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Gastroenterology Jun 2013
Topics: Animals; Humans; Pancreas, Exocrine; Pancreatic Diseases; Prognosis
PubMed: 23622124
DOI: 10.1053/j.gastro.2013.03.009 -
The British Journal of Radiology Jul 2019MRI plays an important role in the clinical management of pancreatic disorders and interpretation is reliant on qualitative assessment of anatomy. Conventional sequences... (Review)
Review
MRI plays an important role in the clinical management of pancreatic disorders and interpretation is reliant on qualitative assessment of anatomy. Conventional sequences capturing pancreatic structure can however be adapted to yield quantitative measures which provide more diagnostic information, with a view to increasing diagnostic accuracy, improving patient stratification, providing robust non-invasive outcome measures for therapeutic trials and ultimately personalizing patient care. In this review, we evaluate the use of established techniques such as secretin-enhanced MR cholangiopancreatography, diffusion-weighted imaging, , * and fat fraction mapping, but also more experimental methods such as MR elastography and arterial spin labelling, and their application to the assessment of diffuse pancreatic disease (including chronic, acute and autoimmune pancreatitis/IgG4 disease, metabolic disease and iron deposition disorders) and cystic/solid focal pancreatic masses. Finally, we explore some of the broader challenges to their implementation and future directions in this promising area.
Topics: Humans; Magnetic Resonance Imaging; Pancreas; Pancreatic Diseases
PubMed: 30982337
DOI: 10.1259/bjr.20180941 -
Advances in Experimental Medicine and... 2010Pancreatitis is an inflammatory disease of the pancreas characterized by acute and chronic condition as well as varying duration and severity. Acute pancreatitis (AP) is... (Review)
Review
Pancreatitis is an inflammatory disease of the pancreas characterized by acute and chronic condition as well as varying duration and severity. Acute pancreatitis (AP) is a severe abdominal inflammation, characterized by parenchymal edema, necrosis with occasional presence of pseudocysts, abscess, hemorrhage, and inflammatory cell infiltration. Its disease spectrum varies from mild edematous to severe disease with fatal complications. Pancreatic acinar cells are very susceptible to inflammation during an episode of AP attack. It is believed that some initiating factors can lead to the premature transformation of inactive pro-proteases into active proteases within the pancreas. The active proteases degrade a number of cellular proteins such as the structural protein F-actin, thus leading to the collapse and malfunction of acinar and pancreatic damage, a process known as autodigestion of the pancreas.
Topics: Animals; Cystic Fibrosis; Diabetes Mellitus; Humans; Medicine, Chinese Traditional; Pancreatic Diseases; Pancreatic Neoplasms; Pancreatitis
PubMed: 20700836
DOI: 10.1007/978-90-481-9060-7_3 -
Nutrients Mar 2022While typically considered a pulmonary disease, cystic fibrosis patients develop significant nutritional complications and comorbidities, especially those who are... (Review)
Review
While typically considered a pulmonary disease, cystic fibrosis patients develop significant nutritional complications and comorbidities, especially those who are pancreatic insufficient. Clinicians must have a high suspicion for cystic fibrosis among patients with clinical symptoms of pancreatic insufficiency, and pancreatic enzymatic replacement therapy (PERT) must be urgently initiated. PERT presents a myriad of considerations for patients and their supporting dieticians and clinicians, including types of administration, therapy failures, and complications.
Topics: Cystic Fibrosis; Enzyme Replacement Therapy; Exocrine Pancreatic Insufficiency; Humans; Pancreas; Pancreatic Diseases
PubMed: 35405954
DOI: 10.3390/nu14071341 -
The Korean Journal of Gastroenterology... May 2020Obesity has become a major medical and public health problem worldwide. Recent studies have shown that obesity is a chronic disease that is associated with many... (Review)
Review
Obesity has become a major medical and public health problem worldwide. Recent studies have shown that obesity is a chronic disease that is associated with many diseases, such as gallstone disease, acute pancreatitis, fatty liver, and digestive cancer. Obesity is also a risk factor for the formation of cholesterol gallstones. Clinical and epidemiological studies have suggested that obesity is positively associated with the risk of gallbladder cancer. Obesity may modulate the lipid and endogenous hormones metabolism, affect gallbladder motility, increase the risk of gallstones, and increased the risk of gallbladder cancer. In addition, obesity has been considered a risk factor for pancreatic diseases, including pancreatitis and pancreatic cancer. Obese patients develop systemic and local complications of acute pancreatitis more frequently. Several epidemiologic studies have suggested an association of pancreatic cancer with high body mass and lack of physical activity. This study reviewed the literature on obesity and pancreatobiliary disease in terms of epidemiology and mechanism.
Topics: Biliary Tract Diseases; Fatty Liver; Gallstones; Humans; Obesity; Pancreatic Diseases; Pancreatic Neoplasms; Pancreatitis; Risk Factors
PubMed: 32448855
DOI: 10.4166/kjg.2020.75.5.240 -
Journal of Ayub Medical College,... 2019Hemosuccus pancreaticus (HP) defined as bleeding into the pancreatic duct was first described in 1931 by Lower and Farell. HP also popularly known as wirsungorrhaghia... (Review)
Review
Hemosuccus pancreaticus (HP) defined as bleeding into the pancreatic duct was first described in 1931 by Lower and Farell. HP also popularly known as wirsungorrhaghia and pseudohemobilia is a rare cause of gastrointestinal bleed. The unfamiliarity of this condition makes HP a diagnostic challenge. HP should be considered in patients with chronic pancreatitis presenting with acute gastrointestinal bleeding. The diagnosis is usually confirmed with a computerized tomography (CT) scan of the abdomen. A mesenteric angiogram with coil embolization can be performed to arrest the bleeding. The literature on this condition is restricted to case reports, case series and retrospective studies. We describe a case of HP in a patient with gastrointestinal bleeding and take this opportunity to review the literature outlining the diagnosis and management of HP.
Topics: Angiography; Gastrointestinal Hemorrhage; Humans; Male; Middle Aged; Pancreatic Diseases; Pancreatic Ducts; Retrospective Studies; Tomography, X-Ray Computed
PubMed: 31933323
DOI: No ID Found -
Digestive Diseases (Basel, Switzerland) 2020Metabolic syndrome and its components such as obesity, hypertriglyceridemia, type-2 diabetes mellitus (DM-T2), and arterial hypertension are unequivocally serious... (Review)
Review
Metabolic syndrome and its components such as obesity, hypertriglyceridemia, type-2 diabetes mellitus (DM-T2), and arterial hypertension are unequivocally serious problems for every society. This is especially true in economically developed countries where the imbalance in lifestyle between caloric intake and caloric output still gets greater and greater. This fact is not only a concern for the adult population but for children as well. However, metabolic syndrome does not only affect society and health in regards to cardiovascular diseases, it significantly concerns gastroenterology where it is classified as nonalcoholic fatty pancreas disease (NAFPD). The data gained from several trials show that the prevalence of NAFDP is 33% (95% CI 24-41%). When it comes to the diagnostic procedures concerning the presence of pancreatic fat, a whole spectrum of suitable methods are recommended. Probably, the most exact method is the use of magnetic resonance imaging. However, for common clinical practice, the abdominal sonographic examination based on the comparison of the pancreatic parenchymatous echogenity versus renal or hepatic echogenity is used. The clinical consequences of pancreatic steatosis and steatopancreatitis are significant. These diseases are connected with DM-T2 and insulin resistance. In recent years, changes of exocrine pancreatic function, particularly its decrease, have also been described. It is known that there is a close correlation between NAFPD and nonalcoholic hepatic steatosis and also with the increased thickness of aortic intima-media. There is also an important relationship between NAFPD and pancreatic carcinoma. Pancreatic steatosis, and especially its NAFPD form, is a serious state which can be treatable by the possible effective management of metabolic syndrome parameters, including obesity.
Topics: Humans; Insulin Resistance; Microbiota; Non-alcoholic Fatty Liver Disease; Obesity; Pancreatic Diseases; Risk Factors
PubMed: 31865317
DOI: 10.1159/000505366 -
Pancreatology : Official Journal of the... Dec 2020Coronavirus disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has led to a world-wide pandemic since its onset in December... (Review)
Review
Coronavirus disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has led to a world-wide pandemic since its onset in December of 2019. Although, a primary respiratory pathogen, over the ensuing period, its extra-pulmonary effects have come to the forefront. The virus, having multi-organ tropism, has been shown to affect a host of other organs beyond the lung, including the pancreas. The data on pancreatic involvement by COVID-19, however, have been limited. Moreover, whether the effects on the pancreas are due to the direct effects of the virus or is just an epi-phenomenon is debatable. The prevalence of pancreatic injury and degree of injury are the other issues that need to be addressed. Pancreatic cancer has a dismal prognosis and the management of the same in the COVID era needs to be tailored assessing the risk-benefit ratio for the same. Additionally, pancreatic surgery increases not only the morbidity of the patient, but also the risk of the operator and burden on the health care system. Hence, the decision for such major procedures needs to be rationalized for optimum benefit during this pandemic. Similarly, for the endoscopist, pancreatic endoscopy needs to be carefully regulated to reduce risk to both the patient and the physician and yet deliver optimum patient care. This review gives a concise summary of various aspects of pancreatic involvement and pancreatic disease management during this pandemic.
Topics: COVID-19; Humans; Pancreas; Pancreatic Diseases; SARS-CoV-2
PubMed: 33250089
DOI: 10.1016/j.pan.2020.10.035 -
Clinical Gastroenterology and... Jan 2019The gut microbiome increasingly is recognized for its role in human health and disease. Initial evidence has indicated that gut microbial dysbiosis is associated with... (Review)
Review
The gut microbiome increasingly is recognized for its role in human health and disease. Initial evidence has indicated that gut microbial dysbiosis is associated with several pancreatic diseases. Although it is not known if these associations are causative, gut dysbiosis is hypothesized to mediate chronic proinflammatory changes in the pancreas. Further mechanistic and epidemiologic studies of the microbiome are needed. Ultimately, targeted modulation of the microbiota could have therapeutic value.
Topics: Dysbiosis; Gastrointestinal Microbiome; Gastrointestinal Tract; Host Microbial Interactions; Humans; Pancreatic Diseases
PubMed: 30144522
DOI: 10.1016/j.cgh.2018.08.045 -
Biomolecules Apr 2022Pancreatic exocrine and endocrine dysfunctions often come together in the course of pancreatic diseases as interdependent manifestations of the same organ. However, the... (Review)
Review
Pancreatic exocrine and endocrine dysfunctions often come together in the course of pancreatic diseases as interdependent manifestations of the same organ. However, the mechanisms underlying the bidirectional connection of the exocrine and endocrine pancreas are not fully understood. In this review, we aimed to synthetize the current knowledge regarding the effects of several exocrine pancreatic pathologies on the homeostasis of β-cells, with a special interest in the predisposition toward diabetes mellitus (DM). We focused on the following pancreatic exocrine diseases: chronic pancreatitis, acute pancreatitis, cystic fibrosis, pancreatic cancer, pancreatic resections, and autoimmune pancreatitis. We discuss the pathophysiologic mechanisms behind the impact on β-cell function and evolution into DM, as well as the associated risk factors in progression to DM, and we describe the most relevant and statistically significant findings in the literature. An early and correct diagnosis of DM in the setting of pancreatic exocrine disorders is of paramount importance for anticipating the disease's course and its therapeutical needs.
Topics: Acute Disease; Diabetes Mellitus; Glucose; Humans; Pancreas, Exocrine; Pancreatic Diseases; Pancreatitis
PubMed: 35625546
DOI: 10.3390/biom12050618