Pancreatic infarction

O Primary peritonitis develops in up to 25% of patients with alcoholic cirrhosis.3 Patients undergoing continuous ambulatory peritoneal dialysis (CAPD) average one episode of peritonitis every 2 years.4 Secondary peritonitis may be caused by perforation of a peptic ulcer traumatic perforation of the stomach, small or large bowel, uterus, or urinary bladder appendicitis pancreatitis diverticulitis bowel infarction inflammatory bowel disease cholecystitis operative contamination of the peritoneum or diseases of the female genital tract such as septic abortion, postoperative uterine infection, endometritis, or salpingitis. Appendicitis is one of the most common causes of intraabdominal infection. In 1998, 278,000 appendectomies were performed in the United States for suspected appendicitis.5... 

Didanosine (ddl) NRTT1 Tablets, 400 mg daily,3 adjusted for weight. 30 min before or 2 h after meals. Separate dosing from fluoroquinolones and tetracyclines by 2 h Peripheral neuropathy, pancreatitis, diarrhea, nausea, hyperuricemia. Possible increase in myocardial infarction Avoid concurrent neuropathic drugs (eg, stavudine, zalcitabine, isoniazid), ribavirin, and alcohol. Do not administer with tenofovir... 

A 55-year-old woman with a history of chronic pancreatitis developed epigastric pain and melena and was found to have a splenic artery pseudoaneurysm expanding a pseudocyst. She was given an intravenous bolus of octreotide followed by an infusion of 50 micrograms/ hour. A CT scan subsequently suggested thrombosis of the pseudoaneurysm, with segmental splenic infarction. Nine months later the pseudoaneurysm had recanalized. 

Acute inflammation Acute viral infections Kidney stones Preeclampsia Surgical trauma Transplant rejection Myocardial infarction CHF Pancreatitis Trauma... 

Severe complications connected with cholera (or combined) immunization are extremely rare and the causal relation is always doubtful. However, when they do occur they constitute a contraindication to further administration. There are occasional reports of neurological and psychiatric reactions (SED-8, 706) (SEDA-1, 246), Guillain-Barre syndrome (SEDA-1, 246), myocarditis (154,155), myocardial infarction (SEDA-3, 261), a syndrome similar to immune complex disease (156), acute renal insufficiency accompanied by hepatitis (157), and pancreatitis (158). 

GGT is fouud particularly iu hepatocytes aud biliary epithelial cells. GGT serum levels may be high iu liver disease, but it is particularly a feature of biliary outflow obstruction more so than hepatocellular damage. GGT serum measuremeut provides a very sensitive indicator of the presence or absence of hepatobiliary disease. However, raised GGT levels have also been reported in a variety of other clinical conditions, including pancreatic disease, myocardial infarction, chronic obstructive pulmonary disease, renal failure, diabetes, obesity and alcoholism. It is also a sensitive indicator of liver damage through alcohol iugestion. 

Intrabiliaiy pressure may rise substantially after morphine (as much as 10 times in 10 minutes), due to spasm of the sphincter of Oddi. Sometimes biliary colic is made worse by morphine, presumably in a patient in whom the dose happens to be adequate to increase intrabiliary pressvue, but insufficient to produce more than slight analgesia. In patients who have had a cholecystectomy this can produce a syndrome sufficiently like a myocardial infarction to cause diagnostic confusion. Naloxone may give dramatic symptomatic relief, as may glyceryl trinitrate. Another result of this action of morphine is to dam back the pancreatic juice and so cause a rise in the serum amylase concentration. Morphine is therefore best avoided in pancreatitis but buprenorphine has less of this effect. 

Elevation of y-GT is found in cholestasis, liver cirrhosis, viral hepatitis, fatty liver, porphyria, toxic liver damage, pancreatitis and pancreatic cancer, myocardial infarction, nephrotic syndrome, diabetes mellitus, right heart failure, obesity, nicotine abuse, and brain tumours. There is a good correlation of y-GT with CEA in colon cancer, involving a metastatic spread to the liver - an increase in y-GT in neoplastic disease is likewise supportive of the diagnosis of hepatic metastases. 

Hepatic parenchymal diseasfii muscle disease Grganophosphorus insecticide oisoningj suxamethonium sensitivity, hepatic parenchymal diseases Muscle diseases, myocardial infarction Hepatic parenchymal diseases Hepatobiliary diseases Hemolysis, hepatic parenchymal diseases, myocardial infarction Pancreatic diseases Hepatobiliary disease Pancreatic diseases... 

Pancreatitis, any cause (P-AMY T) Pancreatic trauma (P-AMYT) Biliary tract disease (P-AMYT) - Intestinal obstruction (PtAMYT) Mesenteric infarction (P-Alv4Y(t Perforated peptic ulcer (P-AMYiT) Gastritis, duodenitis (P-AMY ) Ruptured aortic aneurysm Acute appendicitis Peritonitis Trauma... 

Gallbladder disease, hepatic adenoma, blood clot, pancreatitis Blood clot in lungs or myocardial infarction (heart attack)... 

Elevated lipoprotein concentration contributes to the formation of atherosclerotic plaques and in some cases pancreatitis. Occlusion of blood vessels by atherosclerotic plaques causes tissue infarction (e.g., stroke, myocardial infarction), which is frequently fatal. Pharmacologic reduction of serum lipoprotein levels suppresses the development of atherosclerosis. 

There is one further indication for thrombin occlusion of pancreatitis associated visceral aneurysms. Where the portal vein has occluded as a complication and the patient has a proximal splenic or gastroduodenal aneurysm, the proximal and distal coil embolization of which could compromise the hepatic arterial supply to the liver causing liver infarction, thrombin injection maybe a safer technique [29]. 

Muroi, J., Yorifuji, T., Uematsu, A. et al. (2000) Cerebral infarction and pancreatitis possible complications of patients with 3-hydroxy-3-mthylglutaryl-CoA lyase deficiency. I. Inherit. Metab. Dis., 23, 636-637. 

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