Cases Of Pancreatitis Research Articles

Akut pankreatit olgularında hospitalizasyon ve mortalite durumunun laboratuvar ve radyolojik görüntüleme sonuçları ile değerlendirilmesi

AIM: Acute pancreatitis (AP) is a common diagnosis in emergency services and is very important in terms of morbidity and mortality. It was aimed to evaluate the relationship of laboratory and imaging findings of AP cases with hospitalization and mortality outcomes.
 METHODS: This retrospective study was conducted with 225 cases over the age of 18 who applied to the emergency department between 1 September 2020 and 1 March 2021. Age, gender, laboratory and imaging data of the patients were recorded and evaluated on groups formed according to hospitalization and mortality status.
 RESULTS: The mean age of 225 acute pancreatitis cases was 54.10±19.07 years, and 116 (51.6%) were female. 169 (75.1%) individuals were hospitalized and seven (3.1%) patients resulted in mortality. Age was associated with mortality (p

COVID-19 presenting as Acute abdomen- a study of 3 cases

COVID-19 is a multisystem disease and sometimes patient can present with life threatening extra-pulmonary manifestations. Amongst GI symptoms nausea, vomiting, abdominal pain and diarrhoea are common. Severe hepatobiliary manifestations like acute pancreatitis, acute hepatitis and cholecystitis are rare in SARS-CoV-2 infection. In this case series we described three cases presented with hepatobiliary manifestations. All of them had acute abdominal pain and finally proven to be the case of acute pancreatitis and acalculous cholecystitis in addition to classical COVID- 19 symptoms. Two of them had severe symptoms and required high volume of oxygen, while one case (acalculous cholecystitis) had mild symptom only. All of them recovered successfully. High degree of clinical suspicion is required while managing atypical presentation of COVID-19 cases. This is also vital to refer the cases to advance care hospitals in time to ensure multidisciplinary care. J Bangladesh Coll Phys Surg 2023; 41(4): 320-324

Risk of Pancreatitis With Incretin Therapies Versus Thiazolidinediones in the Veterans Health Administration.

Incretin therapies, comprised of the dipeptidyl peptidase-4 inhibitors (DPP-4i) and glucagon-like peptide-1 receptor agonists (GLP-1 RAs), have been increasingly utilized for the treatment of type 2 diabetes (T2DM). Previous studies have conflicting results regarding risk of pancreatitis associated with these agents-some suggest an increased risk and others find no correlation. Adverse event reporting systems indicate that incretin therapies are some of the most common drugs associated with reports of pancreatitis. This study aimed to compare the odds of developing pancreatitis in veterans with T2DM prescribed an incretin therapy versus thiazolidinediones (TZDs: pioglitazone and rosiglitazone) within the Veterans Health Administration (VHA). This was a retrospective cohort study analyzing veterans with T2DM first prescribed an incretin therapy or a TZD between January 1, 2011, and December 31, 2021. A diagnosis of pancreatitis within 365 days of being prescribed either therapy was counted as a positive case. Data was collected and analyzed utilizing VA's Informatics and Computing Infrastructure (VINCI) and an adjusted odds ratio was calculated. The TZD cohort consisted of 42 912 patients compared with the incretin cohort of 304 811 patients. The TZD cohort had a pancreatitis incidence rate of 1.94 cases per 1000 patients. The incretin cohort had a incidence rate of 2.06 cases per 1000 patients. An adjusted odds ratio found no statistical difference of pancreatitis cases between the TZD and incretin cohorts (adjusted odds ratio [AOR] = 0.94, 95% CI [0.75, 1.18]). This retrospective cohort study of national VHA data found a relatively low incidence of pancreatitis in both cohorts, and an adjusted odds ratio found no statistical difference of pancreatitis in patients prescribed an incretin therapy compared with a control group. This data adds to growing evidence that incretin therapies do not seem to be associated with an increased risk of developing pancreatitis.

Multiple Splanchnic Venous Thromboses: A Fatal Complication of Recurrent Pancreatitis

Splanchnic Venous Thrombosis (SVT) is a condition associated with high morbidity. The etiologies of SVT include intra-abdominal inflammation or infection, surgical intervention, abdominal malignancies such as hepatocellular carcinoma (HCC) and pancreatic carcinoma, or abnormality in coagulation caused by various reasons such as liver cirrhosis. Most cases of pancreatitis are mild and self-limited. On the other hand, approximately one-quarter of patients with pancreatitis may develop vascular complications such as venous thrombosis. Pancreatitis associated with vascular complications is dangerous and potentially fatal. The survival of patients with pancreatitis and vascular complications depends on the early detection of these complications. We report a case of a middle-aged male who had recurrent pancreatitis. On radiological imaging, the patient was found to have a portal vein, splenic vein, and superior mesenteric vein thrombosis. The etiology of thrombosis was considered to be inflammation around the main portal trunk caused by pancreatitis Patient recovered after emergent and timely management with initially low molecular weight heparin and bridged by oral apixaban therapy. The article focuses on the aspects of etiology, pathogenesis, diagnosis, and management of acute pancreatitis with venous thrombosis. J Rang Med Col. September 2023; Vol. 8, No. 2: 60-63

Efficacy and safety of endoscopic retrograde cholangiopancreatography in recurrent pancreatitis of pediatric asparaginase-associated pancreatitis.

Asparaginase (ASP) is an important drug in combined chemotherapy regimens for pediatric acute lymphoblastic leukemia (ALL); ASP-associated pancreatitis (AAP) is the main adverse reaction of ASP. Recurrent pancreatitis is a complication of AAP, for which medication is ineffective. To evaluate the efficacy and safety of endoscopic retrograde cholangiopancreatography (ERCP) in treating recurrent pancreatitis due to AAP. From May 2018 to August 2021, ten children (five males and five females; age range: 4-13 years) with AAP were treated using ERCP due to recurrent pancreatitis. Clinical data of the ten children were collected, including their sex, age, weight, ALL risk grading, clinical symptoms at the onset of pancreatitis, time from the first pancreatitis onset to ERCP, ERCP operation status, and postoperative complications. The symptomatic relief, weight change, and number of pancreatitis onsets before and after ERCP were compared. The preoperative symptoms were abdominal pain, vomiting, inability to eat, weight loss of 2-7 kg, and 2-9 pancreatitis onsets. After the operation, nine of ten patients did not develop pancreatitis, had no abdominal pain, could eat normally; the remaining patient developed three pancreatitis onsets due to the continuous administration of ASP, but eating was not affected. The postoperative weight gain was 1.5-8 kg. There was one case of post ERCP pancreatitis and two cases of postoperative infections; all recovered after medication. ERCP improved clinical symptoms and reduced the incidence of pancreatitis, and was shown to be a safe and effective method for improving the management of recurrent pancreatitis due to AAP.

Pancreatitis Prevention in Tabuk City, Kingdom of Saudi Arabia: Evaluating Public Knowledge and Raising Awareness of Risk Factors and Symptoms.

Pancreatitis is an inflammation of the pancreas.The pancreas is a flat, elongated gland situated in the upper abdomen, beyond the stomach. It produces digestive enzymes and hormones that regulate glucose absorption in the body. Pancreatitis can be acute, developing rapidly and lasting for several days, or chronic, persisting over an extended period and affecting specific individuals. While treatment can improve mild cases of pancreatitis, severe cases can be fatal. This study utilizes a cross-sectional survey design with 549 participants, allowing data collection from a representative sample of Tabuk City's adult population. The participants' knowledge about the risk factors and symptoms of pancreatitis was inadequate. Among those who did not receive any information about pancreatitis and its risk factors, the count was 352 (64.1%). On the other hand, there was increased awareness of pancreatitis and its risk factors, which would lead to early detection and prevention. A total of 483 participants (88%) expressed adequate agreement, and 305 participants (55.6%) demonstrated an adequate response regarding seeking medical attention if they experienced any symptoms of pancreatitis. Our findings revealed a lack of knowledge about the risk factors and symptoms of pancreatitis. Furthermore, there was inadequate awareness regarding governmental initiatives or programs that support access to pancreatitis knowledge and awareness in Tabuk City.

Usefulness of Intraductal Placement of a Dumbbell-Shaped Fully Covered Self-Expandable Metal Stent for Post-Cholecystectomy Bile Leaks.

Background and aims: In the treatment of post-cholecystectomy bile leaks, endoscopic naso-biliary drainage (ENBD) or biliary stenting using plastic stents is the standard of care. Fully covered self-expandable metal stent (FCSEMS) placement across the sphincter of Oddi is considered a salvage therapy for refractory cases, but pancreatitis and migration are the major concerns. Intraductal placement of a dumbbell-shaped FCSEMS (D-SEMS) could avoid these drawbacks of FCMSESs. In this retrospective study, we investigated the usefulness of intraductal placement of the D-SEMS for post-cholecystectomy bile leaks. Methods: Six patients who underwent intraductal placement of the D-SEMS for post-cholecystectomy bile leaks were enrolled. This method was performed as initial treatment in three patients and as salvage treatment in three ENBD refractory cases. Results: Technical and clinical successes were obtained in 6 (100%) patients and 5 (83%) patients, respectively. One clinically unsuccessful patient required laparoscopic peritoneal lavage. The early adverse event was one case of mild pancreatitis (17%). The median duration of the D-SEMS indwelling was 61 days (42-606 days) with no migration cases, all of which were successfully removed. The median follow-up after index ERCP was 761 (range: 161-1392) days with no cases of recurrent bile leaks. Conclusions: Intraductal placement of the D-SEMS for post-cholecystectomy bile leaks might be safe and effective even in refractory cases.

Causal Evaluation of Pancreatitis in Children

Pancreatitis in childhood is not common. It can be associated with severe morbidity and mortality. The role of clinicalevaluation is vital as it can be misdiagnosed easily. This study was aimed to review the prevalence, etiology,presentation and outcome of pancreatitis in children. This cross-sectional study was conducted at the Department ofPediatric Gastroenterology & Nutrition of Bangabandhu Sheikh Mujib Medical University, Dhaka from January,2017 through June, 2018. A total 43 cases of pancreatitis were included in this study. Pancreatitis was classified asacute pancreatitis(AP), acute recurrent pancreatitis (ARP) and chronic pancreatitis (CP) as per diagnostic criteriamade by INSPPIRE (International Study Group of Pediatric Pancreatitis: In Search for a Cure) group. Among 43children (age 10.1 mean ± 2.55,18 males); AP,14 (32.6%); ARP, 14(32.6%) and CP,15(34.8 %). Half of AP wasidiopathic. Majority of ARP (28.6%) were idiopathic and CP (40%) had calcific pancreatitis. Majority of patients hadvomiting followed by moderate to severe abdominal pain. In CP 4(26.6%) patient developed diabetes mellitus.Majority of pancreatitis in children is idiopathic. A sub-set of AP goes on to develop ARP and CP on follow-up andbeing in the idiopathic sub-set is a risk factor. CP is progress to endocrine and exocrine insufficiency. Early diagnosis,close monitoring and proper intervention are mandatory to reduce the potential morbidity and mortality. Bangabandhu Sheikh Mujib Med. Coll. J. 2022;1(2):76-79

Acute pancreatitis following COVID-19 vaccine: A Vietnamese case report

Several vaccines against the coronavirus 2 that causes severe acute respiratory syndrome have been developed in response to the global coronavirus infectious disease 2019 (COVID-19) pandemic. The FDA has established that the available vaccine is effective against both the original and current SARS-CoV-2 variant infections. The vaccine’s effectiveness and adverse effects also need to be evaluated comprehensively. Although the list of side effects of the mRNA COVID-19 vaccine has been reported, only a few cases of pancreatitis have been documented and published. The mechanism in this situation is unknown, and the onset time from the vaccination to symptom onset is variable through several case reports, so healthcare workers need to be suspicious of pancreatitis to make an early diagnosis and deliver the appropriate treatment. We report a 73-year-old man with controlled chronic hepatitis C and uncomplicated gastritis who presented to the hospital with a 4-day fever accompanied by chills, generalized myalgia, a bilateral temporal dull headache, and no abdominal discomfort or pain. A review of other systems was clinically negative after the second dose of the Pfizer/BioNTech mRNA COVID-19 vaccine. He had no history of alcohol consumption, pancreatitis, or allergic reactions to vaccines and had received the uncomplicated first dose of the Pfizer/BioNTech mRNA COVID-19 vaccine previously. Laboratory tests revealed elevated serum pancreatic enzymes. An abdominal magnetic resonance imaging study showed tail segment enlargement of the pancreas with fat stranding and fluid accumulation surrounding the tail of the pancreas, without any local or systemic complications detected. Other laboratory and imaging tests for the detected source of infections are negative, and acute pancreatitis was diagnosed based on the 2012 revision of the Atlanta classification and definitions by international consensus. The patient was diagnosed with COVID-19 vaccination-induced acute pancreatitis. The patient had an uneventful recovery with no complications. After administering the mRNA COVID-19 vaccine, acute pancreatitis could develop. Therefore, it is crucial to recognize acute pancreatitis when abdominal pain and/or abnormally increased pancreatic enzymes occur following a COVID-19 mRNA immunization.

Prevalence of islet cell autoimmunity in paediatric patients in index cases of acute pancreatitis

Prevalence of islet cell autoimmunity in paediatric patients in index cases of acute pancreatitis

Genetic Investigations in Turkish Idiopathic Pancreatitis Patients Show Unique Characteristics.

Pancreatitis is one of the leading causes of digestive system-related hospital admissions, and it has a genetic background in a considerable portion of the patients. In this study, we aimed to investigate the genetic risk factors of idiopathic pancreatitis in Turkish patients and the contribution of copy number variations to the pathogenesis. Idiopathic pancreatitis is defined as failure to detect risk factors despite comprehensive clinical assessments. Next-generation sequencing and multiple ligand-dependent probe amplification of PRSS1, SPINK1, CTRC, and CFTR were performed. For further genotype-phenotype correlations, patients were also questioned for the age of onset, family history, and pancreatic divisum. A total of 68 idiopathic pancreatitis cases were enrolled. Variants with potential clinical significance of PRSS1 were identified in 13.4%, SPINK1 in 6.3%, CTRC in 4.7%, and CFTR in 26.5% of the patients. No copy number variants were seen in any of these genes. At least 7.4% of the participants had complex genetic etiology involving 2 genes. At least 42.6% of the participants had a potential genetic risk factor. Five novel genetic variants were identified, and distinctive genetic risk factors of Turkish population were shown. The results showed that genetic etiology was frequent in pancreatitis and it was even more prominent in patients with early-onset disease. Considering that genetic risk factors may be informative for decisionmaking in the treatment options in addition to providing extensive prognostic value and familial genetic consultation; clinicians need to be more eager to offer genetic tests to pancreatitis patients.

A Case Series Of Scrub Typhus From Eastern State Of India

Scrub typhus is one of the endemic diseases leading to acute febrile illness in the topical countries. It can present with its various manifestations ranging from asymptomatic illness to serious multiorgan dysfunctions. The most common pathophysiology behind this multisystem manifestation is the systemic vasculitis due to exaggerated immune response. Early diagnosis and aggressive treatment along with close monitoring of vitals with best supportive measures may be the satisfactory response to the physician. Here, in this case series we are discussing five cases of scrub typhus presented with various atypical and uncommon manifestation HLH (Case 1), Encephalopathy, Pancytopenia, AKI, Intrahepatic cholestasis, Pancreatitis (Case 2), meningoencephalitis (Case 3), myocarditis (Case 4) and Leukemoid reaction, ALF (Case 5).

SAT076 Olanzapine Induced Pancreatitis

Abstract Disclosure: A. Mandhan: None. N. Friedman: None. S. Stefan: None. Background: Olanzapine, an atypical antipsychotic, is commonly used to treat a variety of mental health conditions, including schizophrenia, bipolar disorder, and depression. Acute pancreatitis from olanzapine is rare. Drug-induced pancreatitis represents 0.1-2% of all cases of acute pancreatitis. Here we describe a case of olanzapine induced severe pancreatitis and new onset of diabetes. Clinical Case: A 43-year-old male with history of bipolar disorder was admitted with vomiting and altered mental status. Symptoms began a week prior to presentation and included polydipsia and polyuria. He had no known history of hyperlipidemia, diabetes or alcohol use. He was treated with olanzapine for six months prior to presentation, and the dose was increased to 35mg/day one month prior to hospital admission. On exam, he appeared older than his stated age, confused, restless and dehydrated. He was afebrile but tachycardic and hypotensive. Laboratory evaluation was notable for glucose of 1619 mg/dL (70-140 mg/dL) metabolic acidosis with ketonuria, lipase level of 684 U/L (n<60), and triglyceride (TG) level of 1574 mg/dL (<150 mg/dL). CT of the abdomen showed severe acute interstitial pancreatitis with retroperitoneal fluid and possible necrosis, normal-appearing gallbladder, no cholelithiasis. He was made NPO, and started on IV fluids and IV Insulin therapy. His HbA1C was 12.6% with negative GAD and IA2 antibodies, consistent with type 2 diabetes. Within twenty-four hours of presentation his DKA resolved, and TG levels down trended below 1,000 mg/dL. He was transitioned to subcutaneous insulin and combination therapy of fenofibrate. The patient was discharged on basal insulin, metformin, fenofibrate, a low dose statin and omega-3 fatty acids. His TG at discharge was 210 mg/dL and olanzapine was not restarted. Conclusions: Olanzapine induced pancreatitis has been described as a rare cause of pancreatitis in the literature. To date, there is only one additional case report about acute necrotizing pancreatitis from olanzapine. Given the ubiquitous use of olanzapine in treating psychiatric disorders, it is important that physicians are aware of this rare but potentially life-threatening adverse reaction. The exact mechanism by which olanzapine causes pancreatitis is unclear, and case reports suggest hypertriglyceridemia as the most common proposed etiology of olanzapine-induced acute pancreatitis. Patients should have a screening lipid panel before beginning therapy to optimize treatment outcomes. Presentation: Saturday, June 17, 2023

S2034 An Interesting Case of Tacrolimus-Induced Pancreatitis

S2034 An Interesting Case of Tacrolimus-Induced Pancreatitis

S1980 An Abnormal Case of Recurrent Acute Pancreatitis Revealing Adenocarcinoma in a 31-Year-Old Male

S1980 An Abnormal Case of Recurrent Acute Pancreatitis Revealing Adenocarcinoma in a 31-Year-Old Male

S1982 A Rare Case of Paxlovid-Induced Pancreatitis

S1982 A Rare Case of Paxlovid-Induced Pancreatitis

S1936 A Not so Common Case of Recurrent Acute Pancreatitis and Its Implications

S1936 A Not so Common Case of Recurrent Acute Pancreatitis and Its Implications

A Case of Acute Pancreatitis in Organophosphate Poisoning

Organophosphate (OP) poisoning is one of the most harmful and easily accessible pesticides for suicide poisoning. It is linked to high mortality and morbidity. Cholinergic syndrome, intermediate syndrome, and syndrome of delayed polyneuropathy are the three primary syndromes that characterize OP poisoning. Organophosphates are strong toxins that are frequently used as pesticides in agriculture. Patients who have consumed organophosphorus may exhibit subclinical symptoms of acute pancreatitis. Correct biochemical analysis and clinical correlation assist in diagnosis. In the study, we described a 24-year-old female who suffered necrotizing pancreatitis after OP poisoning. Keywords: Organophosphate Poisoning, Pesticide, Pancreatitis.

The Effect of Prophylactic Carbapenem Use on Outcomes in Acute Pancreatitis: A Systematic Review and Meta-Analysis.

This study aimed to determine the effect of prophylactic use of carbapenems for acute pancreatitis on clinical outcomes. It was conducted according to the preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines by using the keywords "Pancrea * AND carbapenem OR imipenem OR ertapenem OR meropenem OR doripenem." Primer outcomes were mortality, surgical intervention, and pancreatic and non-pancreatic infection. Subgroup analyses were also performed to reduce the risk of bias. Ten studies with 4038 patients were included in the meta-analyses. While eight of ten were randomized controlled trials, two were observational studies. The prophylactic use of carbapenems had no statistically significant effect on mortality (OR=0.82, 95% CI=0.65-1.04, I²=0%) and surgical intervention. (OR=0.81, 95% CI=0.57-1.17, I²=0%). However, the real impact of prophylaxis on reducing the incidence of mortality and surgical intervention was uncertain due to the insufficient sample size. The prophylactic use of carbapenems was significantly associated with a lower risk of peripancreatic (OR=0.37, 95% CI=0.25-0.55, I²=61%) and non-pancreatic infection risk (OR=0.60, 95% CI=0.46-0.78, I²=65%). The definitions of infection in the articles were not clear, and the diagnostic approach to infection was based on subjective criteria. In addition, there was inadequate collateral damage and safety assessments. In high-quality studies with a low risk of bias, prophylactic carbapenems had no effect on peripancreatic infection (RR=1.54, 95% CI=0.65-3.47, I²=0%) and non-pancreatic infection (RR=0.72, 95% CI=0.48-1.07, I²=0%). Although there is a reduction in the infection risk, routine carbapenem use in acute pancreatitis cases should not be recommended based on current evidence. Cooperation with Infectious Disease specialists and developing diagnostic algorithms are required instead of routine prophylaxis to prevent infection, especially non-pancreatic infection.

Unsolved mystery, the etiology of acute pancreatitis after liver resection: a case report and literature review

Link of Video Abstract: https://youtu.be/WQnJQwwYcHcIntroduction: After liver resection, pancreatitis is a well-known yet uncommon consequence. The actual cause is unclear, and the postoperative condition may mask the clinical symptoms. When a patient unexpectedly worsens after surgery, postoperative pancreatitis should always be taken into consideration due to its high fatality risk. After liver resection, we present our patient with acute pancreatitis. The paper was written using certain hypotheses. First, the surgeon should be aware of the possibility of pancreatitis following liver surgery, which is not included in the literature as a side effect of liver surgery. The second step is to increase our knowledge and develop measures to reduce the risk of acute pancreatitis following liver surgery. Case Description: We present here a case of acute pancreatitis following liver resection surgery from our institution, and we strongly suspect that the results of our postoperative white bile leak test contributed to this. According to the literature analysis, this test is risk-free and won't have a materially detrimental impact on the patient. Keep in mind the white test rule, which suggested things like focus and spooling following the test. Conclusion: The white test is effective for identifying bile leakage following liver resection, however, we do not advise frequent use of this test since there is a chance that it can trigger acute pancreatitis, which can have a substantial negative impact on the patient's morbidity or death. The precise process is still a mystery and will require further experimental research.