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Severe Acute Pancreatitis-Incidence Of Organ Failure

Wolfgang Huber, Hana Algül, Tobias Lahmer, Ulrich Mayr, Miriam Lehmann, Roland M Schmid, Andreas Faltlhauser
BACKGROUND: Acute pancreatitis (AP) usually has a mild course with a mortality rate below 1%. However, around 10% of patients develop severe AP (SAP) involving extra-pancreatic tissues and other organ systems. The mortality of SAP is around 42%. The outcome of SAP is closely related to the development of systemic inflammation and consecutive organ failures. Most current therapies including fluid resuscitation, antimicrobial therapy, drainage procedures, and endoscopic management of complications are symptomatic rather than causative approaches, except sphincterotomy for gallstone pancreatitis...
January 2019: Medicine (Baltimore)
Chaochao Tan, Ying Huang, Liwei Zhang, Jie Chen, Yupeng Wang, Jianqiao Peng, Yanghua Yue
OBJECTIVE: To analyze the clinical value of immature granulocytes in peripheral blood for prediction of persistent systemic inflammatory response syndrome (SIRS) in patients with acute pancreatitis (AP). METHODS: 1 973 patients with AP in Hunan People's Hospital from 2012 to 2017 were retrospectively enrolled and divided by SIRS duration into the persistent SIRS group, temporary SIRS group and non-SIRS group. The independent risk factor for persistent SIRS in AP patients was evaluated by Logistic regression analysis, and predictive value of immature granulocytes for persistent SIRS in AP patients was analyzed by the receiver operating characteristic (ROC) curve...
December 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Oleksiy Yu Cherkun, Dmytro A Sytnik, Andriy S Kaliuzhka, Volodymyr D Sheyko, Volodymyr H Hryn
OBJECTIVE: Introduction: In the past decades, mortality in acute pancreatitis ranges from 3% to 15 % and depends mainly on the severity of the diseases, which is characterized by the development of necrotic processes in the pancreas and systemic complications. Notwithstanding the numerous studies on severe forms of acute pancreatitis, no significant improvement of treatment outcomes of this category of patients is observed. The integrated diagnosis and treatment of this pathology, prognosis and prevention of purulentseptic complications are relevant to date...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
Takeshi Sato, Wataru Shibata, Shin Maeda
Acute and chronic pancreatitises are gastrointestinal inflammatory diseases, the incidence of which is increasing worldwide. Most (~ 80%) acute pancreatitis (AP) patients have mild disease, and about 20% have severe disease, which causes multiple organ failure and has a high mortality rate. Chronic pancreatitis (CP) is characterized by chronic inflammation and destruction of normal pancreatic parenchyma, which leads to loss of exocrine and endocrine tissues. Patients with CP also have a higher incidence of pancreatic ductal adenocarcinoma...
August 23, 2018: Journal of Gastroenterology
Xinyue Hu, Lipeng Zhang
Severe acute pancreatitis (SAP) is still with a high incidence and mortality. Early onset is usually non-infectious inflammation caused by systemic inflammatory response syndrome (SIRS), with the further progress into pancreatic necrosis, which is the main cause of death. The occurrence of infection can induce or aggravate multiple organ failure (MOF), leading to death. Therefore, whether early use of antibiotics to prevent the occurrence of pancreatic infection and how to identify early pancreatic infection, how to choose the start of antibiotic therapy is the hot and difficult point of current study...
July 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Eduardo Labarca, Felix Zubia, Enrique Maraví-Poma, Felipe Martinez
OBJECTIVE: To establish incidence, risk factors, and prognostic implications of abdominal hemorrhage (AH) among critically ill patients with acute pancreatitis (AP). METHODS: Prospective cohort study in 46 intensive care units aimed at describing the characteristics of critically ill patients with AP (Epidemiología de la Pancreatitis Aguda en Medicina Intensiva Study). Adult patients with AP and at least 1 organ failure were included. The presence of AH was established either by using computed tomography, magnetic resonance imaging, or by direct visualization during surgery...
September 2018: Pancreas
Charlotte Garret, Matthieu Péron, Jean Reignier, Aurélie Le Thuaut, Jean-Baptiste Lascarrou, Frédéric Douane, Marc Lerhun, Isabelle Archambeaud, Noëlle Brulé, Cédric Bretonnière, Olivier Zambon, Laurent Nicolet, Nicolas Regenet, Christophe Guitton, Emmanuel Coron
Objective: The primary objective of this article is to identify risk factors for infected pancreatic necrosis (IPN) in patients admitted to the intensive care unit (ICU) for severe acute pancreatitis. We also described outcomes of IPN. Background: Acute pancreatitis is common and associated with multiple, potentially life-threatening complications. Over the last decade, minimally invasive procedures have been developed to treat IPN. Methods: We retrospectively studied consecutive patients admitted for severe acute pancreatitis to the ICUs of the Nantes University Hospital in France, between 2012 and 2015...
July 2018: United European Gastroenterology Journal
Jianfeng Tu, Yue Yang, Jingzhu Zhang, Qi Yang, Guotao Lu, Baiqiang Li, Zhihui Tong, Lu Ke, Weiqin Li, Jieshou Li
Endocrine pancreatic insufficiency secondary to acute pancreatitis (AP) drew increasing attention in the recent years. The aim of the present study was to assess the impact of pancreatic necrosis and organ failure on the risk of developing new-onset diabetes after AP.The follow-up study was conducted for patients recovered from AP in the treatment center of Jinling Hospital. Endocrine function was evaluated by simplified oral glucose tolerance test (OGTT). Pancreatic necrosis was examined by abdominal contrast-enhanced CT (CECT) scan during hospitalization...
June 2018: Medicine (Baltimore)
Zhenhe Li, Guixia Wang, Guodong Zhen, Yuliang Zhang, Jiaqiang Liu, Shanmei Liu
BACKGROUND/AIMS: Severe acute pancreatitis (SAP) is characterized by persistent organ failure. This research aimed to evaluate the effect of hemodialysis combined with hemoperfusion on SAP. MATERIALS AND METHODS: Thirty-seven patients who were treated with hemoperfusion combined with hemodialysis were included in group O, and 31 patients treated with conventional therapy and hemoperfusion were included as control (group C). Leukocyte count, neutrophil percentage, amylase (AMY), blood urine nitrogen (BUN), creatinine (Cr), and total bilirubin (TBIL) were noted...
March 2018: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
Mei Zhang, Hong-Ming Zhu, Fang He, Bang-Yi Li, Xiao-Cui Li
AIM: To elucidate the effects of small intestinal bacterial overgrowth (SIBO) on the severity and complications of acute pancreatitis (AP). METHODS: In total, 208 patients with AP as defined by the revised Atlanta classification were admitted to Xuanwu Hospital of Capital Medical University from 2013 to 2016. All patients were admitted within 72 h of AP onset. The hydrogen breath test was performed 7 d after AP onset to detect hydrogen production and evaluate the development of SIBO...
December 28, 2017: World Journal of Gastroenterology: WJG
Wandong Hong, Suhan Lin, Maddalena Zippi, Wujun Geng, Simon Stock, Zarrin Basharat, Bicheng Cheng, Jingye Pan, Mengtao Zhou
Background and Aims: To investigate the association between serum albumin levels within 24 hrs of patient admission and the development of persistent organ failure in acute pancreatitis. Methods: A total of 700 patients with acute pancreatitis were enrolled. Multivariate logistic regression and subgroup analysis determined whether decreased albumin was independently associated with persistent organ failure and mortality. The diagnostic performance of serum albumin was evaluated by the area under Receiver Operating Characteristic (ROC) curves...
2017: Canadian Journal of Gastroenterology & Hepatology
Peter J Lee, Kunjam Modha, Tiffany Chua, Amitabh Chak, Daniel Jang, Rocio Lopez, Amir Gougol, Georgios I Papachristou, Tyler Stevens
BACKGROUND: Statins possess anti-inflammatory properties and have a protective effect in certain inflammatory conditions; however, their effect on the natural history of pancreatitis is unknown. AIM: The aim of this study is to assess the effect of statin exposure on the severity of pancreatitis and incidence of organ failure using a propensity-matched approach. METHODS: A historical cohort study was conducted of adult patients with acute pancreatitis (AP) admitted in the Cleveland Clinic Health System between 2007 and 2014...
September 2018: Journal of Clinical Gastroenterology
Biswajit Khatua, Bara El-Kurdi, Vijay P Singh
PURPOSE OF REVIEW: The obesity pandemic poses a unique set of problems for acute pancreatitis - both by increasing acute pancreatitis incidence, and worsening acute pancreatitis severity. This review explores these associations, underlying mechanisms, and potential therapies. RECENT FINDINGS: We review how the obesity associated increase in gallstones, surgical, and endoscopic interventions for obesity management, diabetes, and related medications such as incretin-based therapies and hypertriglyceridemia may increase the incidence of acute pancreatitis...
September 2017: Current Opinion in Gastroenterology
Yeon Ji Kim, Dae Bum Kim, Woo Chul Chung, Ji Min Lee, Gun Jung Youn, Yun Duk Jung, Sooa Choi, Jung Hwan Oh
OBJECTIVE: Acute pancreatitis (AP) ranges from a mild and self-limiting disease to a fulminant illness with significant morbidity and mortality. Severe acute pancreatitis (SAP) is defined as persistent organ failure lasting for 48 h. We aimed to determine the factors that predict survival and mortality in patients with SAP. METHODS: We reviewed a consecutive series of patients who were admitted with acute pancreatitis between January 2003 and January 2013. A total of 1213 cases involving 660 patients were evaluated, and 68 cases with SAP were selected for the study...
August 2017: Scandinavian Journal of Gastroenterology
Mark Portelli, Christopher David Jones
BACKGROUND: Severe acute pancreatitis is a subtype of acute pancreatitis, associated with multiple organ failure and systemic inflammatory response syndrome. In this qualitative review we looked at the principles of pathogenesis, classification and surgical management of severe acute pancreatitis. We also looked at the current shift in paradigm in the management of severe acute pancreatitis since the guideline developed by the British Society of Gastroenterology. DATA SOURCES: Studies published between 1st January 1991 and 31st December 2015 were identified with PubMed, MEDLINE, EMBASE and Google Scholar online search engines using the following Medical Subject Headings: "acute pancreatitis, necrosis, mortality, pathogenesis, incidence" and the terms "open necrosectomy and minimally invasive necrosectomy"...
April 2017: Hepatobiliary & Pancreatic Diseases International: HBPD INT
Federico Bolado, Enrique de-Madaria
Acute pancreatitis (AP) is a potentially serious disease whose incidence is on the increase. Pancreas divisum does not meet the required criteria to be considered an aetiological factor. Sphincter of Oddi dysfunction may be another cause of idiopathic AP. Less invasive methods cannot replace Sphincter of Oddi manometry in diagnosis. Almost half of patients with systemic inflammatory response syndrome develop organ failure, but the mechanisms involved are not completely understood. Obesity is a risk factor for severity in AP; the cause could be the presence of free unsaturated fatty acids, which have pro-inflammatory activity...
September 2016: Gastroenterología y Hepatología
I Mikolasevic, L Orlic, G Poropat, I Jakopcic, D Stimac, A Klanac, F Carovic, S Milic
AIM: To explore the effect of nonalcoholic fatty liver as a hepatic manifestation of metabolic syndrome on the severity of acute pancreatitis. We hypothesized that patients with nonalcoholic fatty liver would have a more severe form of acute pancreatitis. PATIENTS AND METHODS: We retrospectively analyzed 822 patients hospitalized with acute pancreatitis. We diagnosed acute pancreatitis and determined its severity according the revised Atlanta classification criteria from 2012...
March 2017: European Journal of Internal Medicine
L Ji, B Sun, C D Cheng, X W Bai, G Wang, R Kong, H Chen, H C Jiang
Objective: To explore the experience and prognostic factors associated with the employment of the step-up approach in the treatment of local complications secondary to severe acute pancreatitis (SAP). Methods: The clinical data of 279 patients admitted to the Department of Pancreatic and Biliary Surgery, First Affiliated Hospital of Harbin Medical University from January 2011 to December 2015, whose local complications secondary to SAP were treated in a staged step-up framework, were retrospectively analyzed...
November 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
W H He, Y Zhu, Y Zhu, P Liu, H Zeng, L Xia, X Huang, Y P Lei, N H Lü
OBJECTIVE: To investigate the difference in severity and clinical outcomes between hypertriglyceridemic pancreatitis (HTGP) and acute pancreatitis (AP) of other causes, and to analyze the correlation between the serum triglyceride (TG) level <24 h after onset and the disease severity. METHODS: Patients were selected from the AP database of the First Affiliated Hospital of Nanchang University, who were admitted between January 2005 and December 2013, aged ≥18 and ≤85 years, excluding pregnant or lactating women...
August 23, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
B Cucuteanu, Cristina Cijevschi Prelipcean, Cătălina Mihai, Mihaela Dranga, D Negru
Acute pancreatitis (AP) is a frequent presentation to the emergency departments with a rising incidence and a great variability in clinical severity and outcome. The aim of this review is to offer a succinct presentation on acute pancreatitis scoring systems and the use of different imaging methods in severity prediction: Ranson criteria, Glasgow criteria, Hong Kong Score, Acute Physiology and Chronic Health Evaluation II (APACHE II), computed tomography scoring systems, Bedside Index of Severity in Acute Pancreatitis (BISAP) score, Panc 3, Japanese Severity Score (JSS), Harmless Acute Pancreatitis Score (HAPS), Pancreatitis Outcome Prediction (POP), Sequential Organ Failure Assessment (SOFA)...
April 2016: Revista Medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti Din Iaş̧i
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