Chronic pancreatitis is a progressive inflammatory disease resulting from repeated episodes of acute pancreatitis that impair exocrine function and eventually produce endocrine insufficiency. Some causes of chronic pancreatitis appear to be associated with alterations in the serine-protease inhibitor, Kazal type 1 (SPINK1), cationic trypsinogen (PRSS1), and cystic fibrosis-transmembrane conductance regulator (CFTR) genes, or with structural disorders in the pancreaticobiliary ductal system, such as pancreatic divisum or anomalous pancreaticobiliary ductal union (APBDU). However, it is unusual to observe both genetic alteration and structural anomaly. Here, we report 2 cases with both APBDU and a mutation in the SPINK1 genes, and we discuss the implications of these findings in clinical practice.
Pancreatitis ; Pancreatitis, Chronic ; Trypsinogen

11 patients aged 24-70, with pancreatitis admitted at Viet Duc Hospital from Jan 1998 to Dec 2002. Ultrasonic examination was carried out and terminated diagnosis was performed surgically, blood level of amylase increased by 3 times versus normal level. The highest incidence level is in the middle age (13/14 patients – 31,7%). Ultrasonic signs characteristic for acute pancreatitis of edematous form is enlarged pancrea with appeared edge, low echo or equal echo of pancrea parenchyma. In necrojy form of acute pancreatitis the pancrea edge is dim, pancrea parenchyma is unregulated with the mixed structure. In 9/41 patients, by ultrasound the pancrea is not appeared. Thus in accessing the pancrea, pancreatitis can be diagnosed with a sensibility of 81,23%
Pancreatitis ; Ultrasonics ; Pancreatitis, Acute Necrotizing

No abstract available.
Pancreatitis, Chronic*

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Pancreatitis, Chronic*

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Pancreatitis, Chronic*

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Pancreatitis, Chronic*

Acute necrotizing pancreatitis accounts for 10% of acute pancreatitis (AP) cases and is associated with a higher mortality and morbidity. Necrosis within the first 4 weeks of disease onset is defined as an acute necrotic collection (ANC), while walled off pancreatic necrosis (WOPN) develops after 4 weeks of disease onset. An infected or symptomatic WOPN requires drainage. The management of pancreatic necrosis has shifted away from open necrosectomy, as it is associated with a high morbidity, to less invasive techniques. In this review, we summarize the current management and therapies for acute necrotizing pancreatitis.
Drainage ; Mortality ; Necrosis ; Pancreatitis* ; Pancreatitis, Acute Necrotizing

Chronic pancreatitis (CP) is an inflammatory disease and causes chronic pain, exocrine and endocrine function failure. Pain is major indication for surgical procedure indication in CP. Advances in noninvasive treatment now allow for better therapeutic options at an early stage of CP. However, many data show that surgical procedure may produce superior results to endoscopic treatment in CP management. Considerable controversy remains with respect to the surgical management of chronic pancreatitis. There are many surgical options to control chronic pain in CP, therefore preoperative assessment is important to choose optimal surgical management. Effective surgical procedures and timing of surgery for chronic pancreatitis remain unclear. This review comprehensively assesses the evidence for these different approaches to surgical intervention in chronic pancreatitis.
Chronic Pain ; Pancreatitis ; Pancreatitis, Chronic* ; Surgeons*

Haemosuccus pancreaticus describes the syndrome of gastrointestinal bleeding into the pancreatic duct, manifested by blood loss through the ampulla of Vater. It has been confined mainly to small series or isolated case reports in patients with chronic pancreatitis with pseudocysts. Endoscopy is useful mostly to exclude other sources of hemorrhage but visualization of bleeding from the papilla is a rare event. A case in herein reported of a patient, suffering from bleeding into the pancreatic duct, who had a history of recurrent, chronic pancreatitis with pseudocysts for 6 months. During duodenoscopic examination, bleeding from the papilla of Vater was identified, however the alternative cause was not suggestive. In alcoholic pancreatitis, recurrent eipsodes of acute pancreatitis with pancreatic ductal hemorrhage is a natural history, so resection of the affected segment of the pancreas can be the treatment of choice. A distal pancreatectomy and splenectomy was performed.
Ampulla of Vater ; Endoscopy ; Hemorrhage ; Humans ; Natural History ; Pancreas ; Pancreatectomy ; Pancreatic Ducts ; Pancreatitis ; Pancreatitis, Alcoholic ; Pancreatitis, Chronic ; Splenectomy

Since the pancreas and the spleen lie in close proximity, splenic complications during the course of pancreatitis are possible, but uncommon. No previously published report in Korean has described splenic subcapsular hematoma due to pancreatitis, and we now report one such case.
Hematoma* ; Pancreas ; Pancreatitis ; Pancreatitis, Chronic* ; Spleen*