Pancreatitis in childhood

Buntain, William L.; Wood, James B.; Woolley, Morton M.

doi:10.1016/s0022-3468(78)80008-6

Cited by 72 publications

(27 citation statements)

References 31 publications

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“…Pancreatitis developed within 2 days of initiation of corticosteroid therapy and pathologically resembled experimentally induced steroid pancreatitis (17,18). A rapid onset of pancreatitis after the start of corticosteroid therapy was also reported in 2 previous cases of SLE (12,14).…”

Section: Discussionsupporting

confidence: 61%

Pancreatitis in systemic lupus erythematosus

Baron

Brisson

1982

Arthritis & Rheumatism

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Pancreatitis has been previously described in association with systemic lupus erythematosus (SLE) (1-16). We report here a lupus patient who developed severe hemorrhagic pancreatitis within 48 hours of initiation of corticosteroid therapy; we also discuss the relation between pancreatitis and SLE. CASE REPORTA 50-year-old black woman was admitted to the hospital on March 23, 1981, after she had a generalized seizure at home. She was known to have discoid lupus since 1963 but first became systemically ill in November 1980 when she developed new skin lesions, fever, and malaise. There was no history of photosensitivity, pleuritic chest pain, Raynaud's phenomenon, or arthritis. Previous illnesses included pulmonary tuberculosis in 1969, which was treated with isoniazid, ethambutol, and streptomycin. The patient was a nondrinker with no history of jaundice or intravenous drug abuse. Medications were methyprylon (300 mg nightly) and propanolol (40 mg twice daily).During examination the patient was agitated and disoriented. Temperature was 39.5"C. Skin lesions consistent with discoid lupus were present. Cotton wool spots were observed in each fundus, and oral mucosal ulcerations were noted. The liver was moderately enlarged, and there was synovitis of both knees; the abdomen was not tender.Results of laboratory investigations included: hemoglobin 9.0 g d d l ; white blood cell count (WBC) 5 ,000/mm3; platelet count 1 1 0,000/mm3; erythrocyte sedimentation rate (Wintrobe) 57 mm/hour; partial thromboplastin time 57.6 seconds; urinalysis 3+ protein, 10-20 red blood celldhigh power field, and several granular casts; blood urea nitrogen and creatinine normal; total bilirubin 1.6 mg/dl; alkaline phosphatase 350 mUlml (30-1 10 mUlml); lactate dehydrogenase 600 mU/ml ( Intravenous therapy with hydrocortisone sodium succinate (100 mg every 8 hours) was started on the evening of March 23, 1981. By the night of March 25, 1981, she had become afebrile and well-oriented but had begun to experience diffuse abdominal pain. On the next morning her serum amylase was 1,400 DYE units and, by the evening of March 26, 1981, her blood pressure and urine output had dropped, the abdomen was distended, and ascites was detectable. Despite management with nasal gastric suction, intravenous fluids, and ventilatory support, the patient experienced a rapidly downhill course consistent with severe pancreatitis. There was persistent elevation of serum amylase, a marked drop in serum calcium, the development of the adult respiratory distress syndrome, and disseminated intravascular coagulation.

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Section: Discussionsupporting

confidence: 61%

Pancreatitis in systemic lupus erythematosus

Baron

Brisson

1982

Arthritis & Rheumatism

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“…The incidence of acute pancreatitis with CDCs has been variously quoted to range from 0 to 70% [19,20,21]. The true incidence of pancreatitis with CDC is difficult to decipher from the literature because serum amylase or lipase levels are not routinely done for pain abdomen in patients with CDC, and the definition of pancreatitis in the setting of CDC is variable.…”

Section: Discussionmentioning

confidence: 99%

“…This ‘psuedopancreatitis’ and hyperamylasemia was associated with high biliary amylase levels and attributed to pancreaticobiliary reflux. While most episodes of pancreatitis are mild and can be managed conservatively, recurrences can only be eliminated by cyst excision and biliopancreatic disconnection [19,20,21,22,23]. …”

Section: Discussionmentioning

confidence: 99%

Management of Complicated Choledochal Cysts

Lal¹,

Agarwal²,

Shivhare³

et al. 2007

Dig Surg

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Objectives: The presentation of choledochal cysts (CDCs) is altered by complications such as acute severe cholangitis, hepatolithiasis, spontaneous perforation, portal hypertension, pancreatitis, malignancy of the biliary tract and previous surgery in the form of internal drainage of the cyst. The management and the outcome of such complicated cysts differ from that of an uncomplicated CDC. This presentation is an analysis of our experience with complicated CDCs. Patients and Methods: One hundred and forty-four patients with CDCs were managed at a tertiary level referral hospital in North India, between January 1989 and June 2004. Thirty-three (23%) CDCs were associated with complicating factors: severe cholangitis requiring a biliary drainage procedure prior to definitive operative procedure (n = 11), spontaneous perforation (n = 3), hepatolithiasis (n = 6), acute cholecystitis (n = 1), recurrent acute pancreatitis (n = 1), chronic pancreatitis (n = 1), gastric outlet obstruction (n = 1), portal hypertension (n = 6), biliary tract malignancy (n = 4) and previous internal drainage of the cyst (n = 5). Five patients had more than one complication. The management outcome of complicated CDCs was compared with that of uncomplicated CDCs. Results: Complicated CDCs were significantly more common with type IV-A anatomy. Endoscopic, percutaneous or external surgical biliary drainage procedure was performed in 14 complicated CDCs prior to cyst excision. Desired definitive surgical procedure could be performed in 26/33 (79%) patients with complicated CDCs as compared to 107/111 (96%) patients with uncomplicated CDCs. Four (12%) patients with complicated CDCs had early postoperative complications as compared to 9/111 (8%) patients with uncomplicated CDCs. During a median follow-up of 13 months (2 months to 8 years), 2 patients with complicated CDCs died due to advanced secondary biliary cirrhosis and advanced gall bladder cancer, respectively. Six patients reported complications. Of the 6 patients, 3 required reoperation for a strictured hepaticojejunostomy (n = 2) and hepatolithiasis (n = 1). In contrast, there was no disease-related mortality and only 1 out of 111 patients with uncomplicated cysts had a complication during follow-up. Conclusion: Complicated CDCs merit a carefully planned management strategy including percutaneous, endoscopic and surgical procedures. The management may have to be staged. The outcome depends on the nature of complication and the management strategy adopted.

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“…Klinikte ayrıca idiopatik pankreatit olarak kabul edilen bir gruptada etyolojik bir neden bulunamamakta, Oddi sfinkter disfonksiyonuna bağlı olabileceği dü-şünülmektedir (2,3,5,6,8).…”

Section: Abstract: Chronic Pancreatitis Childhoodunclassified

“…Zamanla pankreatik yetmezlik gelişirse ağrıda azalmaktadır. Ancak kronik pankreatit vakalarının %15'inde ağrılar ya çok azdır veya ağrı hiç olmaz (2,3,9).…”

Section: Semptomlarunclassified

Çocukluk Çağinda Kroni̇k Pankreatit

Tümay;KANSU¹

1998

Ankara Üniversitesi Tıp Fakültesi Mecmuası

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Pancreatitis in childhood

Cited by 72 publications

References 31 publications

Pancreatitis in systemic lupus erythematosus

Pancreatitis in systemic lupus erythematosus

Management of Complicated Choledochal Cysts

Çocukluk Çağinda Kroni̇k Pankreatit

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