Risks and use of ERCP during the diagnostic workup in a national cohort of biliary cancer.

Background: In biliary cancer, the indication of endoscopic intervention might be diagnostic as well as therapeutic, in the latter situation with the aim to relieve biliary obstruction e.g. by stenting.

Genetic basis of hypertriglyceridemia.

The development of massive sequencing techniques and guidelines for assessing the pathogenicity of variants are allowing us the identification of new cases of familial chylomicronemia syndrome (FCS) mostly in the LPL gene, less frequently in GPIHBP1 and APOA5, and with even fewer cases in LMF1 and APOC2. From the included studies, it can be deduced that, in cases with multifactorial chylomicronemia syndrome (MCS), both loss-of-function variants and common variants in canonical genes for FCH contribute to the manifestation of this other form of chylomicronemia. Other common and rare variants in other triglyceride metabolism genes have been identified in MCS patients, although their real impact on the development of severe hypertriglyceridemia is unknown.

Familial chylomicronemia: New perspectives.

Familial chylomicronemia syndrome (FCS) is a very rare, underdiagnosed disorder that can cause abdominal pain and recurrent pancreatitis from childhood -potentially life-threatening- and chronic complications such as diabetes mellitus and exocrine pancreatic insufficiency. FCS affects the quality of life and mental health of those who suffer from it, aspects that must be taken into account in its treatment, based on a strict low-fat diet, which is difficult to adhere to and persist. People with FCS lack the lipolytic capacity to hydrolyze triglycerides (TG) and have a minimal or null response to conventional lipid-lowering treatments.

Multifactorial chylomicronemia: keys to detecting severe forms.

Multifactorial chylomicronemia associated with multiple comorbidities, drugs and habits is much more common than familial chylomicronemia, an autosomal recessive disease that can be considered as "rare disease". Like the rest of hypertriglyceridemias, chylomicronemias could be classified as primary or monogenic and secondary in which, on the basis of polygenic predisposition, there is concomitant exposure to multiple triggering factors. In this brief revision, we will review its causes and management as well as the keys to its differential diagnosis of the Multifactorial Chylomicronemia.

Identification and Quantification of Deranged Metabolites in Critically Ill Patients Using NMR-Based Metabolomics.

Metabolomics is emerging as a significant approach to reflect the individual's response to pathophysiological conditions. Nuclear magnetic resonance (NMR) spectroscopy has evolved as a tool to identify metabolic dysregulations in critically ill patients afflicted with conditions like acute respiratory distress syndrome (ARDS), severe acute pancreatitis (SAP), acute kidney injury (AKI), and sepsis. The spectral data from the serum sample of the study and control group are recorded using an 800 MHz NMR spectrometer and processed using NMR processing and analysis tools.

Steroid-resistant immunoglobulin G4-related coronary arteritis: a case report.

Background: Immunoglobulin G4 (IgG4)-related diseases are systemic fibroinflammatory disease characterized by extensive infiltration of IgG4-positive plasma cells in the affected tissue(s), with high plasma levels of IgG4. However, coronary involvement is rare.

Case Summary: A 70-year-old man was diagnosed with IgG4-related coronary arteritis, pancreatitis, and cholangitis during full-body contrast computed tomography (CT) examination prior to surgery for an iliac artery aneurysm.

A Rare Case of Autoimmune Pancreatitis in a 9-Year-Old Male Patient: A Comprehensive Diagnosis and Successful Treatment.

Autoimmune pancreatitis (AIP) is a rare and complex condition that can be difficult to identify due to its resemblance to malignancies. This case report presents a unique instance of AIP in a 9-year-old male patient who presented with painless jaundice and elevated liver function test results. His symptoms were persistent even after previous common bile duct stent placement, requiring additional investigation.

Fatal Tracheal and Bronchial Destruction Due to Pulmonary Mucormycosis in a 20-Year-Old with Diabetic Ketoacidosis.

Pulmonary mucormycosis is a rare and aggressive invasive fungal infection that predominantly affects immunocompromised individuals, such as those with diabetes mellitus or those undergoing immunosuppressive therapy. This case describes a severe instance of pulmonary mucormycosis resulting in progressive tracheal wall destruction in a young, previously healthy male. A 20-year-old male with a denied history of diabetes mellitus was admitted to a local hospital with abdominal pain for 9 days and diagnosed with acute pancreatitis and diabetic ketoacidosis (DKA).

Use of Pancreatic Density on Computed Tomography to Predict Postendoscopic Retrograde Cholangiopancreatography Pancreatitis.

Introduction: Postendoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) is a frequent complication, and its pathogenesis remains unclear, with various patient and procedural factors proposed as potential contributors. This study aimed to assess the predictive value of pancreatic to splenic density ratio on computed tomography (CT) for PEP in patients with inadvertent pancreatic duct cannulation.

Methods: This retrospective study involved 2556 patients undergoing ERCP from January 2014 to December 2020.

[Minimally invasive treatment of infected pancreatic necrosis in a patient with lupic pancreatitis].

Acute pancreatitis (AP) is one of the most common gastrointestinal diseases that requires hospital admission in our environment, where early medical treatment and a staggered approach sequence significantly reduces morbidity and mortality. Pancreatic necrosis is associated with a death rate of 8 to 39% and is practically always an indication for intervention. This condition as a manifestation of systemic lupus erythematosus (SLE) is rare and its frequency is less than 5%.

Permanent pacemaker implantation for atrioventricular block secondary to acute pancreatitis in a patient affected by panhypopituitarism.

Background: Hypopituitarism may trigger the development of acute pancreatitis (AP) through multiple mechanisms. AP may alter normal intracardiac conduction leading to an atrioventricular block. Due to the lack of similar cases, the correct timing and indication for pacemaker implantation in such a setting are unknown.

Research Progress and Application Prospects of Animal Models of Group B Coxsackievirus Infections.

Group B Coxsackieviruses (CVBs) consist of six serotypes, CVB1 to CVB6, which can clinically affect the heart, brain, liver, pancreas and other organs, causing myocarditis, encephalitis, myelitis, pancreatitis, hand-foot-and-mouth disease (HFMD) and other diseases, and can even lead to death. CVBs are widespread globally and highly contagious. However, there are currently no approved CVB vaccines or effective treatments.

[Pancreatic cystic neoplasms: work-up and surveillance].

Whereas pancreatic masses are often difficult to detect with transabdominal ultrasound, cross-sectional imaging features high sensitivity for the pancreatic tumors. However, increasing availability of magnetic resonance imaging (MRI) has led to a surge in the detection of benign or precancerous pancreatic lesions. The medical history is characteristic only for two entities.

Nanomedicine regulating PSC-mediated intercellular crosstalk: Mechanisms and therapeutic strategies.

Pancreatic fibrosis (PF) is primarily distinguished by the stimulation of pancreatic stellate cells (PSCs) and excessive extracellular matrix deposition, which is the main barrier impeding drug delivery and distribution. Recently, nanomedicine, with efficient, targeted, and controllable drug release characteristics, has demonstrated enormous advantages in the regression of pancreas fibrotic diseases. Notably, paracrine signals from parenchymal and immune cells such as pancreatic acinar cells, islet cells, pancreatic cancer cells, and immune cells can directly or indirectly modulate PSC differentiation and activation.

Endoscopic innovations in diagnosis and management of pancreatic cancer: a narrative review and future directions.

Pancreatic cancer serves as the third leading cause of cancer-associated morbidity and mortality in the United States, with a 5-year survival rate of only 12% with an expected increase in incidence and mortality in the coming years. Pancreatic ductal adenocarcinomas constitute most pancreatic malignancies. Certain genetic syndromes, including Lynch syndrome, hereditary breast and ovarian cancer syndrome, hereditary pancreatitis, familial adenomatous polyposis, Peutz-Jeghers syndrome, familial pancreatic cancer mutation, and ataxia telangiectasia, confer a significantly higher risk.

Optimized FDG-PET/MRI protocol reveals metabolic predictors of long-term survival in pancreatic cancer patients.

Purpose: To optimize and assess an abbreviated dual time-point 18-Fluor-Deoxyglucose (FDG)-Positron Emission Tomography (PET)/Magnetic Resonance Imaging (MRI) protocol for predicting patient outcomes in pancreatic cancer.

Methods: 70 patients (47 pancreatic cancer, 23 chronic pancreatitis) underwent hybrid PET/MRI with dual time-point PET/CT at 60 and 84 minutes post-injection. Metabolic indices (MI) were calculated from Standardized Uptake Value (SUV) changes (SUVmin, SUVmean and SUVmax).

Pancreatic extracorporeal shock wave lithotripsy: a key technology truly improves treatment model for pancreatic stones.

Chronic pancreatitis (CP) is characterized by irreversible destruction of pancreatic parenchyma, inflammatory cell infiltration and progressive fibrosis of pancreatic tissue. Obstruction of pancreatic duct by pancreatic stone is the common pathological change in the course of CP with the incidence of over 50 % at the diagnosis of CP. These ductal stones would cause pancreatic parenchymal hypertension and local ischemia, which was eventually followed by recurrent episodes of painful pancreatitis or other manifestations of pancreatic exocrine and endocrine insufficiency.

Usefulness of Fecal Calprotectin Measurement in aPediatric Patient with Crohn's Disease.

Acute pancreatitis in children in Japan is often caused by an anatomical abnormality of the pancreatic and bile duct, resulting in fever, abdominal pain, vomiting, diarrhea, and other symptoms.　Crohn's disease, however, is a chronic granulomatous inflammatory bowel disease with ulcerative lesions of the intestinal tract of unknown cause that occurs mainly in young people, with symptoms similar to those of acute pancreatitis.　We report a case of acute pancreatitis diagnosed in a patient not only with incomplete fusion of the pancreatic duct but also with Crohn's disease.

A CNA-35-based high-throughput fibrosis assay reveals ORAI1 as a regulator of collagen release from pancreatic stellate cells.

Rationale: Pancreatic stellate cells (PSCs) produce a collagen-rich connective tissue in chronic pancreatitis and pancreatic ductal adenocarcinoma (PDAC). Ca-permeable ion channels such as ORAI1 are known to affect PSC proliferation and myofibroblastic phenotype. However, it is unknown whether these channels play a role in collagen secretion.