Rationale for eradication of Helicobacter pylori infection in duodenal ulcer disease.

Helicobacter pylori is presently considered a major factor predisposing to the development of duodenal ulceration. The risk of duodenal disease is increased up to 15-fold in patients with H pylori-associated gastritis compared with individuals without H pylori infection. This magnitude of risk with H pylori infection is higher than that of any other known or postulated factor contributing to duodenal ulcer formation.

Ratios of different serum pancreatic enzymes in the diagnosis and staging of chronic pancreatitis.

The aim of this study was to define an optimum serum enzyme ratio for the diagnosis of chronic pancreatitis (CP) and for the evaluation of the stage of the disease. With this goal in mind, a simultaneous and interrelated analysis of different serum pancreatic enzymes was performed in 296 consecutive patients with clinically suspected CP. A total of 167 patients were finally diagnosed with CP and 129 with other digestive diseases (used as controls).

Hyperlipidemia in acute pancreatitis. Relationship with etiology, onset, and severity of the disease.

Serum lipid (triglycerides and cholesterol) concentrations were studied in 49 patients with acute pancreatitis (AP). The aims of the study were to investigate the prevalence of hyperlipidemia (HL) in patients with AP according to etiology and to evaluate whether HL precedes or is a consequence of AP. Moreover, we analyzed the relationship between HL and the development of pancreatic necrosis.

Clinical usefulness of polymorphonuclear elastase in predicting the severity of acute pancreatitis: results of a multicentre study.

The usefulness and clinical applicability of quantitative plasma polymorphonuclear elastase determinations in the diagnosis of the severity of acute pancreatitis was analysed in a multicentre study and was compared with the usual prognostic systems of Ranson and Osborne et al. The study comprised 182 patients, 154 with a mild episode of acute pancreatitis and 28 with a severe episode, defined by the development of major complications or a fatal outcome. In the severe cases neutrophilic elastase reached significantly higher values than in mild cases (P less than 0.

[Acute pancreatitis associated with duodenal immunoblastic sarcoma and upper digestive hemorrhage].

We present a patient with acute pancreatitis that was specially persistent from a biochemical viewpoint, derived from a duodenal sarcomatous tumor of immunoblastic type that narrowed the second duodenal segment for a length of about 8 centimeters. We discuss the possible role of tumoral neoformations in the production of pancreatitis due to increased intraluminal pressure distal to the Vater ampulla, or to occlusion of the Oddi sphincter or the Wirsung duct. We review the existent literature.

[Macroamylasemia: its current and clinical importance].

The understanding of the causes for hyperamylasemia is of great importance when focusing on the differential diagnosis of acute pancreatitis. Among the causes for hyperamylasemia, special interest is given to macroamylasemia not only because it is poorly understood, but also because we are lacking national studies. In this disorder, the amyl binds to another serum substance, varying from one patient to another, and forms a macromolecular complex.