Chronic pancreatitis

Gupte, Anand; Goede, Dianne; Tuite, Robert; Forsmark, Chris E.

doi:10.1136/bmj.k2126

Cited by 35 publications

(37 citation statements)

References 29 publications

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“…Chronic pancreatitis is a complex, multi etiological disease with various clinical presentations. The etiology of CP varies considerably due to differences in environmental exposure (alcohol and smoking) and genetic factors [4]. Most patients are treated with a diagnosis of alcoholic or idiopathic CP while the other causes also warrant consideration such as autoimmune diseases, cystic fibrosis, hypertriglyceridemia, congenital anomalies, pancreatic resection, and genetic defects.…”

Section: Discussionmentioning

confidence: 99%

Successful Embolization of Posterior Inferior Pancreaticoduodenal Artery Pseudoaneurysm on the Grounds of Chronic Pancreatitis—Case Report and Literature Review

Mitrović¹,

Dugalić

Kovač

et al. 2020

Medicina

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Pancreatic pseudoaneurysm is a rare but life-threatening clinical entity. In this paper, we present a case of a 74-year-old man, who was admitted to our clinic with a diagnosis of an acute on chronic pancreatitis complicated by walled-off-pancreatic-necrosis, with subsequent development of peripancreatic pseudoaneurysm. After initial conservative management, the patient recovered and was discharged from the hospital. However, he soon returned feeling anxious due to a pulsatile abdominal mass. Abdominal Color–Doppler examination, CT scan, and angiography revealed large pancreatic necrotic collection in the total size of 9 cm, with centrally enhancing area of 3.5 cm that corresponded to pseudoaneurysm originating from the posterior pancreaticoduodenal vascular arcade. Considering the size, location of the pseudoaneurysm, feeding vessel, and poor general patients condition, we opted for minimally invasive treatment. Pseudoaneurysm was successfully managed by endovascular coil embolization, i.e., “sandwich technique”.

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Section: Discussionmentioning

confidence: 99%

Successful Embolization of Posterior Inferior Pancreaticoduodenal Artery Pseudoaneurysm on the Grounds of Chronic Pancreatitis—Case Report and Literature Review

Mitrović¹,

Dugalić

Kovač

et al. 2020

Medicina

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“…The molecular mechanisms of CP are complex and diagnosis can be di culty in early phases of the disease [2]. Therefore, it is of great importance to understand the molecular mechanism of CP, as well as identify new targets to diagnose CP.…”

Section: Discussionmentioning

confidence: 99%

“…The diagnosis of CP can be di culty in early phases of disease. Here, pancreatic functions are preserved and tests of laboratory and imaging may only display minimally abnormal results [2]. Thus, a comprehensive understanding about the molecular mechanism underlying CP and the identi cation of novel targets to diagnose CP in early phase are necessary.…”

Section: Introductionmentioning

confidence: 99%

Identification of Potential Serum Exosomal microRNAs Involved in Acinar-Ductal Metaplasia That is A Precursor of Pancreatic Cancer Associated with Chronic Pancreatitis

Sheng

Han

Nie

et al. 2020

Preprint

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Backgrounds Due to difficulty in early diagnosis of chronic pancreatitis (CP), it is urgent to find novel biomarkers to detect CP. Exosomal microRNAs (Exo-miRNAs) located in the serum may be potential diagnostic and therapeutic targets for CP. In our study, we performed a bioinformatics analysis to identify differentially expressed Exo-miRNAs (DE-Exo-miRNAs) in the serum of CP patients. Methods The dataset GSE128508 was downloaded from the Gene Expression Omnibus (GEO) database. The analysis was carried out using BRB-ArrayTools and Significance Analysis of Microarrays (SAM). The target genes of DE-S-Exo-miRNAs were predicted by miRWalk databases. Further gene ontology (GO) term and Kyoto Encyclopedia of Genomes (KEGG) pathway analyses were performed with plug-in ClueGO in Cytoscape software 3.7.0. Subsequently, the interaction regulatory network between encoded proteins of target genes was performed with the Search Tool for the Retrieval of Interacting Genes (STRING) database and analyzed using plug-in MCODE and cytoHubba in Cytoscape software 3.7.0. Results We identified 227 DE-Exo-miRNAs in the serum. Further analysis using the miRWalk database identified 5164 target genes of these miRNAs. The protein-protein interaction (PPI) regulatory network of 1912 potential target genes for hub 10 up-regulated miRNAs with high degrees and one down-regulated miRNAs were constructed using the STRING database and Cytoscape software. The functional analysis using Cytoscape software tool highlighted that target genes involved in pancreatic cancer. Acinar-ductal metaplasia (ADM) in the inflammatory environment of CP is a precursor of pancreatic cancer. Subsequently, we constructed a network of target genes associated with ADM and their miRNAs. Conclusions Exo-miRNAs in the serum as well as their target genes may be promising targets for the early diagnosis and treatment of CP. In addition, we identified potential Exo-miRNAs involved in ADM that is a precursor of pancreatic cancer associated with CP.

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“…Recently published evidence-based guidelines from the working group on "Harmonising diagnosis and treatment of CP across Europe" noted that there is no "preferred classification system for defining the aetiology of CP since the available classification systems need to be evaluated in randomised prospective trials" [6]. Contemporary clinical practice updates from North America also have not incorporated the use of clinical classification systems [13]. The Harmonising diagnosis and treatment of CP across Europe working group acknowledged that classification systems are of great importance for guiding the management of CP.…”

Section: Introductionmentioning

confidence: 99%

Clinical Classification and Severity Scoring Systems in Chronic Pancreatitis: A Systematic Review

et al. 2019

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Introduction: Chronic pancreatitis (CP) is characterised by pain, functional deficits, nutritional and mechanical complications. Frequently managed in out-patient settings, the clinical course is unpredictable and requires multi-disciplinary care. There remains substantial variation in management. In contrast to acute pancreatitis, there are no globally accepted classification or severity scores to predict the disease course or compare interventions. We conducted a systematic review to determine the scope and clinical use of existing scoring systems. Methods: A systematic search was developed with a medical librarian using the Embase, Medline and Cochrane databases. Original articles and conference abstracts describing an original or modified classification or scoring system in CP that stratified patients into clinical and/or severity categories were included. To assess clinical application/validation, studies using all or part of a score as a stratification tool to measure another parameter or outcome were selected. Studies reporting on diagnosis or aetiology only were excluded. Four authors performed the search in independent pairs and conflicts were resolved by a fifth author using Covidence TM systematic review software. Results: Following screening 6,652 titles and 235 full-text reviews, 48 papers were analysed. Eleven described original scores and 6 described modifications of published scores. Many were comprehensive but limited in capturing the full spectrum of disease. In 31 studies, a score was used to categorise patients to compare or correlate various outcome measures. Exocrine and endocrine dysfunction and pain were included in 6, 5, and 4 scoring systems, respectively. No score included other nutrition parameters, such as bone health, malnutrition, or nutrient deficiency. Only one score has been objectively validated prospectively and independently for monitoring clinical progression and prognosis, but this had been applied to an in-patient population. Conclusion: Available systems and scores do not reflect recent A.R. and D.B.O.C. contributed equally to the manuscript. Rahman et al.advances and guidelines in CP and are not commonly used. A practical clinical classification and scoring system, validated prospectively for prognostication would be useful for the meaningful analysis in observational and interventional studies in CP.

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Chronic pancreatitis

Cited by 35 publications

References 29 publications

Successful Embolization of Posterior Inferior Pancreaticoduodenal Artery Pseudoaneurysm on the Grounds of Chronic Pancreatitis—Case Report and Literature Review

Successful Embolization of Posterior Inferior Pancreaticoduodenal Artery Pseudoaneurysm on the Grounds of Chronic Pancreatitis—Case Report and Literature Review

Identification of Potential Serum Exosomal microRNAs Involved in Acinar-Ductal Metaplasia That is A Precursor of Pancreatic Cancer Associated with Chronic Pancreatitis

Clinical Classification and Severity Scoring Systems in Chronic Pancreatitis: A Systematic Review

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