 53% deles toleravam a sonda gástrica ou alimentação via oral, e a maioria era do sexo feminino e tinha mais idade do que os pacientes que receberam alimentação parenteral ou jejunal. Outras características clínicas e resultados foram semelhantes em ambos os grupos. CONCLUSÃO A sonda gástrica ou alimentação oral não é contra-indicação absoluta para PAG.


Subject(s)
Humans , Female , Adolescent , Pancreatitis/complications , Acute Disease , Retrospective Studies , Enteral Nutrition , Parenteral Nutrition
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