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Related Concept Videos

Acute Pancreatitis II: Clinical Manifestations and Management01:30

Acute Pancreatitis II: Clinical Manifestations and Management

Acute pancreatitis presents a complex medical emergency characterized by rapid onset inflammation of the pancreas, demanding timely diagnosis and management to prevent complications. The condition primarily manifests through severe upper abdominal pain that often radiates to the back. This pain intensifies following the consumption of fatty foods. Accompanying symptoms such as nausea, vomiting, abdominal distention, fever, dyspnea, cyanosis, and jaundice can vary in intensity but significantly...
Chronic Pancreatitis I: Introduction01:24

Chronic Pancreatitis I: Introduction

The pancreas, an elongated and flat gland situated behind the stomach, serves a vital function in digesting food and managing blood sugar levels.
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...
Chronic Pancreatitis II: Collaborative Care01:29

Chronic Pancreatitis II: Collaborative Care

The management of chronic pancreatitis is multifaceted, involving a comprehensive approach that includes thorough assessment, diagnostic testing, and a variety of management strategies.
Assessment:
Acute Pancreatitis II: Pathophysiology01:21

Acute Pancreatitis II: Pathophysiology

The pathophysiology of acute pancreatitis centers on injury to pancreatic acinar cells, which initiates a cascade of harmful intracellular events.This injury leads to premature activation of trypsinogen to trypsin in the pancreas. Trypsin then activates other digestive enzymes, such as chymotrypsin, elastase, and phospholipase A2, which begin breaking down pancreatic tissue. The resulting autodigestion causes local inflammation, tissue swelling, hemorrhage, and fat necrosis.Injured acinar cells...
Chronic Pancreatitis I: Introduction01:25

Chronic Pancreatitis I: Introduction

Chronic pancreatitis is a long-standing, relapsing inflammation of the pancreas, characterized by irreversible damage to the gland. It results in progressive destruction of the pancreatic parenchyma, fibrosis, and eventual loss of both exocrine and endocrine function. The disease may evolve gradually after multiple episodes of acute pancreatitis or develop independently.EtiologyChronic pancreatitis can arise from a variety of causes:Alcohol use is the leading cause, accounting for 70–80% of...
Chronic Pancreatitis II: Pathophysiology01:21

Chronic Pancreatitis II: Pathophysiology

Chronic pancreatitis is a progressive and irreversible inflammation of the pancreas, most often caused by long-term alcohol abuse, but it can also be related to ductal obstruction, smoking, or genetic factors.Chronic pancreatitis occurs when the pancreas is repeatedly exposed to harmful agents like alcohol, smoking, ductal obstruction, or genetic predisposition. These factors lead to the release of toxic metabolites and inflammatory cytokines, sustaining chronic inflammation in the pancreatic...

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Robotic Lateral Pancreaticojejunostomy for Chronic Pancreatitis
08:10

Robotic Lateral Pancreaticojejunostomy for Chronic Pancreatitis

Published on: December 14, 2019

Minimal change chronic pancreatitis.

T N Walsh1, J Rode, B A Theis

  • 1Department of Surgery, Middlesex Hospital, London.

Gut
|November 1, 1992
PubMed
Summary
This summary is machine-generated.

Minimal change chronic pancreatitis presents with severe pain but subtle imaging findings. Resection offered pain relief for some patients, suggesting a distinct syndrome with unclear etiology.

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Area of Science:

  • Gastroenterology
  • Surgical Pathology

Background:

  • Severe abdominal pain of pancreatic origin can present with minimal or equivocal findings on investigation.
  • The etiology of pancreatic disease is often elusive in these cases.

Purpose of the Study:

  • To report the findings and outcomes of 16 patients with minimal change chronic pancreatitis who underwent surgical resection.
  • To characterize the clinical and histological features of this elusive pancreatic condition.

Main Methods:

  • Retrospective review of 16 patients (12 women, 4 men) with severe pancreatic pain and minimal/equivocal imaging findings.
  • Analysis of surgical resection specimens, including histological examination.
  • Assessment of patient outcomes following conservative management, initial drainage procedures, and subsequent resection.

Main Results:

  • All 16 patients had minimal or equivocal pancreatic imaging findings; five had pancreas divisum.
  • Resection was required due to symptom progression after initial conservative management or drainage procedures.
  • Nine patients experienced pain relief or significant improvement post-resection; six did not improve, and one died from an unrelated cause.
  • Histology revealed chronic inflammatory and subtle non-inflammatory changes, including duct proliferation and adenomatous nodules.

Conclusions:

  • A distinct syndrome of minimal change chronic pancreatitis exists, characterized by severe pain, subtle macroscopic/radiological findings, and unique histology.
  • The etiology of this minimal change pancreatitis remains unclear.
  • Surgical resection may provide symptom relief for select patients with this condition.