Acute pancreatitis
Journal Title: Postępy Nauk Medycznych - Year 2014, Vol 27, Issue 1
Abstract
Acute pancreatitis (AP), which carries 5% of mortality, is one of the most common acute condition in gastroenterology. Alcohol consumption and biliary stone disease cause the most cases of AP. The risk of the post ERCP pancreatitis can be decreased by routine, rectal administration of indomethacine or diclofenac immediately prior or after procedure or by insertion of the pancreatic stent in selected cases. Revision of the Atlanta classification of acute pancreatitis from 2012 introduces new classification of clinical types and severity of AP, revised definitions of local and systemic complications of AP (including new description of fluid collections). Simple prognostic scoring systems like BISAP, assessment of the systemic inflammatory response syndrome or organ failure symptoms are the main tools for the prognosis and assessment of initial severity.Radiographic imaging like computed tomography of the abdomen should be used for the detection of necrosis and other local complications in the late phase (following several days) of the disease. Sufficient fluid resuscitation and enteral nutrition are the cornerstones of management in the early phase of AP. There is no evidence for the beneficial use of prophylactic antibiotics. Early ERCP is limited to some cases of the most severe biliary AP. Cholecystectomy remains the main procedure for prevention of recurrent gallstone pancreatitis and should be preformed before discharge whenever possible.
Authors and Affiliations
Agnieszka Rogowska
Keywords
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