Acute pancreatitis: New developments and strategies for the hospitalist

Abstract

Acute pancreatitis (AP) remains the most common reason for hospital admission of all the gastrointestinal illnesses in the United States. Since the last narrative review in the Journal of Hospital Medicine in 2010, new developments in regard to diagnosis and classification, fluid resuscitation, antibiotic use, nutritional support, and management of complications have helped refine the approach and improve outcomes in this disease. Whereas there is still no proven pharmacologic therapy to specifically combat the inflammatory consequences of AP, recent interventions have led to increased survival, shorter length of stay, and more appropriate transfer criteria for pancreatitis patients. This case‐oriented review will highlight these developments and emphasize the primary role of the hospitalist in managing AP over the course of the admission. It will focus on when to coordinate with subspecialists, how to deliver effective yet efficient hospitalized care, and how to optimize appropriate discharge planning. Journal of Hospital Medicine 2016;11:724–729. © 2016 Society of Hospital Medicine

Carbon monoxide-bound hemoglobin vesicles ameliorate multiorgan injuries induced by severe acute pancreatitis in mice by their anti-inflammatory and antioxidant properties

“…In more severe cases, such as the development of complications including MOF, hospitalization can be prolonged considerably, with a much cost. 30 Although worldwide guidelines have been established for managing acute pancreatitis, including rehydration, early nutrition, acceptable analgesia, oxygenation, and the use of antibiotics, when infections are confirmed, 31−34 there is no recommended drug protocol for preventing the progression of pancreatitis itself. Therefore, Figure 5 evaluation of hepatic injury and immunological staining of liver sections after the administration of saline, hbV, and cO-hbV to cDe diet-induced acute pancreatitis mice.…”

Review of Current Evidence in Acute Pancreatitis

“…The diagnosis of AP is based on two or more of the following criteria: characteristic abdominal pain, elevated levels of serum lipase and amylase [at least three times of the normal value], and/or findings in the images of abdomen, including the ultrasound (USG) images, computed tomography (CT) scans, or magnetic resonance imaging (MRI) [6,35].…”

Review of Current Evidence in the etiopathogenesis, epidemiology, diagnosis and management of acute pancreatitis

“…The diagnosis is made with 2 or more of the following criteria: characteristic abdominal pain, elevated serum lipase and amylase levels at least 3 times the normal value and/or findings in images of abdomen including ultrasound (USG), computed tomography scan (CT) or magnetic resonance imaging (MRI) [6,35].…”