1/38. Perforated duodenal diverticulum: report of two cases.Duodenal diverticula may be complicated by diverticulitis, perforation, hemorrhage, pancreatitis, or biliary obstruction. Two cases of perforated duodenal diverticulum are reported. Both patients were elderly females. Computed tomography of the abdomen showed retroperitoneal air around the duodenum in the first case, and an enterolith in a duodenal diverticulum and a retroperitoneal abscess in the second case. laparotomy and diverticulectomy with two-layer closure of the duodenum was performed in the first case. The second patient was treated conservatively with antibiotics, percutaneous abscess drainage, and endoscopic lithotomy. Both recovered well. Computed tomography is useful in the diagnosis of a perforated duodenal diverticulum. Although surgical intervention is the standard treatment, conservative therapy is also an option. Duodenal enteroliths are rare but may cause perforation of a diverticulum or biliary obstruction. The duodenal blind loop created by a Billroth II gastrectomy provides a static environment for the formation of enteroliths in duodenal diverticula.- - - - - - - - - - ranking = 1keywords = pancreatitis (Clic here for more details about this article) |
2/38. Percutaneous and endoscopic management of bile leak following endoscopic stone retrieval--a case report.Endoscopic sphincterotomy with stone removal is the method of choice for the treatment of choledocholithiasis. The main complications of this procedure are bleeding, pancreatitis, intestinal perforation and cholangitis. Herein, we report on a case of bile peritonitis in a patient who underwent sphincterotomy and stone retrieval. The literature regarding the etiology and management of bile peritonitis is also reviewed.- - - - - - - - - - ranking = 1keywords = pancreatitis (Clic here for more details about this article) |
3/38. Hydatid liver disease as a cause of recurrent pancreatitis.Intrabiliary rupture of a hydatid liver cyst is infrequently reported, but may present with symptoms of choledocholethiasis or cholangitis. We report a case of hydatid liver disease presenting as recurrent pancreatitis, and discuss its clinical, radiological and surgical treatments. Hydatid liver disease has a diverse clinical spectrum, and a diagnosis of acute pancreatitis should be considered in patients with hydatid liver disease presenting with unexplained abdominal pain.- - - - - - - - - - ranking = 6keywords = pancreatitis (Clic here for more details about this article) |
4/38. pancreatitis caused by common bile duct stones in a 3-year-old boy with prior surgery for a choledochal cyst.pancreatitis in children is uncommon. Compared to adults, pancreatitis in children is usually related to trauma, anatomic anomalies, infections, hereditary, and systemic disease, but not gallstones or alcohol. Most cases do not require endoscopic intervention. We report an unusual case of recurrent pancreatitis in a child related to common bile duct stones requiring endoscopic treatments after surgical treatment for choledochal cyst.- - - - - - - - - - ranking = 2keywords = pancreatitis (Clic here for more details about this article) |
5/38. Recurrent pancreatitis as a late complication of endoscopic sphincterotomy for common bile duct stones: diagnosis and therapy.Although long-term complications of endoscopic sphincterotomy (ES) have often been reported, the possible effects of the procedure on the pancreatic duct orifice remain virtually unknown. Three women patients are described who developed attacks of recurrent pancreatitis at 2, 7, and 27 months after ES for bile duct stones. The attacks were apparently caused by a partial stenosis of the pancreatic orifice, arising from post-procedure fibrosis and scarring. The patients were evaluated and treated endoscopically. All three patients benefited from endoscopic therapy; two became symptom-free and one improved. Symptoms recurred in the three patients, after 26, 41, and 23 months. In one patient, re-stenosis was documented and repeat sphincterotomy resulted in complete relief of symptoms during the ensuing 5 months. In the remaining two patients, the symptoms were mild and no further intervention was needed. Concerning complications, one patient suffered a moderately severe pancreatitis without sequelae. Recurrent pancreatitis may emerge as a late complication after ES for common bile duct stones. It is probably causally related to stenosis of the pancreatic orifice brought about by fibrosis and scarring, which may exceptionally develop after the procedure. Endoscopic therapy should probably be considered in the first instance, but the optimal treatment for this condition remains to be determined.- - - - - - - - - - ranking = 7keywords = pancreatitis (Clic here for more details about this article) |
6/38. Spontaneous flow of bile through the human pancreatic duct in the absence of pancreatitis: nature's human experiment.One hundred years ago E. L. Opie proposed two distinct hypotheses to address the pathogenesis of gallstone-induced pancreatitis. These hypotheses appear mutually exclusive. The first predicts that impediment to the flow of pancreatic juice causes pancreatitis (the pancreatic duct obstruction hypothesis), whereas the second predicts that bile flow into the pancreatic duct behind an impacted gallstone would trigger the onset of acute pancreatitis (the common-channel hypothesis). One of the more convincing arguments against the latter hypothesis is the observation that bile, when experimentally perfused through the pancreatic duct of dogs, does not induce pancreatitis. This experimental situation had spontaneously developed in the patient we describe here: a biliopancreatic fistula had permitted the continuous flow of bile through a large portion of the pancreas, which was associated with cholangitis but had apparently never led to pancreatitis. This patient's case would suggest that in humans, just as in experimental animals, bile flow through the pancreatic duct is not necessarily involved in the onset of gallstone-induced pancreatitis and lends further support to Opie's pancreatic duct obstruction hypothesis.- - - - - - - - - - ranking = 10keywords = pancreatitis (Clic here for more details about this article) |
7/38. Gallstone disease and its complications.Gallstone disease is one of the most common disorders of the gastrointestinal tract, and more cholecystectomies are performed each year in the united states than any other elective abdominal operation. As such, clinicians need a fundamental knowledge of gallstone disease and the common complications that are associated with this disease. overall, the prevalence of gallstones in the united states is approximately 10% to 15%, of which, approximately 80% are without symptoms. Symptoms will occur in approximately 20% of those with gallstones, and this subgroup is at the highest risk for developing serious complications from their gallstone disease. These complications can range from simple recurrent biliary colic to severe, life-threatening ascending cholangitis and/or pancreatitis. This review will outline the basis for gallstone formation, the underlying mechanisms that result in gallstone-induced symptoms and a rational approach to individuals who present with symptoms consistent with gallstone disease. Current diagnostic and treatment modalities will be discussed, with a particular emphasis on acute cholecystitis and acute biliary pancreatitis.- - - - - - - - - - ranking = 2keywords = pancreatitis (Clic here for more details about this article) |
8/38. Recurrent asystolic cardiac arrest and laparoscopic cholecystectomy: a case report and review of the literature.Laparoscopic surgery has become a durable alternative for both gynecologic and general surgical procedures, but reported complications are increasing. We describe the case of a 70-year-old male undergoing routine laparoscopic cholecystectomy for gallstone pancreatitis who developed asystolic cardiac arrest intraoperatively. A review of the literature revealed 2 cases of asystolic cardiac arrest during laparoscopy: one was during laparoscopic cholecystectomy and one was during diagnostic laparoscopy for gynecologic evaluation.- - - - - - - - - - ranking = 1keywords = pancreatitis (Clic here for more details about this article) |
9/38. Stones in a long pancreaticobiliary common channel: a rare cause of obstructive jaundice and pancreatitis.A case of obstructive jaundice associated with acute pancreatitis is reported. The underlying cause was a dilated long pancreaticobiliary common channel impacted with stones and bile debris. There was no stone in the rest of the biliary system except for one in the lowest part of the common bile duct and the overall appearance of the stones suggested that they originated within the common channel itself. A long common channel may be an underlying cause of various pathological conditions in the pancreaticobiliary system. Early operative intervention is recommended when such a diagnosis is made.- - - - - - - - - - ranking = 5keywords = pancreatitis (Clic here for more details about this article) |
10/38. Ultrasound in emergency patients: better detection of free intraabdominal fluids by the use of tissue harmonic imaging.BACKGROUND: Ultrasound examination is one of the main investigative procedures in emergency patients who are hospitalized due to abdominal pain. Detectable free fluid collections are important hints to the definite, sometimes life-threatening diagnosis, but their detection in cases of only small amounts is difficult to perform by conventional sonography. patients AND methods: We report about 25 cases of patients who suffered from acute abdominal pain and who were presented as emergency patients to our department of ultrasound. First, the examination was performed by conventional sonography (3.4 MHz). Only with the additional tissue harmonic imaging (THI, 2.3 MHz, pulse inversion) thin borders of free fluids around the liver or other abdominal organs (gallbladder, spleen, pancreas, bowel) could be detected leading to other important diagnostic or therapeutic steps. In this way, the diagnosis of pancreatitis, cholezystitis, peritonitis, peritoneal carcinosis, ascites (liver cirrhosis, serositis, postoperative status after laparotomy), bleeding or paralytic ileus could be elucidated. CONCLUSION: THI sonography improves the detection of small amounts of free abdominal fluid collections. Therefore, this technique is helpful in the diagnostic procedure of emergency patients.- - - - - - - - - - ranking = 1keywords = pancreatitis (Clic here for more details about this article) |
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