Microcristais biliares na pancreatite aguda idiopática: indicío para etiologia biliar oculta subjacente / Biliary microcrystals in idiopathic acute pancreatitis: cleu for occult underlying biliary etiology
Arq. gastroenterol
;
37(2): 93-101, abr.-jun. 2000. tab, ilus
Artigo
em Português
| LILACS
| ID: lil-279422
ABSTRACT
The main causes of pancreatic inflammation worldwide are biliary lithiasis and alcoholism. However, 10 to 30 per cent of patients have been considered to have "idiopathic" acute pancreatitis. Recently, some studies showed that a significant rate of the so called idiopathic pancreatitis are caused by microlithiasis and/or biliary sludge, identified by the presence of cholesterol monohidrate and/or calcium bilirubinate microcrystals in the biliary sediment. In the present study, the analysis of microcrystals from bile obtained during endoscopic retrograde cholangiopancreatography was done in patients with pancreatitis (idiopathic, biliary or alcoholic-20 in each group). Patients with idiopathic pancreatitis and microcrystals in the bile underwent cholecystectomy whenever possible. Those who refused or were inapt to surgery underwent endoscopic sphincterotomy or received continuous therapy with ursodeoxycholic acid. Patients with idiopathic pancreatitis without biliary crystals did not receive any specific treatment. The prevalence of biliary microcrystals in patients with idiopathic pancreatitis (75 per cent) and biliary pancreatitis (90 per cent) was significantly higher than in those with alcoholic pancreatitis (15 per cent). In the identification of the etiology of biliary pancreatitis, the presence of microcrystals had a sensitivity of 90 per cent, specificity of 85 per cent, positive predictive value of 85.7 per cent, negative predictive value of 89.4 per cent and accuracy of 87.5 per cent...
Texto completo:
DisponíveL
Índice:
LILACS (Américas)
Assunto principal:
Pancreatite
/
Tripanossomíase Africana
/
Cálculos Biliares
/
Doença Aguda
Tipo de estudo:
Estudo diagnóstico
/
Estudo de etiologia
/
Estudo observacional
/
Estudo prognóstico
/
Fatores de risco
Limite:
Adolescente
/
Adulto
/
Idoso
/
Feminino
/
Humanos
/
Masculino
Idioma:
Português
Revista:
Arq. gastroenterol
Assunto da revista:
Gastroenterologia
Ano de publicação:
2000
Tipo de documento:
Artigo
País de afiliação:
Brasil
Instituição/País de afiliação:
Universidade Federal de Juiz de Fora/BR
/
Universidade Federal de Säo Paulo/BR
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