A Case of Pleomorphic Carcinoma of the Pancreas

Abstract

Vol 22, No 2, pp 110Y116. It is generally accepted that disorder of coagulation-fibrinolysis system occurs in acute pancreatitis. 1 Patients presenting coagulative abnormalities on admission have high incidence of DIC, MODS and poor prognosis. 2,3 This study aimed to investigate the disorder of coagulation-fibrinolysis system in patients with severe acute pancreatitis (SAP). Diagnosis and evaluation of the severity of acute pancreatitis were made according to the Japanese criteria (Japanese severity score; JSS). In the criteria, SAP is defined as JSSQ2. The subjects were 145 patients with SAP in our department between 1990 and 2006. On admission, aberrant rates of platelet count, prothrombin timeinternational normalized ratio (PT-INR), antithrombin III, thrombin-antithrombin III complex (TAT), activated protein C, fibrin/fibrinogen degradation products, D-dimer, plasminogen activator inhibitor-1, and thrombomodulin were 34%, 32%, 41%, 100%, 91%, 78%, 100%, 58%, 58%, respectively, and those of TAT and D-dimer were very high. PT-INR (R = 0.404), TAT (R = 0.392), and platelet count (R = j0.196) had significant correlation with JSS. TAT concentration on admission was higher in patients of Stage 3&4 (9e JSSe 27) (33 T 14 ng/ml) than Stage 2 (2e JSSe 8) (22 T 4 ng/ml). PT-INR and TAT in non-survivors (1.4 T 0.1 and 43 T 17 ng/ml) were significantly higher than those in survivors (1.1 T 0.0 and 19 T 4 ng/ml). Mortality rate in patients with PT-INRQ1.15 on admission (41%) was significantly higher than that in patients with PT-INRG1.15 on admission (16%). Mortality rate in patients with TATQ45 ng/ml on admission (75%) was significantly higher than that in patients with TATG45ng/ml on admission (17%) (Fig. 1). These results suggest that TAT may be a useful marker for severity and prognosis in SAP. Particularly in patients with TATQ45 ng/ml on admission, intensive care should be performed in a highly specialized institution.JPS SELECTED ABSTRACT 1 FIGURE 1. A: ROC curve of TAT for predicting death in severe acute pancreatitis. B: Prediction of mortality by TAT on admission.luminal LCRF content 4-h after BPJD was significantly lower in rats treated with TI than in controls. The hypertrophied pancreas may require a smaller dose of CCK to increase protein secretion.

Ruptured Anaplastic Pancreatic Carcinoma With Liver Metastasis: A Case Report

“…The clinical manifestations are not different between APC and PDAC; back pain, weight loss, and abdominal distention are the major symptoms. There have been few case reports of APC that presented with the rupture of the tumor into the peritoneal cavity [7,8]. Considering the pathological nature of APC, which grows rapidly and is rich vascularity, it is plausible that spontaneous rupture of the tumor may occur, albeit infrequently.…”

“…The fatality observed 3 months after the surgical intervention is reported to be 58.6%, and the average survival period is 5.5 months. Surgical intervention for APC is controversial because of the poor survival rate despite the complete removal of the tumor [8]. The majority of APCs are detected at an advanced stage and a combined resection of the invaded organs is frequently required.…”