The clinical characteristics of focal acute pancreatitis based on imaging diagnosis: comparison with non-localized acute pancreatitis- a preliminary result.

BACKGROUND: Focal acute pancreatitis is a special type of acute pancreatitis, which diagnosis is based on image showing a focal mass formation in the pancreas. For acute pancreatitis with or without focal inflammatory enlargement, little is known on differences between them. Our purpose was to find differences between focal acute pancreatitis and non-localized acute pancreatitis. METHODS: We reviewed the medical records of a total of 24 patients diagnosed with focal acute pancreatitis by imaging and clinical diagnosis, and 27 cases of acute pancreatitis which manifest non-localized pancreas inflammation were selected as the control group. The differences of the two groups were compared to describe their clinical characteristics. RESULTS: Differences in bloating (4.2% VS 29.6%,P = 0.026), abdominal tenderness (58.3% VS 85.2%,P = 0.032), peripheral blood neutrophil ratio (60.1 ± 23.3VS 75.9 ± 12.6,P = 0.004), serum D-Dimer (0.40(0.25,0.98) VS 1.59(0.49,4.63),P = 0.008), serum GGT (40(25,91) VS120(22,383),P = 0.046), serum amylase(435(241,718) VS 591(394,1333),P = 0.044) and lipase(988(648,1067) VS 1686(525,2675),P = 0.027) between focal acute pancreatitis and non-localized acute pancreatitis groups were statistically significant. However, difference of the severity of two groups was not statistically significant (P = 1.000). CONCLUSION: Compared with non-localized acute pancreatitis, changes in symptoms, signs and laboratory indicators of focal acute pancreatitis are non-obvious, however, there was no significant difference in the severity of two groups, indicating that we should pay more attention to diagnosis of focal acute pancreatitis in clinical practice.

Safety and feasibility of early oral nutrition after endoscopic treatment for patients with liver cirrhosis: A historical prospective and comparative effectiveness study.

BACKGROUND: This study aimed to evaluate the safety and efficacy of early oral nutrition (EON) after endoscopic treatment compared with parenteral nutrition (PN) for patients with gastroesophageal variceal bleeding varices as cirrhotic complications. METHODS: This historical prospective study enrolled patients from Qilu Hospital of Shandong University in China with gastroesophageal varices as cirrhotic complications and who were undergoing endoscopic therapy. A total of 197 patients who fasted for 4 h after treatment were prospectively enrolled as the ON group, whereas those who fasted >48 h were retrospectively matched in a ratio of 1:1 as the PN group. The primary end point was variceal rebleeding, whereas the secondary end points were mortality and adverse events during the 42-day follow-up. Hospitalization duration and expenses, levels of inflammatory factors, defecation time, and the satisfaction of patients were evaluated. RESULTS: During the 42-day follow-up, no significant difference was observed in the rate of variceal rebleeding (P = 0.586) and morality (P = 1.000) between the ON and PN groups. However, the average days of hospitalization (P < 0.001) and expenses (P < 0.001) were significantly decreased in the ON group. Furthermore, the serum C-reactive protein level (P = 0.002) and defecation time (P < 0.001) were lower and the satisfaction rate was higher (P < 0.001) for those in the ON group than for those in the PN group. Linear regression analysis showed that the tissue adhesive dosage was related to diet time (P = 0.038; 95% CI, 0.135-4.516). CONCLUSION: EON was proven to be safe and feasible and, hence, was recommended after endoscopic treatment in patients with cirrhosis.