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Enrique de-Madaria Profile picture
@DeMadaria
Jun 26, 2022 β€’ 29 tweets β€’ 12 min read β€’ Read on X
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Quick introduction to autoimmune pancreatitis, based on my recent talk in the @EurPancClub meeting #EPCKyiv2022 #GItwitter #TheAmylaseSchool #PancreasTwitter #PancreasLovers #MedTwitter
πŸ‘‡πŸ‘‡πŸ‘‡
Epidemiology
Presentation
Extrapancreatic involvement (type 1 autoimmune pancreatitis)
AIP and IBD I
AIP and IBD II
Pathology AIP type 1-I
Pathology AIP type 1-II
Pathology AIP type 1-III
Pathology AIP type 1-IV
Pathology AIP type 2-I
Pathology AIP type 2-II
Biomarkers
Imaging of autoimmune pancreatitis
Imaging II- type 1 autoimmune pancreatitis extrapancreatic involvement
Imaging III- type 1 autoimmune pancreatitis extrapancreatic involvement
Imaging VI- type 1 autoimmune pancreatitis extrapancreatic involvement
Classification of bile duct involvement, type 1 autoimmune pancreatitis
Mikulicz disease, type 1 AIP
Retroperitoneal fibrosis, type 1 autoimmune pancreatitis
Diagnosis of autoimmune pancreatitis, not easy!!
Diagnosis of AIP II
Diagnosis of mass-forming autoimmune pancreatitis, BE CAREFUL!!! Cancer is more frequent
Treatment of autoimmune pancreatitis

@maloehr1
Treatment of autoimmune pancreatitis, follow-up and relapses
Rituximab on autoimmune pancreatitis
I hope you learned and liked it! If so please retweet the first tweet to share it!
@KM_Pawlak @drdalbir @BilalMohammadMD @drkeithsiau @DCharabaty @RashidLui @SunilAminMD @stevenbollipo @Samir_Grover @drmoutaz @KralJan @RodriguezParra_ @MZorniak @SanchezLunaMD
By the way, please join the @harvardmed MINIMALLY INVASIVE AND NOVEL THERAPEUTICS (MINT) 2022 course on foregut diseases, for GI, surgeons, nurses... interested in foregut diseases
Have a look and join now in advances.massgeneral.org/digestive-heal…

@krishnanendo @CharuParanjape @MGHSurgery

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More from @DeMadaria

Enrique de-Madaria Profile picture
Oct 16, 2022
Sometimes pancreatitis involves the duodenum, letΒ΄s talk about paraduodenal/groove pancreatitis
Don't miss this #GItwitter thread based on my talk for @harvardmed @HMSPostgradCE #HarvardMINT2022 course
Thanks, @CharuParanjape @krishnanendo for one of my best experiences ever!
Pancreas inflammation involving the duodenum has many names: Cystic dystrophy on aberrant pancreas of the duodenal wall, Groove pancreatitis... Adsay and Zamboni proposed paraduodenal pancreatitis as a term that involves these 2 organs
There are 2 important concepts:
1) The pancreatic-duodenal groove is the space between the duodenum and the pancreas: vessels, lymph nodes, Wirsung, Santorini, CBD & some acini are there. Those acini can suffer from pancreatitis: that`s groove pancreatitis
Read 27 tweets
Enrique de-Madaria Profile picture
Sep 14, 2022
Our dream comes true: the #WATERFALLtrial has been published in @NEJM Aggressive fluid resuscitation in acute pancreatitis is not safe & does not improve outcomes #GItwitter #SomosAEG @aegastro
What's behind this publication?
It all started 21 years ago
nejm.org/doi/full/10.10…
2001, I started to attend patients with acute pancreatitis as a GI resident in @GVAsalualicante. Books and papers recommended aggressive fluid resuscitation. It was believed that many fluids increased pancreatic blood flow preventing pancreatic necrosis
But I asked to myself, what is aggressive fluid resuscitation, how much fluids, and which type of fluids? I looked for specific data, but all was vague. I asked in GI meetings, and the answers of experts were vague, no specific fluid rate, just generalities
Read 28 tweets
Enrique de-Madaria Profile picture
Jul 30, 2022
1/5 @pancreatitis_nl trials addressing the management of infected pancreatic necrosis in acute pancreatitis #TheAmylaseSchool @my_ueg @EurPancClub @MarcBesselink #ClinicalResearch
2/5
 Panther trial: A Step-up Approach or Open Necrosectomy for Necrotizing Pancreatitis @NEJM
This trial robustly demonstrated that minimally invasive treatment (percutaneous drainage and minim. invasive surgery if needed) was better than open surgery
nejm.org/doi/10.1056/NE…
3/5 Penguin trial: Endoscopic Transgastric vs Surgical Necrosectomy for Infected Necrotizing Pancreatitis @JAMA_current jamanetwork.com/journals/jama/… This trial showed that endoscopic necrosectomy was better (less aggressive) than open surgery
Read 9 tweets
Enrique de-Madaria Profile picture
Apr 11, 2021
How to do a pro search in Pubmed?

This special #TheAmylaseSchool infographics (or mini-course) is a guide to navigate the deep waters of Pubmed (and not get drown). I provide a pdf at the end of the Twitter Thread

1/5
 Author Journal Date Title Abstract Language Affiliation
πŸ‘‡ ImageImageImageImage
How to search in Pubmed 2/5
Mesh terms, Boolean operators, My NCBI filters
πŸ‘‡ ImageImageImageImage
How to search in Pubmed 3/5
How to save your search
πŸ‘‡ Image
Read 15 tweets
Enrique de-Madaria Profile picture
Feb 21, 2021
What is a Groove Pancreatitis (GP)? #GroovePancreatitis #ParaduodenalPancreatitis #CysticDystrophyDuodenalWall What are the symptoms, consequences, management?
Do not miss this @aegastro #HiloAEG #UEGambassador @my_ueg Twitter thread #TheAmylaseSchool Image
The groove area or pancreaticoduodenal groove involves the space between the duodenum, the head of the pancreas and the common bile duct karger.com/Article/FullTe… Image
Groove pancreatitis is a segmental chronic pancreatitis that affects the groove area; it was described in 1973 by Becker
link.springer.com/book/10.1007/9… Image
Read 15 tweets
Enrique de-Madaria Profile picture
Jan 3, 2021
Cross-sectional imaging often reveals unexpected pancreatic cystic lesions, it is a frequent clinical problem, Should we observe or remove it? What's the diagnosis? Is our patient in danger of malignancy?
Don’t miss this @aegastro @my_ueg #EducAEG #UEGambassador twitter thread
Importance of Pancreatic Cystic Neoplasms (PCN):
Most are asymptomatic at diagnosis, frequency increases with age
Symptoms: acute pancreatitis (Wirsung obstructed by the cyst or mucus), pain, obstructive chronic pancreatitis, jaundice
> symptoms, >malignancy risk!
Classification of PCN:
Mucinous: intraductal papillary mucinous neop. and mucinous cystic neop.
Nonmucinous: serous cystic neoplasm, solid pseudopapillary neoplasm and cystic neuroendocrine tumours
Endoderm- derived columnar epithelium is characteristic for mucinous lesions
πŸ‘‡
Read 18 tweets

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