Acute Pancreatitis: Current Understanding of Development, Diagnosis, and Treatment

Подолужный, В. И.

doi:10.23946/2500-0764-2017-2-4-62-71

Cited by 9 publications

(3 citation statements)

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“…В медицинской статистике частота заболеваний ОП в крупных мегаполисах за последние 10 лет уверенно вышла на первое место и составляет 24-26 % от острой хирургической потологии, уступая только острому аппендициту. Несмотря на снижение общей летальности при ОП до 2,4-3,6 %, послеоперационная летальность остается достаточно высокой и составляет 20-27 % [1][2][3]. Социально-эконо-мическую значимость ОП определяет и то, что большинство больных ОП находятся в трудоспособном возврасте, это диктует необходимость разработки путей решения данной проблемы, методов диагностики и лечения, улучшающих исходы заболевания.…”

Section: Introductionunclassified

“…В качестве диагностических критериев до настоящего времени используют активность протеолитических ферментов (амилазы, липазы крови, диастазы мочи). Таким образом, достоверных маркеров оценки тяжести ОП и прогноза перехода заболевания в более тяжелую форму на современном этапе развития хирургии нет, что определяет необходимость активного научного поиска [3][4][5][6].…”

Section: Introductionunclassified

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Atomic force microscopy of erythrocytes of patients with different severity of pancreatitis

Pakhomova,

Kochetova,

Gulikian

et al. 2023

Sibirskij nauchnyj medicinskij zhurnal

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Aim of the study was to prove the possibility of using red blood cell probe microscopy as a predictor of the development of pancreonecrosis.Material and methods. Atomic force microscopy was performed in 143 people (82 were male and 61 were female). The study was performed on an Integra Aura probe microscope (ZAO NT-MDT, Russia). Each erythrocyte was scanned for cell membrane and cell as a whole. A total of 940 red blood cells were examined. According to the severity of acute pancreatitis, patients are distributed in three groups. As a control group, 37 people without somatic pathology were examined. Diagnosis and treatment of patients was carried out in the public health institution “Design Bureau” Russian Railways-Medicine “Krasnoyarsk” from 2015–2019.Results. The study showed that the shape of erythrocyte does not depend on the severity of pancreatitis and does not change, however, structural changes of the membrane occur in the form of the formation of multiple erosions on its surface. The membrane is deformed, and its adhesion increases. These changes reduce the transport capacity of the blood, which, in our opinion, leads to an increase in the general intoxication of the body and to a deterioration in the condition of the patient.Conclusions. Apparently, pancreatic enzymes entering the free bloodstream in the first phase of pancreatitis cause not only oxidative stress, but also the reorganization and destruction of the erythrocyte membrane. The increase in membrane rigidity and deformation of the erythrocyte surface cytoskeleton against the background of increased adhesion seems to disrupt the gas transmission function of erythrocyte and microrheological properties of blood, which in turn disrupts the exchange of amino acids, lipids and detoxification capabilities of blood. The appearance of erythrocytes in the free bloodstream with the presence of erosion on the surface of the erythrocyte membrane can serve as a prediction of a non-favorable course of acute pancreatitis and a predictor of a possible transition of edema pancreatitis to pancreonecrosis.

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Section: Introductionunclassified

Atomic force microscopy of erythrocytes of patients with different severity of pancreatitis

Pakhomova,

Kochetova,

Gulikian

et al. 2023

Sibirskij nauchnyj medicinskij zhurnal

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“…According to the guidelines for the treatment of pancreatitis, one of the criteria of pancreatitis severity is organ failure that remains within 24 h after admission [3]. All clinical recommendations over the past 6 years specify the requirement to assess patient's condition severity immediately after diagnosing and to carry out reassessment over time, especially within 48 h [6], [7], [8].…”

Section: Introductionmentioning

confidence: 99%

Computerized Tomography Score for the Assessment of Multiple Organ Failure and Determining Severity of Pancreatitis: Key Principles for the Assessment of Affected Organs

Ermekova

Aliyakparov

Шакеев

et al. 2020

Open Access Maced J Med Sci

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BACKGROUND: Pancreatitis severity is an important death rate indicator that plays a crucial role in deciding on proper handling of patients at their initial admission, when making a decision on patient’s transfer to the intensive care unit. Many studies point out a direct relation between death rate and the number of affected organs. In view of that, looking for new criteria for assessment of multiple organ failure is still useful in clinical practice. Assessment of multiple organ failure with patients undergoing treatment in the intensive care unit is carried out with the use of various integrated indicators based both on clinical laboratory assessment of patient’s condition, and on data obtained with the help of advanced imaging methods. However, many researchers point out that the facilities of diagnostic radiology, including in particular computerized tomography (CT), are not used to the full extent. AIM: We proposed expanding functionality of abdominal CT examination by means of pancreatitis severity assessment that takes into account changes in the pancreas and in addition enables assessing multiple organ failure with examined patients. We identified the organs and systems whose changes need to be monitored through CT imaging to be able to assess multiple organ failure in the patients with pancreatitis. METHODS: Out of 314 patients, 100 patients were selected diagnosed with pancreatitis confirmed by changes demonstrated by the laboratory test results. Of those, 24 patients (24.0%) revealed presence of multiple organ failure (maximum of 5 organ systems), 46 patients revealed a single organ failure. RESULTS: Development of early organ failure accompanied 82% of cases of severe pancreatitis and considerably aggravated predicted outcome and course of severe AP. Among them, 30 patients had pancreatitis without changes of the vital organs and 70 patients had dysfunctions of the vital organs, suffered from organ or multiple organ failure, and received treatment in the surgery unit and the intensive care unit of the Department of Surgical Conditions of Karaganda Medical University. In view of CT results, we assessed a relation between multiple organ failure and specific failure of a single organ and necrosis and death rate. We analyzed a relation between organ failure and degree of the pancreas necrosis. CONCLUSION: Identified changes enabled us to create a CT score for the assessment of pancreatitis severity that can be used not only for identification but also for the prediction of organ failure at an early stage of pancreatitis with high accuracy as compared against conventional CT systems for the assessment of patients’ condition. It can also be used to differentiate extent organ dysfunction and the number of affected organs.

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Comparison of minimal invasive technologies for treatment of infected pancreatic necrosis

Gallyamov¹,

Агапов²,

Busyrev³

et al. 2020

Khir. Z. im. N.I. Pirogova

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Acute Pancreatitis: Current Understanding of Development, Diagnosis, and Treatment

Abstract: ® 6 стр. 14 стр. 22 стр. 27 стр. 34 стр. 45 стр. 56 стр. 62стр. 72 стр.

Cited by 9 publications

References 0 publications

Atomic force microscopy of erythrocytes of patients with different severity of pancreatitis

Atomic force microscopy of erythrocytes of patients with different severity of pancreatitis

Computerized Tomography Score for the Assessment of Multiple Organ Failure and Determining Severity of Pancreatitis: Key Principles for the Assessment of Affected Organs

Comparison of minimal invasive technologies for treatment of infected pancreatic necrosis

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