Superior mesenteric artery syndrome (SMAS) is a rare clinical condition. Eleven cases of SMAS treated surgically are reported after follow-up periods of 6 months to 6 years. The value of hypotonic duodenography in the diagnosis of the syndrome is emphasized.
The purpose of this study was to compare the diagnostic efficacy of endoscopic retrograde pancreatography (ERP) and secretin-CCK test for the diagnosis of pancreatic disease. The bicarbonate output after the secretin stimulation was low in 26 out of 30 patients (87%) with pancreatitis, whereas ERP revealed an abnormal duct in 21 (70%) of these patients. In all 7 patients with pancreatic carcinoma, ERP showed major abnormalities, whereas the bicarbonate output was reduced only in four of them. Thus, the secretin test appears to be at least as efficient as the ERP in disclosing pancreatitis. On the other hand, ERP seems to be a more reliable method for the diagnosis of pancreatic carcinoma.
Pancreatic lesions have been produced in rats by the injection of different solutions into the pancreatic duct system. Alcoholic bile (bile containing about 1.5 mg per cent alcohol) caused more extensive lesions (hemorrhagic necrosis) than normal bile. Alcohol (0.5 per cent), on the contrary, gave the same type of lesions as did saline (interstitial edema only). Alcohol intake thus appears to potentiate the injurious effect of bile on the pancreas. It is suggested that this may be an important factor in the production of acute pancreatitis in alcoholism in man.
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