Chronic pancreatitis is an inflammatory disease characterized by the progressive destruction of pancreatic tissue and resulting in pancreatic exocrine and endocrine insufficiency. Although a lot of efforts have been made in managing chronic pancreatitis, treatment of chronic pancreatitis is still challenging and remains mostly empirical. Medical treatment of chronic pancreatitis focuses on chro...

The mechanisms of pancreatic pain, a cardinal symptom of pancreatitis, are unknown. Proinflammatory agents that activate transient receptor potential (TRP) channels in nociceptive neurons can cause neurogenic inflammation and pain. We report a major role for TRPV4, which detects osmotic pressure and arachidonic acid metabolites, and TRPA1, which responds to 4-hydroxynonenal and cyclopentenone p...

Background. Pancreatic enzyme supplementation is widely used to treat pain in patients with chronic pancreatitis, despite little evidence for efficacy. We performed a systematic review of the literature and a meta-analysis to investigate its effectiveness. Methods. All randomized controlled parallel or crossover trials in patients with chronic pancreatitis comparing pancreatic enzyme supplement...

BACKGROUND AND OBJECTIVES Thoracic endometriosis is a rare form of extragenital endometriosis with important clinical ramifications. Up to 80% of women with thoracic endometriosis have concomitant abdominopelvic endometriosis, yet the surgical treatment is usually performed with separate procedures. This is the largest published series of the combination of video-assisted thoracoscopic surgery ...

Medical treatment of chronic pancreatitis is based on the three main characteristics of the disease, pain and exocrine and endocrine insufficiency. Pain is the leading symptom of chronic pancreatitis. Patients may suffer from continuous pain or relapsing pain in parallel with relapses of the chronic inflammatory process or complications. Pain may decrease over time due to what is called “burn o...

Objective Pancreatic ductal adenocarcinoma has a five year survival rate of 20% following radical surgical resection. The aggressive tumor biology and heterogenous nature of pancreatic ductal adenocarcinoma results in metastatic spread which further decreases overall survival. We report a patient who successfully underwent a pulmonary metastasectomy five years after the resection of a pancreati...

BACKGROUND Endoscopic ultrasound-guided celiac plexus neurolysis (EUS-CPN) represents an alternative approach to pain palliation in patients with advanced pancreatic cancer. AIM to evaluate the safety and initial efficacy of EUS-CPN in patients with painful unresectable pancreatic cancer. METHODS Patients with inoperable body-tail pancreatic adenocarcinoma without prior chemotherapy and pai...

We report a case of a symptomatic angioleiomyoma in the left posterior mediastinum. A 66-year-old woman presented with left back and flank pain for 6 months. Chest computed tomography (CT) and magnetic resonance imaging (MRI) revealed a well-circumscribed 4.3 cm round mass. The mass was initially diagnosed as nerve sheath tumor, because of her symptoms and its close location to the sympathetic ...

Lung herniation after minimally invasive thoracoscopic pulmonary vein ablation has never been described before so far. We report for the first time, of its incidence in a 62-year-old patient, 6 weeks after a minimally invasive cardiac surgery (MICS) for atrial fibrillation ablation. We suggest that even after MICS, a high resolution computerized tomography scan should be performed in patients p...

Pain is a common symptom of pancreatic disease and is frequently difficult to manage. Pain relief provided by narcotics is often suboptimal and is associated with significant side effects. An alternative approach to pain management in pancreatic disease is the use of celiac plexus block (CPB) or neurolysis (CPN). Originally performed by anesthesiologists and radiologists via a posterior approac...