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2.
Medicine (Baltimore) ; 99(3): e18861, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32011507

RESUMO

Serum amylase levels in patients with acute pancreatitis often remain or fluctuate above the upper normal limit for over a week. This study investigated the clinical characteristics of patients with prolonged hyperamylasemia and their prognoses, including recurrence.We retrospectively analyzed patients with first attacks of acute pancreatitis in a single center between March 2010 and December 2016. Patients were divided into 2 groups according to normalization of the serum amylase levels within a week.A total of 313 patients were enrolled after exclusion. The serum amylase levels were normalized within a week in 205 patients (65.5%, group 1) and elevated over a week in 108 patients (34.5%, group 2). Group 2 was more related to alcohol, higher computed tomography (CT) severity index, local pancreatic complication, and moderately severe pancreatitis than group 1 (P < .05). Recurrent pancreatitis developed significantly more in group 2 (39.8%) than in group 1 (19.5%) (P < .001). The factors related to recurrent pancreatitis were amylase group, sex, alcohol, CT severity index, necrosis, and severity of pancreatitis (P < .05). Multivariate analysis showed that recurrent pancreatitis was independently associated with amylase group (odds ratio [OR] 2.123, 95% confidence interval [CI]= 1.227-3.673, P = .007) and alcohol (OR 2.023, 95% CI 1.134-3.611, P = .017).In conclusion, prolonged hyperamylasemia over a week is associated with recurrence of acute pancreatitis.


Assuntos
Hiperamilassemia/complicações , Pancreatite/etiologia , Doença Aguda , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pancreatite/diagnóstico por imagem , Recidiva , Estudos Retrospectivos , Fatores de Risco
3.
J Med Case Rep ; 13(1): 387, 2019 Dec 30.
Artigo em Inglês | MEDLINE | ID: mdl-31884973

RESUMO

BACKGROUND: Chest pain associated with transient electrocardiogram changes mimicking an acute myocardial infarction have been described in acute pancreatitis. These ischemic electrocardiogram changes can present a diagnostic dilemma, especially when patients present with concurrent angina pectoris and epigastric pain warranting noninvasive or invasive imaging studies. CASE PRESENTATION: A 45-year-old African-American man with a history of alcohol use disorder presented to the emergency department of our institution with 36 hours of concurrent epigastric pain and left-sided chest pain radiating to his left arm and associated with nausea and dyspnea. On physical examination, he was afebrile; his blood pressure was elevated; and he had epigastric tenderness. His laboratory test results were significant for hypokalemia, normal troponin, and elevated serum lipase and amylase levels. Serial electrocardiograms for persistent chest pain showed ST-segment elevations with dynamic T-wave changes in the right precordial electrocardiogram leads, consistent with Wellens syndrome. He was immediately taken to the cardiac catheterization laboratory, where selective coronary angiography showed normal coronary arteries with an anomalous origin of the right coronary artery from the opposite sinus. Given his elevated lipase and amylase levels, the patient was treated for acute alcohol-induced pancreatitis with intravenous fluids and pain control. His chest pain and ischemic electrocardiogram changes resolved within 24 hours of admission, and coronary computed tomography angiography showed an interarterial course of the right coronary artery without high-risk features. CONCLUSIONS: Clinicians may consider deferring immediate cardiac catheterization and attribute electrocardiogram changes to acute pancreatitis in patients presenting with angina pectoris and acute pancreatitis if confirmed by normal cardiac enzymes and elevated levels of lipase and amylase. However, when clinical signs and electrocardiogram findings are highly suggestive of myocardial ischemia/injury, immediate noninvasive coronary computed tomography angiography may be the best approach to make an early diagnosis.


Assuntos
Dor Abdominal/induzido quimicamente , Transtornos Induzidos por Álcool/diagnóstico por imagem , Dor no Peito/induzido quimicamente , Vasos Coronários/diagnóstico por imagem , Etanol/envenenamento , Pancreatite/diagnóstico por imagem , Dor Abdominal/sangue , Dor Abdominal/diagnóstico por imagem , Transtornos Induzidos por Álcool/sangue , Transtornos Induzidos por Álcool/terapia , Dor no Peito/sangue , Dor no Peito/diagnóstico por imagem , Angiografia Coronária , Vasos Coronários/fisiopatologia , Diagnóstico Diferencial , Eletrocardiografia , Serviço Hospitalar de Emergência , Hidratação , Humanos , Masculino , Pessoa de Meia-Idade , Manejo da Dor , Pancreatite/fisiopatologia , Pancreatite/terapia , Resultado do Tratamento
4.
Rev Med Chil ; 147(8): 1078-1081, 2019 Aug.
Artigo em Espanhol | MEDLINE | ID: mdl-31859975

RESUMO

Acute pancreatitis during pregnancy is uncommon and usually associated with gallstones. However other etiologies must be considered. We report a 24 years old woman with a 32 weeks pregnancy consulting for abdominal pain, nausea and vomiting. She had elevated lipase and amylase levels, a corrected serum calcium of 13.1 mg/dl and a serum phosphate of 1.6 mg/dl. A magnetic resonance colangiopancreatography showed an enlarged pancreas with inflammatory changes and a normal Wirsung duct. A parathyroid nodule was found on cervical ultrasonography. The patient was treated initially with cinacalcet with partial response. A parathyroidectomy was performed at 39 weeks of pregnancy with a good maternal and fetal evolution.


Assuntos
Hipercalcemia/complicações , Pancreatite/etiologia , Complicações na Gravidez/etiologia , Dor Abdominal/etiologia , Adenoma/diagnóstico por imagem , Colangiopancreatografia por Ressonância Magnética/métodos , Feminino , Humanos , Pancreatite/diagnóstico por imagem , Pancreatite/cirurgia , Neoplasias das Paratireoides/diagnóstico por imagem , Paratireoidectomia/métodos , Gravidez , Complicações na Gravidez/cirurgia , Resultado do Tratamento , Adulto Jovem
5.
Methodist Debakey Cardiovasc J ; 15(3): 220-222, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31687102

RESUMO

It is estimated that there are more than 210,000 hospital admissions for acute pancreatitis and more than 56,000 admissions for chronic pancreatitis each year in the United States. Pancreatitis comes with numerous complications that can increase morbidity, mortality, and length of hospital stay. Local and systemic complications include pseudocysts, necrosis, sepsis, multiorgan failure, and vascular complications. Thrombosis of the splanchnic venous system occurs in approximately 2% of patients with pancreatitis, but thrombosis is rarely seen in the arterial system. In this report, we describe a case of thrombosis of the abdominal aorta and superior mesenteric artery in a female patient who presented with acute pancreatitis.


Assuntos
Doenças da Aorta/etiologia , Artéria Mesentérica Superior , Oclusão Vascular Mesentérica/etiologia , Pancreatite/complicações , Trombose/etiologia , Antibacterianos/uso terapêutico , Anticoagulantes/uso terapêutico , Doenças da Aorta/diagnóstico por imagem , Doenças da Aorta/tratamento farmacológico , Feminino , Hidratação , Humanos , Artéria Mesentérica Superior/diagnóstico por imagem , Oclusão Vascular Mesentérica/diagnóstico por imagem , Oclusão Vascular Mesentérica/tratamento farmacológico , Pessoa de Meia-Idade , Pancreatite/diagnóstico por imagem , Pancreatite/terapia , Trombose/diagnóstico por imagem , Trombose/tratamento farmacológico , Resultado do Tratamento
6.
Sheng Wu Yi Xue Gong Cheng Xue Za Zhi ; 36(5): 755-762, 2019 Oct 25.
Artigo em Chinês | MEDLINE | ID: mdl-31631623

RESUMO

Autoimmune pancreatitis (AIP) is a unique subtype of chronic pancreatitis, which shares many clinical presentations with pancreatic ductal adenocarcinoma (PDA). The misdiagnosis of AIP often leads to unnecessary pancreatic resection. 18F-FDG positron emission tomography/ computed tomography (PET/CT) could provide comprehensive information on the morphology, density, and functional metabolism of the pancreas at the same time. It has been proved to be a promising modality for noninvasive differentiation between AIP and PDA. However, there is a lack of clinical analysis of PET/CT image texture features. Difficulty still remains in differentiating AIP and PDA based on commonly used diagnostic methods. Therefore, this paper studied the differentiation of AIP and PDA based on multi-modality texture features. We utilized multiple feature extraction algorithms to extract the texture features from CT and PET images at first. Then, the Fisher criterion and sequence forward floating selection algorithm (SFFS) combined with support vector machine (SVM) was employed to select the optimal multi-modality feature subset. Finally, the SVM classifier was used to differentiate AIP from PDA. The results prove that texture analysis of lesions helps to achieve accurate differentiation of AIP and PDA.


Assuntos
Adenocarcinoma/diagnóstico por imagem , Doenças Autoimunes/diagnóstico por imagem , Neoplasias Pancreáticas/diagnóstico por imagem , Pancreatite/diagnóstico por imagem , Algoritmos , Diagnóstico Diferencial , Fluordesoxiglucose F18 , Humanos , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Máquina de Vetores de Suporte
9.
BMJ Case Rep ; 12(9)2019 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-31519719

RESUMO

Atypical haemolytic uraemic syndrome (aHUS) is a disease of complement dysregulation and can be fatal if not treated in a timely manner. Although normally associated with triggers such as infection or pregnancy, this case demonstrates acute pancreatitis as the triggering event. The patient's initial presentation of thrombocytopaenia and acute renal failure was first attributed to a systemic inflammatory response syndrome due to pancreatitis, but with detailed history and further laboratory investigation, we were able to show that patient was having symptoms associated with aHUS. On early recognition of aHUS, this patient was able to receive the proper standard of care with eculizumab and had a full recovery while preventing renal failure. When patients present with thrombocytopaenia and renal failure in acute pancreatitis, we want to ensure physicians keep aHUS on the differential.


Assuntos
Síndrome Hemolítico-Urêmica Atípica/etiologia , Pancreatite/complicações , Insuficiência Renal/etiologia , Trombocitopenia/etiologia , Doença Aguda , Adulto , Anticorpos Monoclonais Humanizados/administração & dosagem , Anticorpos Monoclonais Humanizados/uso terapêutico , Síndrome Hemolítico-Urêmica Atípica/diagnóstico , Síndrome Hemolítico-Urêmica Atípica/tratamento farmacológico , Inativadores do Complemento/administração & dosagem , Inativadores do Complemento/uso terapêutico , Diagnóstico Diferencial , Humanos , Masculino , Pancreatite/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
11.
BMC Gastroenterol ; 19(1): 141, 2019 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-31395017

RESUMO

BACKGROUND: Abdominal compartment syndrome (ACS) is associated with mortality in patients with critical illness such as severe acute pancreatitis, but it remains unclear whether decompressive laparotomy for ACS can improve the prognosis of patients. CASE PRESENTATION: A woman in her 60s visited our hospital because of upper abdominal pain. On the basis of her laboratory data and abdominal contrast-enhanced computed tomography findings, acute gallstone pancreatitis was diagnosed. She underwent endoscopic sphincterotomy for the removal of the common bile duct stone. Then, a drainage tube was placed in the bile duct. However, on the 5th hospital day, her intra-abdominal pressure increased to 22 mmHg and renal dysfunction was observed, which led to the diagnosis of ACS. As intensive medical treatments did not improve her ACS, she underwent decompressive laparotomy on the 9th hospital day. Postoperatively, her laboratory data and intravesical pressure improved, and she was discharged from the hospital after abdominal closure, continuous drainage, and antibiotic therapy. CONCLUSION: As the effectiveness of decompressive laparotomy for ACS has not been established, this treatment indication remains controversial. Decompressive laparotomy is considered useful for the management of ACS, if it is performed at an appropriate time, as in the present case.


Assuntos
Descompressão Cirúrgica/métodos , Hipertensão Intra-Abdominal/cirurgia , Laparotomia/métodos , Pancreatite/cirurgia , Humanos , Hipertensão Intra-Abdominal/diagnóstico por imagem , Hipertensão Intra-Abdominal/etiologia , Pancreatite/diagnóstico por imagem
12.
Clin Nucl Med ; 44(10): 836-837, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31283599

RESUMO

A 46-year-old man with metastatic lung adenocarcinoma was treated with pembrolizumab. FDG PET/CT was performed after 3 cycles of treatment and revealed a focal region of pancreatic tail enlargement with an SUVmax value of 7. Following treatment with corticosteroids and discontinuation of pembrolizumab, radiological resolution was observed, and a diagnosis of focal immunotherapy-induced pancreatitis was made. A unique spectrum of FDG-avid adverse events can develop in patients treated with immune-checkpoint inhibitors that may mimic metastatic disease. Knowledge of the radiologic features of these potential imaging pitfalls is crucial among those interpreting FDG PET/CT to allow prompt and decisive treatment.


Assuntos
Fluordesoxiglucose F18 , Imunoterapia/efeitos adversos , Pancreatite/diagnóstico por imagem , Pancreatite/etiologia , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Adenocarcinoma de Pulmão/diagnóstico por imagem , Adenocarcinoma de Pulmão/tratamento farmacológico , Adenocarcinoma de Pulmão/patologia , Anticorpos Monoclonais Humanizados/efeitos adversos , Anticorpos Monoclonais Humanizados/uso terapêutico , Diagnóstico Diferencial , Humanos , Masculino , Pessoa de Meia-Idade
13.
BMJ Case Rep ; 12(7)2019 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-31296632

RESUMO

Acute pancreatitis(AP) is one of the common causes of acute abdomen and known to be associated with high morbidity and mortality in severe cases. Though most common causes of AP are cholelithiasis and alcoholism, it has also been reported in association with diabetic ketoacidosis (DKA). Triad of AP, hypertriglyceridaemia (HTG) and DKA is rare co-association and here the causal factor of AP is still not fully established. We report a case of AP in a DKA patient with recent diagnosis of hyperlipidaemia and diabetes. Usually AP has been associated with severe HTG; interestingly, our patient showed only moderate raise in triglycerides but still suffered AP during DKA. Hence, it raises question about the real culprit in this enigmatic triad.


Assuntos
Diabetes Mellitus Tipo 2/complicações , Cetoacidose Diabética/complicações , Hipertrigliceridemia/complicações , Pancreatite/complicações , Adulto , Diabetes Mellitus Tipo 2/terapia , Cetoacidose Diabética/terapia , Hidratação , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Hipertrigliceridemia/terapia , Hipoglicemiantes/uso terapêutico , Infusões Intravenosas , Insulina/administração & dosagem , Insulina/uso terapêutico , Masculino , Metformina/uso terapêutico , Pâncreas/diagnóstico por imagem , Pancreatite/diagnóstico por imagem , Pancreatite/terapia , Tomografia Computadorizada por Raios X
14.
Medicine (Baltimore) ; 98(28): e16435, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31305468

RESUMO

RATIONALE: Mucinous cystic neoplasms (MCNs) are pancreatic mucin-producing cystic lesions with a distinctive ovarian-type stroma. The diagnosis is generally easy in typical cases; however, differential diagnosis is difficult in others such as in the case we report herein. PATIENT CONCERNS: A 27-year-old woman with sudden onset of epigastric pain was referred to our hospital for suspected acute pancreatitis. Contrast-enhanced computed tomography revealed a 25-mm cystic lesion in the pancreas and a low density area with delayed enhancement at the right upper side of the cystic lesion. DIAGNOSES: During its clinical course, the cystic lesion underwent various morphological changes. Eventually, it presented typical findings of MCNs, and could be accurately diagnosed. INTERVENTIONS: Laparoscopic distal pancreatectomy was performed on the patient by preserving the spleen. OUTCOMES: The patient revealed no symptoms till 1 year after the operation. LESSONS: This case of MCN with intriguing short-term morphological changes was associated with recurrent pancreatitis. A combination of imaging modalities is essential for accurate diagnosis of MCNs, and follow-up with serial imaging might be useful for certain unusual lesions.


Assuntos
Adenocarcinoma Mucinoso/patologia , Pâncreas/patologia , Cisto Pancreático/patologia , Neoplasias Pancreáticas/patologia , Pancreatite/patologia , Adenocarcinoma Mucinoso/complicações , Adenocarcinoma Mucinoso/diagnóstico por imagem , Adenocarcinoma Mucinoso/cirurgia , Adulto , Progressão da Doença , Feminino , Humanos , Pâncreas/diagnóstico por imagem , Pâncreas/cirurgia , Cisto Pancreático/complicações , Cisto Pancreático/diagnóstico por imagem , Cisto Pancreático/cirurgia , Neoplasias Pancreáticas/complicações , Neoplasias Pancreáticas/diagnóstico por imagem , Neoplasias Pancreáticas/cirurgia , Pancreatite/complicações , Pancreatite/diagnóstico por imagem , Pancreatite/cirurgia , Recidiva
15.
BMC Surg ; 19(1): 77, 2019 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-31277624

RESUMO

BACKGROUND: The laparoscopic Roux-en-Y gastric bypass (LRYGBP) is the second most performed bariatric surgical procedure. With the increasing number of patients undergoing bariatric surgery, the number of complications is also growing. Early diagnosis and treatment of the complications is crucial. CASE PRESENTATION: A very unusual complication was met after an uneventful laparoscopic gastric bypass (LGBP) procedure due to an obstructing blood clot in the biliairy limb resulting in an acute pancreatitis and gastric distention, accompanied by an obstructing blood clot in the distal ileum causing small bowel obstruction. A review of the occurrence of these complications and the diagnosis and treatment is presented. CONCLUSION: Post-bariatric acute pancreatitis is uncommon, but could be fatal. Blood clots should be considered as possible causes of small bowel obstruction, ileus or pancreatitis.


Assuntos
Derivação Gástrica/efeitos adversos , Doenças do Íleo/etiologia , Obstrução Intestinal/etiologia , Laparoscopia/efeitos adversos , Pancreatite/etiologia , Complicações Pós-Operatórias/etiologia , Adulto , Feminino , Humanos , Doenças do Íleo/diagnóstico por imagem , Doenças do Íleo/terapia , Obstrução Intestinal/diagnóstico por imagem , Obstrução Intestinal/terapia , Obesidade Mórbida/cirurgia , Pancreatite/diagnóstico por imagem , Pancreatite/terapia , Complicações Pós-Operatórias/diagnóstico por imagem , Complicações Pós-Operatórias/terapia , Tomografia Computadorizada por Raios X
17.
BMC Gastroenterol ; 19(1): 87, 2019 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-31195984

RESUMO

BACKGROUND: The relationship between visceral adiposity and acute pancreatitis (AP) has not been completely elucidated. This study evaluated the significance of visceral adipose tissue (VAT) and the ratio of VAT to skeletal muscle tissue (VAT/SMT) in the prognosis of AP patients. METHODS: Based on a 1:2 propensity score matching, 306 hospitalized patients were enrolled in the study analysis from 2010 to 2017. VAT, subcutaneous adipose tissue (SAT), and SMT were measured using unenhanced computed tomography (CT). Cox proportional hazards models were applied for the analysis. RESULTS: VAT and the VAT/SMT ratio were significantly higher in the severe AP (SAP) and moderately severe AP (MSAP) groups compared to the mild AP (MAP) group (both p < 0.001). Intensive care transfer, AP severity, systemic complications, and prognostic scores (Acute Physiology and Chronic Health Evaluation II [APACHE-II] score ≥ 8, Ranson's score ≥ 3, Bedside Index of Severity in Acute Pancreatitis [BISAP] score ≥ 3, and the systemic inflammatory response syndrome [SIRS] score ≥ 2) significantly correlated with VAT and the VAT/SMT ratio in AP patients. The multivariate adjusted hazard ratios (HRs) for VAT and the VAT/SMT ratio in the relationship of body parameters and AP mortality were 1.042 (95% confidence interval (CI), 1.019-1.066) and 7.820 (95% CI, 1.978-30.917), respectively. Compared with other prognostic scores, VAT had the highest area under the curve of receiver operating characteristics (ROC) (0.943, 95% CI, 0.909-0.976). CONCLUSION: High VAT and VAT/SMT ratio are independent negative prognostic indicators of AP. TRIAL REGISTRATION: Clinical study registration number: NCT03482921 . Date of registration: 03/23/2018.


Assuntos
Gordura Intra-Abdominal/patologia , Músculo Esquelético/patologia , Pancreatite/patologia , Gordura Subcutânea/patologia , Tomografia Computadorizada por Raios X/estatística & dados numéricos , APACHE , Doença Aguda , Adulto , Idoso , Feminino , Humanos , Gordura Intra-Abdominal/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/diagnóstico por imagem , Pancreatite/diagnóstico por imagem , Prognóstico , Pontuação de Propensão , Modelos de Riscos Proporcionais , Curva ROC , Gordura Subcutânea/diagnóstico por imagem , Síndrome de Resposta Inflamatória Sistêmica
18.
Ann R Coll Surg Engl ; 101(6): 428-431, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31155897

RESUMO

INTRODUCTION: Intraoperative cholangiography is sporadically used in patients undergoing laparoscopic cholecystectomy to delineate common bile duct anatomy and exclude retained stones. In patients with acute gallstone pancreatitis, intraoperative cholangiography may reduce the need for preoperative magnetic resonance cholangiopancreatography. MATERIALS AND METHODS: A retrospective review of a prospectively collected patient database was undertaken over a 15-year period. The primary objective was to evaluate intraoperative assessment of the common bile duct with intraoperative cholangiography in patients with acute gallstone pancreatitis. RESULTS: A total of 2215 patients underwent laparoscopic cholecystectomy between October 1998 and December 2013; 113 patients (of whom 77 were women) with a mean age of 54 years (range 16-88 years) were diagnosed with acute gallstone pancreatitis. Of these, 102 patients (90%) underwent laparoscopic cholecystectomy with intraoperative cholangiography, which was normal in 89 cases. Thirteen patients had choledocholithiasis on intraoperative cholangiography, 11 of whom were managed with concomitant trans-cystic duct exploration and clearance. Two patients required postoperative endoscopic retrograde cholangiopancreatography. CONCLUSIONS: In patients diagnosed with acute gallstone pancreatitis, it is reasonable to proceed directly to surgery using intraoperative cholangiography on the same admission as the definitive assessment of the common bile duct. This negates the need for magnetic resonance cholangiopancreatography and can translate into cost savings and reduced length of stay.


Assuntos
Colangiografia , Colangiopancreatografia por Ressonância Magnética , Colecistectomia Laparoscópica/métodos , Cálculos Biliares/cirurgia , Pancreatite/cirurgia , Doença Aguda , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Ducto Colédoco/diagnóstico por imagem , Feminino , Cálculos Biliares/diagnóstico por imagem , Humanos , Período Intraoperatório , Masculino , Pessoa de Meia-Idade , Pancreatite/diagnóstico por imagem , Estudos Retrospectivos , Adulto Jovem
19.
Intern Med ; 58(20): 2957-2962, 2019 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-31243233

RESUMO

Gemcitabine plus nab-paclitaxel is the current standard chemotherapy for patients with metastatic pancreatic cancer. We conducted a phase I/II study in Japan, in which high response rates and manageable toxicity were observed. In this study, two patients were reported as experiencing pancreatitis due to chemotherapy. In general, pancreatitis is sometimes observed when the tumor involves the pancreatic duct, and the onset is observed before the diagnosis or at the initial stage. The onset of pancreatitis in these cases was unique and observed after the start of chemotherapy. Pancreatitis may be induced by the alleviation of stenosis of the pancreatic duct associated with tumor shrinkage.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Carcinoma Ductal Pancreático/tratamento farmacológico , Carcinoma Ductal Pancreático/secundário , Neoplasias Pancreáticas/tratamento farmacológico , Pancreatite/induzido quimicamente , Doença Aguda , Idoso , Albuminas/administração & dosagem , Albuminas/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma Ductal Pancreático/diagnóstico por imagem , Desoxicitidina/administração & dosagem , Desoxicitidina/efeitos adversos , Desoxicitidina/análogos & derivados , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Paclitaxel/administração & dosagem , Paclitaxel/efeitos adversos , Neoplasias Pancreáticas/diagnóstico por imagem , Neoplasias Pancreáticas/patologia , Pancreatite/diagnóstico por imagem , Tomografia Computadorizada por Raios X
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