Pancreatitis associated with hyperparathyroidism

Stiel, Mirjam C.; Piper, D. W.

doi:10.1007/bf02231921

Cited by 4 publications

(1 citation statement)

References 21 publications

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“…T h e p t o p e r a t i v e cases followed resection of an aortic aneurysm, closure of a f a x 1 fistula, a Ptilya gastrectomy, and excision of a parathyroid adenoma. Pancreatitis has been described in association with hyperparathyroidism [Cope et a&, 1957) and in association with removal of parathyroid tuniours (Stiel and Piper, 1962 ; Johnson and Stiel, 1967 ;Reeve et alii, 1970). Johnson and Stiel (1967) also stress the high mortality of this complication of parathyroid surgery.…”

Section: ( C ) Pancwntitis Dire To Miscellaneoais Causesmentioning

confidence: 99%

Acute Pancreatitis: A Review

Barraclough

Coupland

1972

Australian and New Zealand Journal of Surgery

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A series of 68 patients with acute pancreatitis admitted to the Royal North Shore Hospital of Sydney in a three-year period is discussed. An aetiological diagnosis was made in 68% of these. There were three cases associated with a parathyroid adenoma and a 10% incidence of haemorrhagic pancreatitis, and pseudocysts occurred in 6%. There was no mortality in the 22 patients who underwent laparotomy. The aetiological mechanisms, diagnosis and treatment of acute pancreatitis are reviewed.

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Section: ( C ) Pancwntitis Dire To Miscellaneoais Causesmentioning

confidence: 99%

Acute Pancreatitis: A Review

Barraclough

Coupland

1972

Australian and New Zealand Journal of Surgery

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Akute Pankreaserkrankungen

Wänke¹,

Goebell²,

Hotz³

et al. 1976

Pankreas

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Pancreatitis Following Parathyroid Surgery

Reeve¹,

Delbridge²

1982

Annals of Surgery

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While pancreatitis may provide the clue to the diagnosis of hyperparathyroidism preoperatively, the occurrence of pancreatitis following parathyroidectomy is not generally recognized. In this study preoperative and postoperative serum amylase estimations, together with a clinical assessment, were performed on 86 patients undergoing neck exploration for hyperparathyroidism. It was found that postoperative hyperamylasaemia occurred in 35% of the total group, while clinically significant pancreatitis was found in 9% of cases. Pancreatitis was significantly more common when thyroidectomy was performed at the time of parathyroidectomy, occurring in 23% of this group of patients, and may be due to the blunted C-cell response of calcitonin secretion to the induced hypercalcaemia associated with operative manipulation. Careful attention should be paid to postoperative abdominal symptoms, for they may indicate pancreatitis.THE RELATIONSHIP between the pancreas and parathyroid glands was the subject of a number of case reports in the literature earlier this century," 2 but it was not until 1957 that Cope3 first demonstrated that pancreatitis may be the presenting symptom of hyperparathyroidism. This relationship is now generally accepted, although some more recent series4 have shown that the incidence is probably lower than that claimed in earlier reports, which gave figures of up to 10%.5 Other authors6 claim that pancreatitis is only a chance occurrence and that there is no relationship between the two disorders at all.The converse relationship, i.e., pancreatitis following parathyroid surgery in patients who had not previously had pancreatitis, has been less well documented, with only isolated reports being found.7'8 The purpose of this study was to investigate the incidence of postoperative pancreatitis in patients undergoing neck exploration for hyperparathyroidism. A single adenoma was removed in 66 cases, and two adenomas were removed in one case; a subtotal parathyroidectomy was performed in' 13 cases; a parathyroid carcinoma was removed in one case, metastatic adenocarcinoma in a lymph node was found in one case, and no parathyroid pathology wasJ identified in three patients, one of whom had two sep' arate operative procedures. Serum amylase estimations were performed on 74 patients preoperatively and on all 86 patients postop,eratively. The postoperative amylase estimations were repeated on a daily basis for 48 hours or until the levels had returned to normal. In addition, a record was kept of the occurrence of significant abdominal pain or of any other clinical finding consistent with pancreatitis' Serum amylase estimations were also performed both preoperatively and postoperatively on a control group of 34 patients undergoing thyroid surgery (either total thyroidectomy, total thyroid lobectomy, or bilateral subtotal thyroidectomy) in whom no parathyroid surgery was performed.i Nasogastric suction and intravenous fluids were used postoperatively. In the absence of a raised serum amylase level or abdominal pain,...

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Pancreatitis associated with hyperparathyroidism

Cited by 4 publications

References 21 publications

Acute Pancreatitis: A Review

Acute Pancreatitis: A Review

Akute Pankreaserkrankungen

Pancreatitis Following Parathyroid Surgery

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