• Title/Summary/Keyword: acute pancreatitis

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A Rare Cause of Recurrent Acute Pancreatitis in a Child: Isovaleric Acidemia with Novel Mutation

  • Sag, Elif;Cebi, Alper Han;Kaya, Gulay;Karaguzel, Gulay;Cakir, Murat
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.20 no.1
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    • pp.61-64
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    • 2017
  • Recurrent acute pancreatic attacks is a rare clinical condition (2-5% of all acute pancreatis) in children and is mainly idiopathic in most cases. Sometimes it may be associated with congenital anomalies, metabolic diseases or hereditary conditions. Isovaleric acidemia (IVA) is a rare autosomal recessive amino acid metabolism disorder associated with isovaleryl coenzyme A dehydrogenase deficiency presenting the clinical findings such metabolic acidosis with increased anion gap, hyperammonemia, ketonemia, hypoglycemia, "the odor of sweaty feet," abdominal pain, vomiting, feeding intolerance, shock and coma. Recurrent acute pancreatitis associated with IVA have been rarely reported. Herein; we report a child who admitted with recurrent acute pancreatic attacks and had the final diagnosis of IVA. Mutation analysis revealed a novel homozygous mutation of (p.E117K [c.349G>A]) in the IVA gene. Organic acidemias must kept in mind in the differential diagnosis of recurrent acute pancreatic attacks in children.

Study of Efficacy of Foeniculi Fructus and Lonicerae Flos Extract on Acute Pancreatitis (소회향과 금은화 추출물의 급성췌장염에 대한 예방효과)

  • Joo, Jeoung-Sek;Kim, Jeong-Sang;Jeong, Jong-Gil;Kim, Bong-Kyoo
    • The Korea Journal of Herbology
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    • v.25 no.4
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    • pp.39-45
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    • 2010
  • Objectives : This study was undertaken to compare the effect of Foeniculi Fructus and Lonicerae Flos extract on the cerulein-induced acute pancreatitis in rats. Methods : Acute pancreatitis was induced by intraperitoneal injection of cerulein. Foeniculi Fructus extract (FE; 300 mg/kg) and Lonicerae Flos extract (LE; 300 mg/kg) were injected 2hr before induction of acute pancreatitis. Rats were sacrificed 6hr after first injection of cerulein. The severity of pancreatitis was assessed by measuring pancreatic weight/body weight ratio, neutrophil, lymphocyte, serum amylase activity, platelet activating factor (PAF) activity, tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$) activity, interleukin 6 (IL-6) activity and by histological assessments of inflammatory cell infiltration. Results : 1. The pancreatic weight/body weight ratios of FE and LE group compared with the control group were decreased significantly. 2. The neutrophil content ratio of FE and LE group compared with the control group were decreased. 3. The lymphocyte content ratio of FE and LE group compared with the control group were increased significantly. 4. The activities of serum amylase of FE and LE group compared with the control group were decreased significantly. 5. The activities of serum PAF of FE and LE group compared with the control group were decreased significantly. 6. The activities of TNF-${\alpha}$ of FE and LE group compared with the control group were decreased significantly. 7. The activities of IL-6 of FE and LE group compared with the control group were decreased significantly. 8. The pancreas injected with FE and LE showed reduction of swelling of acinar cells, inflammation and vacuolization than the control group on light microscopic observation. Conclusions : These results suggest that Foeniculi Fructus and Lonicerae Flos extract have an effect to suppress inflammation on cerulein-induced acute pancreatitis in rats. But there are no significant differences between Foeniculi Fructus extract and Lonicerae Flos extract.

Use of the Color Doppler Ultrasonography for the Evaluation of the Hemodynamic Changes of the Cranial Pancreaticoduodenal Arterial Flow in Experimentally Induced Acute Pancreatitis Dogs (실험적으로 유발된 급성 췌장염 견에서 컬러도플러 초음파를 이용한 전방 십이지장 동맥 혈류의 혈역학적 변화에 대한 평가)

  • Lee, Hae-Woon;Um, Ki-Dong;Sung, Yoon-Sang;Lee, Jung-Min;Lee, Jong-Won;Lee, Geun-Woo;Kim, Myung-Chul;Kim, Doo;Park, Sun-Il
    • Journal of Veterinary Clinics
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    • v.20 no.3
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    • pp.334-340
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    • 2003
  • For the study of the hemodynamic changes of the cranial pancreaticoduodenal arterial flow(cPDAF) in the dog with acute pancreatitis, acute pancreatitis was experimentally induced in 10 dogs by the injection of oleic acid into the accessory pancreatic duct. The parameters of cPDAF were measured by transcutaneous pulsed-wave Doppler ultrasonography. The hemodynamic changes included resistive indexe(RI), pulsatility index(PI) and maximum velocity (Vmax). Ultrasonographic scans were performed before the induction of pancreatitis and once daily for five days after the induction. The RI, PI and Vmax were increased with day as follows; the RI prior to induction was 0.625$\pm$0.096 (mean$\pm$SD), the PI was 1.117$\pm$0.289 and the Vmax was 0.349$\pm$0.094 m/s. After five days, the RI was 0.727$\pm$0.051 (p<0.0l), the PI was 1.480$\pm$0.284 (p<0.0l) and the Vmax was 0.585:$\pm$0.114 m/s (p<0.00l). These results show that there is some relation between the increase of the RI, PI and Vmax of cPDAF and the progress of acute pancreatitis in dogs. Therefore, the measurements of the hemodynamic changes of cPDAF may be a valuable technique for the evaluation of acute pancreatitis in dogs.

Colonic Complication of Acute Necrotizing Pancreatitis - a Case Report - (급성 괴사성 췌장염에서 발생한 결장 합병증 -1 예 보고-)

  • Sohn, Bo-Sung;Jung, Jae-Hee;Song, Young-Tack
    • Advances in pediatric surgery
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    • v.9 no.2
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    • pp.113-116
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    • 2003
  • We present a case of a colonic involvement associated with necrotizing pancreatitis, with a review of the literature. A 10 year old boy had an appendectomy at the local clinic ten days ago. On admission, he complained nausea, vomiting and severe constipation. His abdomen was distended and he had tenderness on the left abdomen. Laboratory and radiologic studies revealed findings consistent with acute pancreatitis with colonic complication. He was treated conservatively for 30 days but did not improve. On hospital 30th day, abdominal pain developed and his vital sign changed. Abdominal CT suggested ischemic change of the transverse colon. At laparotomy, the left colon showed stenosis. The greatly distended transverse colon was resected and a transverse end colostomy was done. He was discharged at postoperative 45th day with improvement and colostomy closure was performed 8 months later.

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Recurrent Acute Pancreatitis Associated with Sphincter of Oddi Dysfunction in a Child (오디 괄약근 기능 이상으로 인한 소아의 재발 급성 췌장염 1예)

  • Choi, Byung-Ho;Park, Sun-Min;Kim, Ho-Gak;Kim, Jung-Mi;Hong, Suk-Jin;Kim, Jung-Ok;Cho, Min-Hyun;Choe, Byung-Ho
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.11 no.2
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    • pp.193-197
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    • 2008
  • Recent studies suggest that sphincter of Oddi dysfunction (SOD) is one of the possible causes of unexplained recurrent acute pancreatitis in children. A 14-year-old boy who had suffered from idiopathic recurrent acute pancreatitis was diagnosed with SOD. Abdominal ultrasonography, computerized tomography, and magnetic resonance cholangiopancreatography revealed no evidence of stone, tumor, or pancreatic ductal anomaly. Endoscopic retrograde cholangiopancreatography (ERCP) and sphincter of Oddi manometry (SOM) revealed elevated basal pressure and tachyoddia consistent with SOD. Hence, an endoscopic pancreatic sphincterotomy was performed. We report a case of recurrent acute pancreatitis associated with SOD in a child. ERCP and SOM may be considered in patients with multiple unexplained attacks of pancreatic pain and negative abdominal imaging.

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Effects of Gami-Daehwangmokdanpi-Tang against CCK-induced acute pancreatitis (CCK로 유발시킨 급성 췌장염에 대한 가미대황목단피탕의 효과)

  • Park, Sung-Joo;Jeong, Jong-Gil;Seo, Sang-Wan;Hwang, Sang-Wook;Kim, Yong-Woo;Song, Dal-Soo;Chae, Young-Seok;Shin, Min-Kyo;Song, Ho-Joon
    • The Korea Journal of Herbology
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    • v.20 no.3
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    • pp.59-65
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    • 2005
  • Objective : Daehwangmokdanpi-Tang (DWT) has been frequently used as a remedy for antiinflamation. To evaluate effect of acute pancreatitis by DWT, we examined the effects of DWT on the cholecystokinin-octapeptide (CCK)-induced acute pancreatitis (AP) in rats. Methods : Male Wistar rats weighing 200 to 250 g were divided into three groups. Normal untreated group, in treatment with DWT group; DWT was administered orally, followed by $75\;{\mu}g/kg$ CCK subcutaneously three times, after 1, 3 and 5 h. This whole procedure was repeated for 5 days. In treatment with saline group, the protocol was the same as in treatment group with DWT. Results : The author determined the pancreatic weight/body weight ratio, the levels of pancreatic HSP (heat shock protein)60 and HSP72 and the secretion of pro-inflammatory cytokines. Repeated CCK treatment resulted in the typical laboratory and morphological changes of experimentally induced pancreatitis. DWT was significantly decreased the pancreatic weight/body weight ratio in CCK-induced AP. Futhermore, The author demonstrated that DWT increased HSP60 and HSP72 compared with CCK-induced AP. Additionally, the secretion of $IL-1{\beta}\;and\;TNF-{\alpha}$ and the levels of amylase and lipase were lower than that saline. Conclusions : These results suggested that DWT may has a protective effect against CCK-induced AP.

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Association Between Pancreatitis and Subsequent Risk of Pancreatic Cancer: a Systematic Review of Epidemiological Studies

  • Tong, Gui-Xian;Geng, Qing-Qing;Chai, Jing;Cheng, Jing;Chen, Peng-Lai;Liang, Han;Shen, Xing-Rong;Wang, De-Bin
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.12
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    • pp.5029-5034
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    • 2014
  • This study aimed to summarize published epidemiological evidence for the relationship between pancreatitis and subsequent risk of pancreatic cancer (PC). We searched Medline and Embase for epidemiological studies published by February $5^{th}$, 2014 examining the risk of PC in pancreatitis patients using highly inclusive algorithms. Information about first author, year of publication, country of study, recruitment period, type of pancreatitis, study design, sample size, source of controls and attained age of subjects were extracted by two researchers and Stata 11.0 was used to perform the statistical analyses and examine publication bias. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated with the random effects model. A total of 17 articles documenting 3 cohort and 14 case-control studies containing 14,667 PC cases and 17,587 pancreatitis cases were included in this study. The pooled OR between pancreatitis and PC risk was 7.05 (95%CI: 6.42-7.75). Howeever, the pooled ORs of case-control and cohort studies were 4.62 (95%CI: 4.08-5.22) and 16.3 (95%CI: 14.3-18.6) respectively. The risk of PC was the highest in patients with chronic pancreatitis (pooled OR=10.35; 95%CI: 9.13-11.75), followed by unspecified type of pancreatitis (pooled OR=6.41; 95%CI: 4.93-8.34), both acute and chronic pancreatitis (pooled OR=6.13; 95%CI: 5.00-7.52), and acute pancreatitis (pooled OR=2.12; 95%CI: 1.59-2.83). The pooled OR of PC in pancreatitis cases diagnosed within 1 year was the highest (pooled OR=23.3; 95%CI: 14.0-38.9); and the risk in subjects diagnosed with pancreatitis for no less than 2, 5 and 10 years were 3.03 (95%CI: 2.41-3.81), 2.82 (95%CI: 2.12-3.76) and 2.25 (95%CI: 1.59-3.19) respectively. Pancreatitis, especially chronic pancreatitis, was associated with a significantly increased risk of PC; and the risk decreased with increasing duration since diagnosis of pancreatitis.

A Case of Organophosphate Insecticide Intoxication by Repetitive Parenteral Exposure, Complicated with Intermediate Syndrome and Acute Pancreatitis (반복적인 비경구노출에 의한 유기인계 중독: 중간형증후군과 급성췌장염 1례)

  • Oh, Se-Hyun;Kang, Hui-Dong;Lee, Boo-Soo
    • Journal of The Korean Society of Clinical Toxicology
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    • v.4 no.2
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    • pp.161-165
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    • 2006
  • Organophosphate insecticides, commonly used in agriculture, are a gradually increasing cause of accidental and suicidal poisoning. Intoxication can occur by ingestion, inhalation or dermal contact. Exposure to organophosphorus agents causes a sequentially triphasic illness consisting of the cholinergic phase, the intermediate syndrome, and organophosphate-induced delayed polyneuropathy. Acute pancreatitis as a rare complication of organophosphate intoxication has also been infrequently observed. We report a case of intoxication with organophosphate (phos-phamidon) by parenteral exposure (inhalation and/or dermal contact). A 34-year-old male patient was transferred to our Emergency Medical Center and was intubated due to a progressive respiratory failure. He presented with meiotic pupils, cranial nerve palsies, weak respiration, and proximal limb motor weaknesses without sensory changes. He had been employed in filling syringes with phosphamidon during the previous month. Because the patient's history and symptoms suggested organophosphate intoxication with intermediate syndrome, he was mechanically ventilated for 18 days with continuous infusion of atropine and pralidoxime (total amounts of 159 mg and 216 g, respectively). During his admission, hyperamylasemia and hyperli-pasemia were detected, and his abdominal CT scan showed a finding compatible with acute pancreatitis. He was administered a conservative treatment with NPO and nasogastric drainage. The patient was discharged and showed neither gastrointestinal nor neurologic sequelae upon follow up at one week and three months.

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A Case of Isoniazid Induced Acute Pancreatitis (Isoniazid에 의해 유발된 급성 췌장염 1예)

  • Chung, Byung Ha;Nam, Hae Seong;Kwon, Jung Hyun;Im, So Hi;Park, Sun Hee;Kim, Jin Woo;Kim, Seung Joon;Lee, Sook Young;Kim, Young Kyoon;Park, Sung Hak
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.4
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    • pp.411-414
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    • 2004
  • Isoniazid is a first-line drug in the treatment of tuberculosis. A variety of adverse reactions of isoniazid have been reported. These include hepatitis, peripheral neuropathy, skin rashes, neurologic disturbances and hematologic alterations. Among these, acute pancreatitis due to isoniazid is very rare. We report a case of acute pancreatitis due to isoniazid confirmed by rechallenge test with review of some literatures.

A Case of Parathyroid Adenoma Presenting as Acute Pancreatitis Accompanied with Empty Sella (공터키안(Empty sella)을 동반한 급성췌장염으로 발현된 부갑상선 선종 1예)

  • Jun, Eon-Ju;O, Ji-He;Bae, Kyung-Ryun;Jang, Saet-Byul;Jun, Seung-Woon;Jung, Eui-Dal;Shon, Ho-Sang;Won, Kyu-Chang
    • Journal of Yeungnam Medical Science
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    • v.26 no.1
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    • pp.63-69
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    • 2009
  • The incidence of coexisting hyperparathyroidism and empty sella syndrome is rare and the etiology end incidence of their coexistence is not known. The association of hyperparathyroidism and the empty sella syndrome may be related to multiple endocrine neoplasia (MEN) syndrome due to a genetic disorder. We experienced a rare case of hyperparathyroidism presenting as acute pancreatitis combined with empty sella. We report here a 37-year old female who manifested epigastric pain because of acute pancreatitis. She had hypercalcemia due to parathyroid adenoma. A pituitary gland was not visible in the sella turcica on MRI scans. On genetic analysis, she did not show a mutation of the MENIN gene. Empty sella is thought to be a coincidental finding with hyperparathyroidism.

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