ABSTRACT
Two series of patients treated for primary hyperparathyroidism are reviewed for the incidence of associated pancreatitis. In an earlier series of 150 hyperparathyroid patients, six had documented pancreatitis as one of the primary clinical manifestations. Review of a more recent series failed to uncover a single case of pancreatitis in 26 patients with primary hyperparathyroidism. The incidence of pancreatitis associated with hyperparathyroidism appears to be steadily decreasing, possibly reflecting the earlier diagnosis of parathyroid disease, which is due to widespread screening testing methods currently available.
Subject(s)
Hyperparathyroidism/complications , Pancreatitis/complications , Adult , Aged , Female , Humans , Hyperparathyroidism/surgery , Male , Middle AgedABSTRACT
Preoperative and postoperative carcinoembryonic antigen (CEA) levels were evaluated in 42 patients with colorectal carcinoma. Preoperative CEA values correlated inversely with survival at a statistically significant level and provided prognostic information not available by pathologic staging. Postoperative plasma CEA can accurately predict recurrent disease and may, when serial values are elevated, serve as an indication for a second-look procedure.
Subject(s)
Carcinoembryonic Antigen/analysis , Colonic Neoplasms/diagnosis , Rectal Neoplasms/diagnosis , Colonic Neoplasms/surgery , Humans , Neoplasm Recurrence, Local/diagnosis , Prognosis , Rectal Neoplasms/surgery , Time FactorsSubject(s)
Intubation, Gastrointestinal/adverse effects , Intussusception/etiology , Adolescent , Aged , Female , Humans , Male , Middle AgedABSTRACT
A systematic approach to the management of patients with pancreatic abscess is presented. The method includes an aggressive diagnostic approach relying on radiographic and ultrasound examinations, adequate transperitoneal drainage of the abscess, coupled with gastrostomy and feeding jejunostomy. The importance of nutritional support using an elemental diet administered through a jejunostomy is emphasized.
Subject(s)
Abscess/therapy , Pancreatic Diseases/therapy , Abscess/diagnosis , Abscess/surgery , Adult , Drainage , Female , Gastrostomy , Humans , Jejunum/surgery , Male , Middle Aged , Pancreatic Diseases/diagnosis , Pancreatic Diseases/surgery , Parenteral Nutrition , RecurrenceABSTRACT
Azathioprine therapy in a patient with granulomatous ileocolitis was associated with an attack of acute pancreatitis, which was confirmed by laparotomy. Recurrence of pancreatitis occurred after rechallenge with a single dose of azathioprine.
Subject(s)
Azathioprine/adverse effects , Pancreatitis/chemically induced , Acute Disease , Adult , Azathioprine/therapeutic use , Crohn Disease/drug therapy , Granuloma/drug therapy , Humans , MaleABSTRACT
A patient with a persistent external pancreatic fistula was studied by endoscopic cholangiopancreatography (ERCP). The ERCP demonstrated the probable site of the fistula and a high-grade, main pancreatic ductal stricture. This information prompted early, successful surgical correction of the pancreatic fistula by drainage into a Roux-en Y jejunal loop.
Subject(s)
Cholangiography/methods , Pancreatic Ducts/diagnostic imaging , Pancreatic Fistula/surgery , Abscess/surgery , Cholecystectomy , Female , Humans , Methods , Middle Aged , Pancreatic Cyst/surgery , Pancreatic Ducts/surgery , Pancreatic Fistula/diagnostic imaging , Postoperative Complications/diagnostic imaging , Postoperative Complications/surgeryABSTRACT
In a consecutive series of 118 total thyroidectomies during a period of 11 years, autotransplantation of one or more parathyroid glands was used in 64 patients. During the first nine years of this series, autotransplantation was used in only 25 per cent of the total thyroidectomies, with a 3 per cent incidence of permanent hypoparathyroidism. During the last two years, autotransplantation of the parathyroid was used in 89 per cent of 54 total thyroidectomies, with a zero incidence of hypoparathyroidism.
Subject(s)
Carcinoma/surgery , Parathyroid Glands/transplantation , Thyroid Neoplasms/surgery , Thyroidectomy , Adolescent , Adult , Aged , Female , Forearm , Humans , Hypoparathyroidism/etiology , Hypoparathyroidism/prevention & control , Male , Middle Aged , Muscles/surgery , Neck , Thyroidectomy/adverse effects , Transplantation, AutologousABSTRACT
Plasma carcinoembryonic antigen (CEA) levels were correlated with the stage of the tumor in 43 patients who underwent laparotomy for histologically proven pancreatic adenocarcinoma. Elevated CEA levels were noted in one third of the patients with tumors localized to the pancreas. When the carcinoma had extended beyond the pancreas or distant metastases were present, 78% of patients had elevated levels. Of the entire group of patients, 72% had elevated CEA levels.
Subject(s)
Adenocarcinoma/immunology , Carcinoembryonic Antigen/analysis , Pancreatic Neoplasms/immunology , Adenocarcinoma/pathology , Adenocarcinoma/surgery , Humans , Neoplasm Metastasis , Pancreatic Neoplasms/pathology , Pancreatic Neoplasms/surgeryABSTRACT
From a review of 800 patients with acute pancreatitis, eight having rare causation were selected. Definite obstruction of the common pancreatic duct was noted in four patients, and direct injury of the parenchyma, vascular lesions of pancreatic vessels and presumed autoimmune factors were responsible in the remaining four patients. Although the definitive treatment of nonobstructive pancreatitis remains controversial, surgical relief of obstruction of the pancreatic duct provides the most appropriate therapeutic approach for obstructive pancreatitis.
Subject(s)
Pancreatitis/etiology , Acute Disease , Adolescent , Adult , Aged , Ampulla of Vater , Biliary Tract Diseases/complications , Celiac Artery , Common Bile Duct , Drainage/adverse effects , Female , Humans , Hypercalcemia/complications , Intubation/adverse effects , Male , Middle Aged , Necrosis , Pancreatic Diseases/complications , Pancreatic Ducts , Pancreatic Neoplasms/complications , Thromboembolism/complications , Vascular Diseases/complicationsABSTRACT
This report illustrates many of the long term complicatio of syphilis involving the stomach. A 49-year-old woman with diffuse squamous metaplasia of the gastric mucosa developed invasive pure squamous cell carcinoma. The literature is reviewed and the probable pathophysiology is discussed.
Subject(s)
Adenocarcinoma, Scirrhous/complications , Carcinoma, Squamous Cell/etiology , Linitis Plastica/complications , Stomach Neoplasms/etiology , Syphilis, Latent/complications , Carcinoma, Squamous Cell/diagnosis , Female , Humans , Middle Aged , Stomach Neoplasms/complications , Stomach Neoplasms/diagnosisSubject(s)
Colon/surgery , Diverticulum, Colon/surgery , Adolescent , Adult , Diverticulum, Colon/diagnosis , Diverticulum, Colon/epidemiology , Female , Humans , Illinois , MaleABSTRACT
Comparison of a group of patients with acute alcoholic pancreatitis with a group with gallstone pancreatitis has established the serum amylase level on admission as one of the most useful laboratory tests in aiding to differentiate the two entities. A serum amylase level greater than 1,500 IU was most often due to gallstone pancreatitis, as was elevation of the serum bilirubin and alkaline phosphatase levels.
Subject(s)
Alcoholism/complications , Cholelithiasis/complications , Pancreatitis/diagnosis , Acute Disease , Adolescent , Adult , Aged , Alcoholism/blood , Alkaline Phosphatase/blood , Amylases/blood , Bilirubin/blood , Cholecystectomy , Cholecystography , Cholelithiasis/blood , Clinical Enzyme Tests , Diagnosis, Differential , Female , Humans , Male , Middle Aged , Pancreatitis/blood , Pancreatitis/surgery , RecurrenceABSTRACT
Recurrence of pancreatic ascites in a patient after two courses of peritoneal lavage suggested pancreatic ductal disruption as the etiolgy, and this was confirmed at operation. Peritoneal lavage in two other patients with pancreatic ascites without ductal disruption or cysts was associated with resolution ascites. The use of peritoneal lavage in patients with acute or chronic pancreatic ascites may guide the selection of those requiring early surgical treatment.
Subject(s)
Ascites/diagnosis , Pancreatitis/complications , Acute Disease , Adult , Amylases/analysis , Amylases/blood , Ascites/etiology , Ascites/therapy , Ascitic Fluid/analysis , Cholecystectomy , Chronic Disease , Female , Humans , Male , Middle Aged , Pancreatic Fistula/complications , Peritoneal Dialysis , RecurrenceABSTRACT
Significant upper gastrointestinal bleeding following operation was noted in 14 of 218 patients undergoing external biliary drainage. None of these patients sustained hepatic injury or needed hepatic resection. Three patients died from causes related to the upper gastrointestinal hemorrhage, and in 12 of the 14 patients the episode of hemorrhage occurred within three days of the biliary tract operation. The majority of the patients were febrile or septic at the time of the biliary operation. Biliary tract infection, when combined with external biliary drainage, may predipose to major upper gastrointestinal hemorrhage.
Subject(s)
Common Bile Duct/surgery , Drainage/adverse effects , Gastrointestinal Hemorrhage/etiology , Postoperative Complications/etiology , Adult , Biliary Tract Diseases/surgery , Cholecystectomy/adverse effects , Duodenal Ulcer/complications , Esophagitis/etiology , Female , Gastrointestinal Hemorrhage/therapy , Humans , Male , Peptic Ulcer Hemorrhage/etiology , Postoperative Complications/therapy , Sepsis/etiologyABSTRACT
In a review of the surgical management of 64 patients with gallstone pancreatitis, recurrence of pancreatitis requiring readmission was noted in 48 per cent of those who had correction of biliary tract disease delayed to a separate admission. When patients were operated upon during the recovery phase of the first admission for pancreatitis, the hospital stay was reduced, there were no deaths and the morbidity was not increased. None of these patients had a documented recurrence of pancreatitis.
