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At least 721 records · Page 40Linked to original sources
PubMed1989

The human celiac ganglion and its splanchnic nerves.

Forty-six dissections of the celiac ganglion were performed on post-mortem specimens, and the form, location and nervous connections of the ganglion on both sides were studied. The triangular form was the most common observed, the ganglions were found to envelope both the celiac and superior mesenteric arteries, putting them closely together, and forming a celiacomesenteric complex similar to that found in the pig. The splanchnic nerves penetrated the diaphragm through a special triangular opening lateral to the crus, in 70-91%. These findings concerning form and nervous connections are somewhat different from those reported in the literature.

Aged↗
PubMed1993

Pancreatic pain: is there a medical alternative to surgery?

The non-surgical management of chronic pancreatic pain is reviewed. In accordance with the suggested multifactorial origin of pancreatic pain, different treatment principles are practised. Besides conventional analgesic drugs, oral pancreatic enzymes seem efficient in a subgroup of patients with chronic pancreatitis. Endoscopic treatment aiming at reduction of the pancreatic duct-tissue pressure is promising, but it is still in its infancy. Coeliac nerve blockage is recommended in patients with pancreatic cancer and pain, whereas external radiotherapy plays a role in a diminishing number of these patients. Treatment of chronic pancreatic pain is an example of a complex clinical problem in which a multidisciplinary approach is mandatory.

Abdominal Pain↗
PubMed1998

Young woman's digestive arterial occlusion--a case report and literature review.

The authors report the observation of a 31-year-old woman who presented with total occlusion of digestive arteries and was successfully treated pharmacologically. A review of the literature shows that digestive arteries thrombosis is a rare condition in young women. Only 15 cases have been previously reported. Prognosis was poor with a mortality rate of 71%; 93% used oral contraception and more than 50% were smokers. All these cases were curiously similar. The authors accentuate the role of iloprost in the recovery of the patient. Digestive artery occlusion should be taken into consideration in the differential diagnosis of abdominal pain, especially in young women who smoke and take estrogen-containing birth control pills.

Adult↗
PubMed1993

Audit of neural blockade for palliative care patients in an acute unit.

During the period from September 1990 to March 1992, 155 nerve blocks were performed for 125 patients as part of the clinical management of pain due to malignant disease. The efficacy, in terms of pain score reduction, and spontaneously reported side effects secondary to these procedures were prospectively audited. Neural blockade was undertaken in accordance with strict clinical criteria, and medication was optimized with the aim of achieving maximum analgesia with minimum side effects at all times. Pain was assessed before the block, 24 hours after the block and at follow-up (two to six weeks) using visual analogue scores or verbal rating scales. All patients were audited. The total (all patients, all blocks) median (lower-upper quartile) pain score dropped from 8 (6-10) cm before the block to 2 (0-4) cm at 24 hours after the block (p < 0.05) and to 1 (0-4) cm at follow-up (p < 0.005). A concomitant reduction in analgesic requirements was observed. The incidence of serious side effects was low (two patients in this series). The results indicate the usefulness of these techniques for patients in the palliative care setting.

Analgesia, Epidural↗
PubMed2003

Angioplasty/stenting of the superior mesenteric artery and celiac trunk: early and late outcomes.

PURPOSE: To analyze the early results and durability of angioplasty/stenting of the superior mesenteric artery (SMA) and celiac trunk (CT). METHODS: Twenty-two patients (19 women; mean age 69.2 years, range 52-88) with 24 symptomatic SMA or CT stenotic lesions were treated with dilation/stenting over a recent 4.5-year period. Two patients had lesions in both the SMA and CT treated. Clinical follow-up and duplex exams were done to evaluate long-term patency. Kaplan-Meier life-table analyses estimated the freedom from recurrent stenosis and recurrent symptoms, as well as survival rates. RESULTS: The initial technical and clinical success rates were 96% (23/24) and 95% (21/22), respectively, with no perioperative mortality or major morbidity. During a mean follow-up of 26 months (range 1-54), the primary late clinical success rate was 61% (11/18; 4 lost to follow-up), and freedom from recurrent stenosis (> or =70%) was 30% (6/20). The freedom from recurrent stenosis at 1, 2, 3, and 4 years were 65%, 47%, 39%, and 13%; freedom from recurrent symptoms was 67% at all 4 intervals. The survival rates were 93%, 93%, 80%, and 53% at 1 to 4 years, respectively. CONCLUSIONS: Angioplasty/stenting of SMA and CT stenoses has a high initial technical success rate and acceptable early and late clinical outcomes; however, it is associated with a high incidence of late restenosis based on strict Doppler criteria.

Aged↗
PubMed1977

[Effect of surugatoxin on celiac ganglia in cats (author's transl)].

Pharmacological properties of surugatoxin (SGTX), the toxic principle from Japanese ivory mollusc (Babylonia japonica), have been studied. In the present paper, the effect of SGTX on celiac ganglia in cats was investigated by measuring blood pressure from femoral artery and regional blood flow in liver (LBF) and spleen (SBF) of anaesthetized cats. SGTX(50 nmol/kg i.v.) markedly inhibited both the hypertension and changes of LBF and SBF in response to splanchnic (preganglionic) nerve stimulation. On the other hand, it did not inhibit the changes of SBF by splenic(postganglionic) nerve stimulation. The hypertension and changes in LBF and SBF in response to DMPP(94.2 nmol/kg i.v.) were abolished by SGTX(50 nmol/kg i.v.), whereas those to McN-A-343 (94.8 nmol/kg i.v.) were not. SGTX usually enhanced the pressor response to McN-A-343. These results indicate that SGTX has a blocking effect on the nicotinic receptor in celiac ganglia as well as in superior cervical ganglia of cats and rats.

(4-(m-Chlorophenylcarbamoyloxy)-2-butynyl)trimethy↗
PubMed1989

Crossover study on effects of duct obliteration, celiac denervation, and autotransplantation on glucose- and meal-stimulated insulin, glucagon, and pancreatic polypeptide levels.

In segmental-pancreas transplantation the body and tail of the pancreas are used. In an experimental study in dogs, the effects of sequentially conducted removal of the right pancreatic lobe (pancreatic head), duct obliteration, celiac denervation, and autotransplantation were studied according to a crossover design. Two groups of dogs were studied. In both groups the right lobe of the pancreas was removed at primary operation, and the duct of the transected left lobe (body and tail) was injected with fibrin sealant. The left lobe was completely freed from surrounding tissue (celiac denervation) in group 1 (n = 9), and the innervation of the left lobe was left intact in group 2 (n = 8). At 12 wk, two dogs in group 1 and four dogs in group 2 underwent successful autotransplantation of the left lobe. Pancreatic hormone secretion was stimulated by intravenous glucose injection and test-meal administration before primary operation and at 11 and 18 wk thereafter. The combination of removal of the right lobe and duct obliteration led to a decrease in glucose tolerance at both stimulation tests and a decrease in peripheral insulin release after intravenous glucose injection. At test-meal administration, no change in insulin and glucagon levels was demonstrated. If celiac denervation was added, similar results were obtained based on the understanding that the peripheral insulin release after the test meal was significantly elevated. Meal-stimulated pancreatic polypeptide response was abolished in both groups. Removal of the right lobe leads to parasympathic denervation of the left lobe, and celiac denervation mainly interferes with alpha-adrenergic innervation.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗