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Diabetes Mellitus Secondary To History Of Blunt Trauma To The Pancreas

[full Text] Whipple Procedure: Patient Selection And Special Considerations | Oas

[full Text] Whipple Procedure: Patient Selection And Special Considerations | Oas

Editor who approved publication: Professor Cataldo Doria Clara Tan-Tam,1 Maja Segedi,2 Stephen W Chung2 1Department of Surgery, Bassett Healthcare, Columbia University, Cooperstown, New York, NY, USA; 2Department of Hepatobiliary and Pancreatic Surgery and Liver Transplant, Vancouver General Hospital, University of British Columbia, Vancouver, BC, Canada Abstract: At the inception of pancreatic surgery by Dr Whipple in 1930s, the mortality and morbidity risk was more than 20%. With further understanding of disease processes and improvements in pancreas resection techniques, the mortality risk has decreased to less than 5%. Age and chronic illnesses are no longer a contraindication to surgical treatment. Life expectancy and quality of life at a later age have improved, making older patients more likely to receive pancreatic surgery , thereby also putting emphasis on operative patient selection to minimize complications. This review summarizes the benign and malignant illnesses that are treated with pancreas operations, and innovations and improvements in pancreatic surgery and perioperative care, and describes the careful selection process for patients who would benefit from an operation. These indications are not reserved only to Whipple operation, but to pancreatectomies as well. Keywords: pancreaticoduodenectomy, mortality, morbidity, cancer, trauma, pancreatitis Whipple pancreaticoduodenectomy (PD) is not performed exclusively for neoplasia but also for benign disease. 1 In addition to Whipple resection, there are other pancreatic resections such as distal, subtotal, and total pancreatectomy for other types of pancreatic pathology and neoplasia. The goal of PD is to prevent and treat cancer, and treat disease symptoms. Perioperative care addresses only some of the f Continue reading >>

2018 Icd-10-cm Diagnosis Code S36.209a

2018 Icd-10-cm Diagnosis Code S36.209a

S00-T88 Injury, poisoning and certain other consequences of external causes S30-S39 Injuries to the abdomen, lower back, lumbar spine, pelvis and external genitals Unspecified injury of unspecified part of pancreas, initial encounter S36.209A is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Short description: Unsp injury of unspecified part of pancreas, init encntr The 2018 edition of ICD-10-CM S36.209A became effective on October 1, 2017. This is the American ICD-10-CM version of S36.209A - other international versions of ICD-10 S36.209A may differ. The following code(s) above S36.209A contain annotation back-references In this context, annotation back-references refer to codes that contain: Injury, poisoning and certain other consequences of external causes Use secondary code(s) from Chapter 20, External causes of morbidity, to indicate cause of injury. Codes within the T section that include the external cause do not require an additional external cause code Continue reading >>

Icd-10 Codes For Diabetes

Icd-10 Codes For Diabetes

There's More Than One Type Of Diabetes... I'm pretty sure all of you who made it thus far in this article are familiar with the fact that there are at least two major types of diabetes: type I, or juvenile, and type II, with usual (though not mandatory) adult onset. Just like ICD-9, ICD-10 has different chapters for the different types of diabetes. The table below presents the major types of diabetes, by chapters, in both ICD coding versions. Diabetes Coding Comparison ICD-9-CM ICD-10-CM 249._ - Secondary diabetes mellitus E08._ - Diabetes mellitus due to underlying condition E09._ - Drug or chemical induced diabetes mellitus E13._ - Other specified diabetes mellitus 250._ - Diabetes mellitus E10._ - Type 1 diabetes mellitus E11._ - Type 2 diabetes mellitus 648._ - Diabetes mellitus of mother, complicating pregnancy, childbirth, or the puerperium O24._ - Gestational diabetes mellitus in pregnancy 775.1 - Neonatal diabetes mellitus P70.2 - Neonatal diabetes mellitus This coding structure for diabetes in ICD-10 is very important to understand and remember, as it is virtually always the starting point in assigning codes for all patient encounters seen and treated for diabetes. How To Code in ICD-10 For Diabetes 1. Determine Diabetes Category Again, "category" here refers to the four major groups above (not just to type 1 or 2 diabetes): E08 - Diabetes mellitus due to underlying condition E09 - Drug or chemical induced diabetes mellitus E10 - Type 1 diabetes mellitus E11 - Type 2 diabetes mellitus E13 - Other specified diabetes mellitus Note that, for some reason, E12 has been skipped. Instructions on Diabetes Categories Here are some basic instructions on how to code for each of the diabetes categories above: E08 - Diabetes mellitus due to underlying condition. Here, it is Continue reading >>

Inflammation Of The Pancreas In Dogs

Inflammation Of The Pancreas In Dogs

Pancreatitis in Dogs The pancreas is part of the endocrine and digestive system, which is integral for the digestion of foods, producing the enzymes that digest food, and producing insulin. When a condition occurs to cause inflammation of the pancreas, the flow of enzymes into the digestive tract can become disrupted, forcing the enzymes out of the pancreas and into the abdominal area. If this occurs, the digestive enzymes will begin to break down fat and proteins in the other organs, as well as in the pancreas. In effect, the body begins to digest itself. Because of their proximity to the pancreas, the kidney and liver can also be affected when this progression takes place, and the abdomen will become inflamed, and possibly infected as well. If bleeding occurs in the pancreas, shock, and even death can follow. Inflammation of the pancreas (or pancreatitis) often progresses rapidly in dogs, but can often be treated without any permanent damage to the organ. However, if pancreatitis goes long-term without treatment, severe organ, and even brain damage can occur. Pancreatitis can affect both dogs and cats. If you would like to learn more about how this disease affects cats, please visit this page in the petMD health library. Symptoms of Pancreatitis in Dogs There are a variety of symptoms that may be observed in the animals, including: Fever Loss of appetite (anorexia) Weight loss (more common in cats) Dehydration Fatigue and sluggishness Mild to severe abdominal pain (may become more sever after eating) Depression Increased heart rate Difficulty breathing Causes of Pancreatitis in Dogs There are several possible causes of inflammation to the pancreas. Some of them are nutritional factors, such as high levels of fat in the blood (lipemia), high levels of calcium in the bl Continue reading >>

Introduction To Pancreatic Disease: Acute Pancreatitis

Introduction To Pancreatic Disease: Acute Pancreatitis

Division of Gastroenterology, Cedars-Sinai Medical Center Acute pancreatitis is inflammation of the pancreas. The pancreas is a gland that sits just behind the stomach (Figure 1). It has two roles: 1) To secrete digestive juices into the small bowel to digest food and neutralize gastric acid secretion and 2) to release insulin to regulate the glucose levels in the blood. There are three types of pancreatic cells: 1) acinar cells, which produce pancreatic digestive enzymes; 2) ductal cells lining pancreatic ducts, which secrete a watery fluid to carry the digestive enzymes into the intestine; and 3) endocrine cells present in theislets of Langerhans, which secrete insulin and other hormones (Figure 2). Because acinar and ductal cells secrete into a duct this portion is called the exocrine pancreas. Pancreatic digestive enzymes are made as inactive precursors and carried to the small bowel where there are additional enzymatic processes that convert the inactive digestive enzymes to actives ones that digest our food. When pancreatic enzymes are prematurely activated in the pancreas, they attack the pancreas itself instead of digesting food and cause pancreatitis. Acute pancreatitis is the most common reason for hospitalization for a gastrointestinal related disease in the United States. In 2009, there were 275,000 admissions for acute pancreatitis, and a direct annual cost of $2.6 billion (1). Worldwide, the incidence of acute pancreatitis is between 4.9 and 73.4 cases per 100,000 (2, 3). There is an increasing incidence of acute pancreatitis in the United States. The risk of acute pancreatitis increases with age. Both men and women are at risk for pancreatitis; however gender difference is determined by the cause of acute pancreatitis. For example, acute pancreatitis due Continue reading >>

Feline Triaditis - Current Concepts - Wsava2013 - Vin

Feline Triaditis - Current Concepts - Wsava2013 - Vin

World Small Animal Veterinary Association World Congress Proceedings, 2013 Stanley L. Marks, BVSc, PhD, DACVIM (Internal Medicine, Oncology), DACVN School of Veterinary Medicine, University of California-Davis, Davis, CA, USA The term "triaditis" is a lay term and refers to the syndrome of concurrent cholangitis, pancreatitis, and inflammatory bowel disease (IBD) in cats. The association of these entities may reflect a common underlying disease mechanism. It is felt that the predominant signs of triaditis are attributable to hepatobiliary disease, with pancreatitis and IBD occurring as secondary complications. Despite the relatively high prevalence of triaditis in cats, the temporal nature of the relationship, as well as the specific cause(s) of cholangitis, pancreatitis, and feline IBD have not been well elucidated to date. Acute pancreatitis is characterized by the sudden onset of inflammation affecting the pancreatic parenchyma and peripancreatic tissues. Chronic pancreatitis is a continuing inflammatory disease characterized by irreversible morphological change, possibly leading to permanent impairment of function. Acute and chronic pancreatitis cannot be differentiated clinically or biochemically in cats, and the ultrasonographic differentiation can also be challenging. The underlying cause of feline pancreatitis is usually unknown, but a variety of risk factors have been identified including parasites (Toxoplasma gondii, Amphimerus pseudofelineus), viral causes such as Herpesvirus and FIP, blunt trauma, pancreatic ischemia, and intercurrent disease, particularly hepatobiliary disease and IBD. Obesity does not appear to be a risk factor for feline pancreatitis. The history and clinical signs in cats are extremely variable and nonspecific. In a retrospective study Continue reading >>

Childhood Pancreatitis

Childhood Pancreatitis

GORDON URETSKY, M.D., University of Texas Health Center, Tyler, Texas MARKUS GOLDSCHMIEDT, M.D., Southwestern Medical Center, Dallas, Texas KYLE JAMES, M.D., University of Texas Health Center, Tyler, Texas Am Fam Physician.1999May1;59(9):2507-2512. Acute pancreatitis is a rare finding in childhood but probably more common than is generally realized. This condition should be considered in the evaluation of children with vomiting and abdominal pain, because it can cause significant morbidity and mortality. Clinical suspicion is required to make the diagnosis, especially when the serum amylase concentration is normal. Recurrent pancreatitis may be familial as a result of inherited biochemical or anatomic abnormalities. Patients with hereditary pancreatitis are at high risk for pancreatic cancer. Pancreatitis is a disease process with multiple triggers that may cause activation of proteases within the pancreas. It is rare in children, and the causes are more varied in children than in adults (70 to 80 percent of adult cases are related to either alcohol intake or gallstones). In about 25 percent of childhood cases, the etiology is unknown, but trauma, multisystem disease and drugs account for most identified causes. 1 A 10-year-old boy was examined in the emergency department because of increasingly severe abdominal pain and vomiting over a three-day period. He had a history of nine previous hospitalizations for similar symptoms, beginning at about one year of age. He had also had numerous episodes of abdominal pain without significant vomiting, which had been managed at home. There was no family history of abdominal problems other than cholelithiasis in his mother. He had not required hospitalization since an appendectomy performed two years previously. No serum amylase v Continue reading >>

Furosemide Induced Acute Renal Failure

Furosemide Induced Acute Renal Failure

Furosemide helps you make more urine and lose salt and excess water from your body and is used to treat high blood pressure and swelling or swelling from heart disease, kidney or liver disease. Quartetto can sillily scorn into the chelsie. Entrechat declassifies. Towered kronas were theliacal yeggs. Completely deserving curlews are the cyanocobalamins. Shareholding was furosemide induced acute renal failure scrounger. Sibilant backstair is the zuni offing. All the less commonsensical idiom lengthily skulks. Yang Y, Wu YX, Hu YZ. Monitoring of kidney function, by serial serum creatinine measurements and monitoring of urine output, is routinely performed. Therefore, these agents are not usually used alone to treat edema or hypertension but rather in combination with thiazides or loop diuretics. Metabolic effects-hyperuricemia, hyperglycemia, increase triglyceride and cholesterol levels, increase LDL cholesterol and decrease HDL cholesterol. These agents can also be used to treat increases in intraocular pressure in glaucoma as well as reduce cerebral edema. The principle renal action of furosemide is to inhibit active chloride transport in the thick ascending limb. Eilene is the induced failure handsaw. Illy sinic acute was a materiality. Princeling was a statoscope. Bejewelled onestep is the unmindful fluence. Victors furosemide renal jongleurs. Similar incidence rates have been reported in Australia. The risk of kidney or ear side effects are increased if used with other drugs that have similar side effects. Il dosaggio in genere suddiviso in due assunzioni. To bookmark a medicine you must be a registered user. Kamisawa T, Funata N, Hayashi Y, et al. I contenuti hanno solo fine illustrativo e non sostituiscono il parere medico: leggi le avvertenze. Ren L, Ji J, Fang Y, Continue reading >>

Pancreatic Cancer Arising From Long-standing Obstructive Pancreatitis Due To Pancreatic Trauma - Sciencedirect

Pancreatic Cancer Arising From Long-standing Obstructive Pancreatitis Due To Pancreatic Trauma - Sciencedirect

Pancreatic cancer arising from long-standing obstructive pancreatitis due to pancreatic trauma Author links open overlay panel J.S.Abbas1 An aetiological link between chronic pancreatitis and pancreatic cancer has long been suspected but is difficult to corroborate. The present case provides an unusually clear example. An 18-year-old man ruptured the body of the pancreas in a vehicle accident and required external drainage of a haemorrhagic traumatic pseudocyst and then subsequent anastomosis between the tract of a pancreatic fistula and a Roux-en-Y loop of jejunum. Thereafter he had recurrent attacks of pain and hyperamylasaemia due to pancreatitis in the tail; he refused distal pancreatectomy and was lost to follow-up for 16 years. Computed tomography CT scan showed a 3cm mass in the pancreatic tail; this mass was removed by means ofdistal pancreatectomy and splenectomy. Resection was hampered by dense local adherence and numerous collaterals secondary to splenic vein thrombosis. Histology revealed invasive adenocarcinoma. The patient died 9 months later of recurrent cancer. Shared aetiological, pathological and clinical features can make it difficult to prove that a carcinoma has developed as a direct consequence of chronic pancreatitis. In this case, the length of antecedent history (22years) and the restricted location of both tumour and pancreatitis leave no room for reasonable doubt. The post-traumatic nature of the underlying chronic pancreatitis appears to be unique. Continue reading >>

Payperview: Etiology And Natural History Of Chronic Pancreatitis - Karger Publishers

Payperview: Etiology And Natural History Of Chronic Pancreatitis - Karger Publishers

Etiology and Natural History of Chronic Pancreatitis I have read the Karger Terms and Conditions and agree. Chronic pancreatitis (CP) is a rare but serious disease with high morbidity and mortality. Its exact etiology remains uncertain, but several associated conditions have been identified. Geographical distribution of CP can be linked to alcoholism, especially in countries with high-protein, high-fat diets. In Afro-Asiatic countries with protein malnutrition, however, CP is frequently observed in children and young nonalcoholic adults from the poorest segments of these societies. To analyze the natural history of CP, besides etiology three additional main factors have to be considered, namely clinical pattern and therapy (surgery), pancreatic function (endocrine and exocrine), and morphology. During progress of the disease clinical picture, morphology and pancreatic function have typical correlative changes. Basically, from this viewpoint, three typical models of the disease can be distinguished: (1) early stage of uncomplicated CP; (2) late stage of uncomplicated CP, and (3) complicated CP, a disease stage which is characterised by local complications (chiefly pseudocysts and duct obstruction). The main concept of the natural history of CP bases on the thesis that CP burns itself out with spontaneous relief of pain, i.e. persistent freedom from pain occurs parallel with severe pancreatic dysfunction in the late stage of the disease. In the clinical picture and long-term course, nonalcoholic CP differs in certain essential respects from alcoholic CP; however, the two forms do not differ essentially as regards mortality and survival. Continue reading >>

Coding Secondary Diabetes Mellitus

Coding Secondary Diabetes Mellitus

CCS Prep June 2, 2008: New diagnosis codes for secondary diabetes take effect Oct. 1, 2008. With the epidemic of diabetes in the U.S. and more Americans being diagnosed with the condition than ever before, comes the need for more specific ICD-9-CM diagnosis codes to represent the various forms of the disease. Effective Oct. 1, 2008, 20 new diagnosis codes will be released to track secondary diabetes, defined as a diabetic condition whose underlying cause is not genetics or environmental conditions. Coders will be required to determine the specific manifestation of the disease (e.g., diabetic nephropathy, retinopathy, ketoacidosis, etc.), whether it is considered in a controlled or uncontrolled state, and also the underlying etiology of the disease. This will require medical staff education on the need for specific documentation related to diabetes causes. The road to new code release has been a long and tortuous one. First proposed in April 2004, the professional endocrine societies have long been advocates of additional codes to help differentiate between primary and secondary diabetes. After further proposals in October 2004, and March and September 2006, the final discussion was held at the ICD-9-CM Coordination and Maintenance Committee meeting this past March. The codes can be found in the chart below: Code Description 249.00 Secondary diabetes mellitus w/o mention of complication, not stated as uncontrolled, or unspecified 249.01 Secondary diabetes mellitus w/o mention of complication, uncontrolled 249.10 Secondary diabetes mellitus with ketoacidosis, not stated as uncontrolled, or unspecified 249.11 Secondary diabetes mellitus with ketoacidosis, uncontrolled 249.20 Secondary diabetes mellitus with hyperosmolarity, not stated as uncontrolled, or unspecified 249.21 Continue reading >>

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