scholarly journals Defining a Therapeutic Program for Recurrent Acute Pancreatitis Patients with Unknown Etiology

2014 ◽  
Vol 7 ◽  
pp. CGast.S13531 ◽  
Author(s):  
Vincenzo Neri ◽  
Francesco Lapolla ◽  
Alessandra Di Lascia ◽  
Libero Luca Giambavicchio
Keyword(s):  
Acute Pancreatitis ◽  
Sphincter Of Oddi ◽  
Diagnostic Process ◽  
Unknown Etiology ◽  
Sphincter Of Oddi Dysfunction ◽  
Endoscopic Retrograde ◽  
Recurrent Acute Pancreatitis ◽  
Therapeutic Program ◽  
Oddi Dysfunction

Aim To define a therapeutic program for mild-moderate acute pancreatitis (AP), often recurrent, which at the end of the diagnostic process remains of undefined etiology. Material and Methods In the period 2011-2012, we observed 64 cases of AP: 52 mild-moderate, 12 severe; biliary 39, biliary in alcoholic chronic pancreatitis 5, unexplained recurrent 20. The clinical and instrumental evaluation of the 20 cases of unexplained AP showed 6 patients with biliary sludge, 4 microlithiasis, 4 sphincter of Oddi dysfunction, and 6 cases that remained undefined. Results Among 20 patients with recurrent, unexplained AP at initial etiological assessment, we performed 10 video laparo cholecystectomies (VLCs), 2 open cholecystectomies and 4 endoscopic retrograde cholangiopancreatography/endoscopic sphincterotomies (ERCP/ES) in patients who had undergone previous cholecystectomy; 4 patients refused surgery. Among these 20 patients, 6 had AP that remained unexplained after second-level imaging investigations. For these patients, 4 VLCs and 2 ERCP/ES were performed. Follow-up after six months was negative for further recurrence. Conclusion The recurrence of unexplained acute pancreatitis could be treated with empirical cholecystectomy and/or ERCP/ES in cases of previous cholecystectomy.

Recurrent Acute Pancreatitis Associated with Sphincter of Oddi Dysfunction in a Child

2008 ◽  
Vol 11 (2) ◽  
pp. 193
Author(s):  
Byung Ho Choi ◽  
Sun Min Park ◽  
Ho Gak Kim ◽  
Jung Mi Kim ◽  
Suk Jin Hong ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Sphincter Of Oddi ◽  
Sphincter Of Oddi Dysfunction ◽  
Recurrent Acute Pancreatitis ◽  
Oddi Dysfunction

833 An Interesting Association Between Recurrent Acute Pancreatitis and Myotonic Dystrophy, A Case Report

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
K A Vijayagopal ◽  
M Issa ◽  
M Fok ◽  
M S Javed
Keyword(s):  
Acute Pancreatitis ◽  
Case Report ◽  
Myotonic Dystrophy ◽  
Striated Muscle ◽  
Case Reports ◽  
Sphincter Of Oddi ◽  
Sphincter Of Oddi Dysfunction ◽  
Recurrent Acute Pancreatitis ◽  
Emergency Presentation ◽  
Review Reports

Abstract Myotonic Dystrophy(MD) is an autosomal dominant genetic condition affecting the musculoskeletal system. Recurrent acute pancreatitis(RAP) is a frequent presentation in the emergency surgical scenario with two or more episodes of established acute pancreatitis separated by a minimum of 3 month periods. We report here a case of a patient presenting with a background of Myotonic Dystrophy with a third episode of RAP. Diagnostic work up led to the discovery of microlithiasis as a possible cause of pancreatitis in our patient. Literature review reports two other case reports detailing a potential association between MD and pancreatitis at the time of writing. This could be due to disturbances of the pancreatobiliary system, resulting from the sphincter of Oddi dysfunction (SOD) and gallbladder myotonia as MD affects the smooth and striated muscle of the gastrointestinal tract. In our case report, we highlight the importance of understanding how MD is a rare cause for a common surgical emergency presentation clinicians should be aware of.

scholarly journals Acute Recurrent Pancreatitis

2003 ◽  
Vol 17 (6) ◽  
pp. 381-383 ◽  
Author(s):  
Glen A Lehman
Keyword(s):  
Acute Pancreatitis ◽  
Endoscopic Sphincterotomy ◽  
Microscopic Analysis ◽  
Sphincter Of Oddi ◽  
Recurrent Pancreatitis ◽  
Endoscopic Retrograde ◽  
Recurrent Acute Pancreatitis ◽  
Idiopathic Pancreatitis ◽  
Minor Papilla ◽  
The Common

History, physical examination, simple laboratory and radiological tests, and endoscopic retrograde cholangiopancreatography (ERCP) are able to establish the cause of recurrent acute pancreatitis in 70% to 90% of patients. Dysfunction of the biliary and/or pancreatic sphincter, as identified by sphincter of Oddi manometry, accounts for the majority of the remaining cases. The diagnosis may be missed if the pancreatic sphincter is not evaluated. Pancreas divisum is a prevalent congenital abnormality that is usually innocuous but can lead to recurrent attacks of acute pancreatitis or abdominal pain. In select cases, endoscopic sphincterotomy of the minor papilla can provide relief of symptoms and prevent further attacks. A small proportion of patients with idiopathic pancreatitis have tiny stones in the common bile duct (microlithiasis). Crystals can be visualized during microscopic analysis of bile that is aspirated at the time of ERCP. Neoplasia is a rare cause of pancreatitis, and the diagnosis can usually be established by computerized tomography or ERCP. A wide variety of medications can also cause recurrent pancreatitis. ERCP, sphincter of Oddi manometry, and microscopy of aspirated bile should be undertaken in patients with recurrent pancreatitis in whom the diagnosis is not obvious.

Sign in / Sign up

Export Citation Format

Share Document