Acute Necrotizing Pancreatitis: Treatment Strategy According to the Status of Infection

Büchler, Markus W.; Gloor, Beat; Muller, Christophe; Friess, Helmut; Seiler, Christian; Uhl, Waldemar

doi:10.1097/00000658-200011000-00001

Cited by 705 publications

(537 citation statements)

References 41 publications

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“…Because the elevations in white blood count and temperature may be identical in sterile and infected necrosis (188), and because organ failure may occur in a substantial percentage of patients with both sterile and infected necrosis (45% vs 62% in one series) (83), it is impossible to distinguish these conditions clinically unless CT scan shows evidence of air bubbles in the retroperitoneum. The distinction between sterile and infected necrosis is an important concern throughout the course of necrotizing pancreatitis, but particularly during the second and third weeks, when at least one-half of cases of infected necrosis are documented (47,117,126,159,170).…”

Section: Level Of Evidence: IIImentioning

confidence: 99%

Practice Guidelines in Acute Pancreatitis

Banks

Freeman

2006

Am J Gastroenterology

1,659

980

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Section: Level Of Evidence: IIImentioning

confidence: 99%

Practice Guidelines in Acute Pancreatitis

Banks

Freeman

2006

Am J Gastroenterology

1,659

980

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“…The pancreatic abscess is defined as a collection of purulent material encapsulated by a fibrous wall located in the pancreas or in the retropancreatic region 7,11,16 . It occurs in 10% of cases of pancreatic necrosis and fine needle aspiration can reveal polymicrobial flora with intestinal bacteria Gramnegative and Gram-positive 24,33 .…”

Section: Collections and Pancreatic Abscessmentioning

confidence: 99%

“…Surgical drainage, together with debridement and local cleaning has historically mortality and morbidity high, ranging from 10% to 59% and 60% to 93%, respectively 16,59,66 .…”

Section: Collections and Pancreatic Abscessmentioning

confidence: 99%

“…The same difficulty is found in the characterization of the existence of sterile/infected fluid collection and abscess, and abscess with pseudocyst. The evolution of organ dysfunction or IMOS and a positive aspiration, provide grants to characterize the presence of infection, pancreatic necrosis, collection or presence of abscess 16,25,59 .…”

Section: Introductionmentioning

confidence: 99%

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Quando e como tratar as complicações na necrose pancreática infectada

Silva¹,

Pacheco-Junior²,

Moricz³

et al. 2010

ABCD, arq. bras. cir. dig.

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-Introduction -Acute pancreatitis is presented in its severe form between 10% and 15% of cases and is associated with high mortality. In the initial phase, evolution characterized by the onset of organ dysfunction and subsequently by the presence of pancreatic necrosis and its complications. Methods -It was performed a literature review with consultations in the following databases: PubMed, SciELO, Lilacs. Headings used were the following: acute pancreatitis, infection, pancreatic necrosis. Conclusion -The treatment of pancreatic necrosis, despite the advent of modern methods and techniques, is still challenging. Because of the multiplicity of aspects that may take the examination of each case, in view of the extent, severity and location of facilities within a patient's care, the treatment should be individualized for each case.RESUMO -Introdução -A pancreatite aguda se apresenta na sua forma grave entre 10% e 15% dos casos e está associada com alta mortalidade. Na fase inicial da evolução caracteriza-se pelo aparecimento de disfunções orgânicas e posteriormente pela presença de necrose pancreática e suas complicações. Método -Foi realizada revisão da literatura com consultas feitas nas seguintes bases de dados: Pubmed, Scielo, Lilacs. Os descritores cruzados foram os seguintes: pancreatite aguda, infecção, necrose pancreática. Conclusão -O tratamento da necrose pancreática, apesar do advento de modernos métodos e técnicas, ainda continua desafiador. Devido à multiplicidade de aspectos que pode assumir, a análise de cada caso, tendo em vista a extensão, gravidade e meios existentes no local de atendimento do paciente, é que deverá orientar o tratamento possível, sendo ele sempre individualizado a cada caso.

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“…3,4 The study purports to judge the efficacy of IAP and APP early in the onset of the disease as predictors of outcome. The authors agree that infection is a significant contributor to mortality after the early phase of the disease, 5,6 but there is no evidence to indicate that this can be adequately detected 72 h after admission.…”

mentioning

confidence: 99%