Total pancreatic necrosis after organophosphate intoxication / 医学前沿

Cases of acute pancreatitis induced by organophosphate intoxication are encountered occasionally in clinics, but very few of them develop into severe pancreas necrosis and irreversible pancreatic function impairment. Here, we report a 47-year-old female organophosphate poisoning case after ingestion of massive insecticides; she was considered to have total necrosis and function failure of the pancreas via serum amylase test, glucose level test, and CT imaging. The patient exhibited no relief under the regular medicine treatment, which included sandostatin, antibiotics, intravenous atropine, and pralidoxime methiodide. She received percutaneous catheterization and drainage of pancreatic zone to expel hazardous necrotic waste, also by which the pathogenic evidence was obtained and the antibiotics were adjusted subsequently. The patient recovered gradually, was discharged after 2 weeks, and was prescribed with oral pancreatin capsules before meals and hypodermic insulin at meals and bedtime to compensate the impaired pancreatic function.

Management of Cervical Chylous Fistula Following Neck Dissection in Thyroid Cancer Patients / 대한내분비외과학회지

PURPOSE: Cervical chylous fistula (CF) development is a rare complication after neck dissection in patients with thyroid carcinoma. However, CFs are potentially fatal if left untreated. The present study evaluated three CF management protocols in thyroid cancer patients who had undergone neck dissection. METHODS: A total of 22 CF cases developed in the 353 neck dissections performed in 309 thyroid cancer patients over a period of 2 years. The CF cases involved 6 males and 16 females with a median age of 43.3 years (range, 26-63). The patients weredivided into 3 groups for analysis based on treatment modalities: Group A (n=14), conservative treatment only; Group B (n=5), conservative treatment plus Sandostatin® administration (initially, there were 7 patients in this group, but 2 patients were converted to re-surgery) Group C (n=3), re-surgery due to high-output fistula (>500 ml/d), which in some cases did not respond to conservative treatment plus SandostatinⓇ. Each group was analyzed in terms of total drainage volume, duration of hospital stay and response to treatment. RESULTS: Eighteen CFs occurred in left neck dissection patients, and 4 in right neck patients. Chylous drainage was greater in left neck compared to right neck patients (P= 0.033). All right-sided fistulasclosed following conservative treatment only. The chyle drainage period was longer for Group A (7.6 days) than Group B (4.2 days) patients (P= 0.019), and the duration of hospital stay was longer for Group A than Group B patients (P=0.026). In Group C, re-surgery to close the fistula resulted in termination of chyle flow in all cases. The only complication was wound infection in 1 case (4.6 %). There were no recurrences of CFs in any group. CONCLUSION: The majority of CF cases can be successfully controlled using conservative treatment only. The additional use of Sandostatin® can reduce the duration of CF drainage and lead to earlier CF closure. However, in case where fistula output exceeds 500 ml/d, early re-surgery should be considered.

Estimation of the effects of local drug injection on the benign thyroid tumour / 中国实用内科杂志

0.05)in sex,age and volume of lesions.Over a course of treatment the average volume of thyroid adenomas of each group significantly(P

Endoscopic injection hemostasis and sequential application of sandostatin in treatment of Dieulafoy's lesion / 中华消化杂志

Objective To evaluate the efficacy of endoscopic injection hemostasis and sequential application of sandostatin in treatment of Dieulafoy's lesion. Methods After diagnosis of Dieulafoy's lesion confirmed, endoscopic injection hemostasis(EIH) together with mixture hypertonic saline and epinephrine(HSE) was performed, and then sandostatin was given consecutively for 7 days. The control group included the patients who were not given sandostatin or given just for 1 to 2 days. Results The rates of recurrent bleeding and transfer into surgery in sandostatin group were significantly lower than those in control group,(12.5% and 6.3% versus 53.8% and 46.2% respectively, P

Clinical study on the treatment of severe acute pancreatitis with combination of sandostatin and growth hormone / 中国普通外科杂志

Objective To evaluate the therapeutic effect of combination of sandostatin and growth hormone (GH) in the treatment of severe acute pancreatitis (SAP ). Methods Sixty patients with SAP were divided randomly into 3 groups:(1)Sandostatin treatment(ST) group (n=15);(2)combination of sandostatin with GH treatment(CT) group (n=30) ;(3)control group (n=15). The changes in serum IL-1, IL-6,TNF-? and albumin levels after treatment, and the incidence of complications, the duration of hospital stay and cost were compared among the 3 groups. Results The complications, mortality, duration of hospital stay in the CT group were significantly shorter than those in ST group and control group (all P