PubMed HealthSearch

Biomedical subjects

G Lundh

Publications and source records attributed to G Lundh.

At least 19 recordsLinked to original sources

Evaluation of the diagnosis pancreatitis.

A widely used classification of pancreatitis is the one proposed in Marseilles in 1963, which distinguishes among acute, acute relapsing, chronic relapsing, and chronic pancreatitis. The diagnostic criteria in chronic pancreatitis are permanent damage of morphology and/or function of the pancreas after clinical symptoms of pancreatitis. In clinical practice, however, it can be difficult to find the suitable and comparable diagnosis in accordance with the Marseilles classification. In the present study the exocrine and endocrine function and the morphology of the pancreas have been thoroughly investigated in 54 patients who have been treated for various diagnoses of pancreatitis. The results show that the above diagnostic criteria often are difficult to interpret. We consider that the prevailing classification of pancreatitis needs to be revised in the light of progress in investigative techniques. A proposal for a modified classification is presented.

Adult

Clinical course and autopsy findings in acute and chronic pancreatitis.

A retrospective study of 314 patients hospitalized for pancreatitis in the period 1972-1973, showed that 74 (24%) had died in the course of five years. The aim of the study was to elucidate the etiology and the course of the pancreatitis and the immediate cause of death in the 61 cases where an autopsy was performed. There were three types of histopathological findings at autopsy concerning the pancreas: acute hemorrhagic pancreatitis, chronic pancreatitis and one group with no or minimal changes in the pancreas. The last group had had typical clinical symptoms of pancreatitis with abdominal pain and elevated urine and/or serum amylase, in many patients a very marked rise. Alcoholism was the dominant predisposing factor, regardless of the type of histopathological findings, but when the first attack of pancreatitis appeared at advanced age, biliary tract disease and cancer were the dominant causes. Liver damage was a common finding in alcoholic pancreatitis.

Adult

Prognosis in acute haemorrhagic, necrotizing pancreatitis.

Acute haemorrhagic and/or necrotizing pancreatitis is a most serious condition. A retrospective account is presented of the clinical course, treatment and results in 61 patients with the diagnosis confirmed at laparotomy and/or autopsy. Forty-eight patients (79%) died while in hospital. Of the 13 surviving patients, 10 were followed up for periods ranging from 1.5 to 9 years. They were reinvestigated with respect to morphologic and exocrine and endocrine functional changes in the pancreas. The aetiology of the acute condition was biliary tract disease in 33% of the total series and alcoholism in 59%. Neither cause of the disease nor type of treatment (surgery with or without peritoneal lavage) had statistically significant effect on survival. At the follow-up examination the endocrine and exocrine pancreatic functions were satisfactory in many patients. In almost half of the surviving patients, endoscopic retrograde pancreatography showed openly minor changes.

Acute Disease