ABSTRACT
Between July 1987 and February 1990, 42 patients with pancreatic pseudocysts were treated. In 83% the pseudocyst was related to alcohol. Patients were managed by observation (7), surgical external drainage (7), and internal drainage (12). Fifteen patients were treated by ultrasound guided percutaneous catheter drainage (UGPCD) with apparent success in 67%. In 5 of these UGPCD was abandoned because of either prolonged drainage or infection of the pseudocyst. In patients with recurrent pseudocysts or in those with failed UGPCD, the cystic collections were successfully drained internally in 16 out of 17 patients (94%). Internal drainage appears to be acceptable treatment for mature pseudocysts, recurrent pseudocysts or for failed UGPCD, provided there is no downstream pancreatic duct obstruction or duct dilatation. If either exist, resection or direct ductal drainage will be required.
Subject(s)
Pancreatic Pseudocyst/therapy , Adult , Algorithms , Drainage/methods , Female , Humans , MaleABSTRACT
Pancreatitis was previously an unknown disease among black South Africans but has recently emerged as a common clinical problem. This has taken place pari passu with a change in the pattern of alcoholic consumption--Western-type spirits in addition to home-brews. Seventy patients with chronic alcoholic pancreatitis manifesting as clinically acute pancreatitis, and 90 patients with chronic calcific pancreatitis were studied. A high alcohol intake was associated with the pancreatitis in all cases. The prognosis in clinically acute pancreatitis was good, whereas chronic calcific pancreatitis has a high morbidity and mortality rate.
Subject(s)
Alcoholism/complications , Pancreatitis/etiology , Acute Disease , Adult , Black or African American , Aged , Black People , Chronic Disease , Female , Humans , Male , Middle Aged , South AfricaABSTRACT
Primary lymphoma of the small bowel resulting in pancreatic duct or biliary obstruction is rare. Only 1 case of pancreatic obstruction causing pancreatitis has previously been reported. A patient with primary small-bowel lymphoma of the 'Western' variety is described. This was associated with extensive duodenal involvement and obstruction of the pancreatic and biliary system accompanied by obstructive jaundice and pancreatitis.
Subject(s)
Cholestasis, Extrahepatic/etiology , Duodenal Neoplasms/complications , Lymphoma/complications , Pancreatitis/etiology , Constriction, Pathologic/etiology , Humans , Male , Middle Aged , Pancreatic Ducts/pathologyABSTRACT
Twenty (44%) of 45 patients with cutaneous pellagra had diarrhoea. Inflammation was seen on sigmoidoscopy in 42 and was severe in 5 (11%), moderate in 4 (9%) and mild in 33 (73%). Six patients (13%) had perianal excoriation. Rectal biopsies taken in all cases showed extensive ulceration in 1 case, moderate to severe inflammation in 16 (36%) and mild inflammation in 18 (40%). Minimal oedema of the lamina propria was seen in 11 (24%) patients. At 5 to 7 days after starting vitamin treatment in nine cases histological changes had returned to normal in 4, improved in 3 and had not changed in 2. Diarrhoea stopped within a week in all cases.
Subject(s)
Colonic Diseases/etiology , Pellagra/complications , Adult , Aged , Colitis/therapy , Colonic Diseases/pathology , Colonic Diseases/therapy , Diarrhea/therapy , Female , Humans , Male , Middle Aged , Pellagra/drug therapy , Skin Diseases/complications , Skin Diseases/pathology , Vitamins/therapeutic useABSTRACT
An unusual case of factitious hypoglycaemia is described. The distinction between exogenous and endogenous hyperinsulinism is illustrated.
