Diagnosis, objective assessment of severity, and management of acute pancreatitis

Dervenis, Christos; Johnson, C. Daniel; Bassi, Claudio; Bradley, Edward L.; Imrie, C. W.; Mj, McMahon; Modlin, I M

doi:10.1007/bf02925968

Cited by 358 publications

(25 citation statements)

References 89 publications

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“…Over the last decade, the consensus view of the most appropriate management of sterile pancreatic and peripancreatic necrosis is conservative therapy. 240,241 Multiple studies have shown no benefit from surgical intervention. In particular, sterile necrosis without the presence of sustained organ failure is usually not of great prognostic significance.…”

Section: Management Of Sterile Necrosismentioning

confidence: 99%

Acute Pancreatitis: Bench to the Bedside

et al. 2007

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Section: Management Of Sterile Necrosismentioning

confidence: 99%

Acute Pancreatitis: Bench to the Bedside

et al. 2007

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“…Still, the APACHE II score takes into account various parameters, including acute physiological variables, age, and chronic health conditions, some of which may not be relevant to AP prognosis, whereas other important measures, such as pancreatic injury and significant regional complications, are missed [ 21 , 33 , 34 ]. Unlike the APACHE II score, the seven prognostic indicators included in the unwScore and wScore models all play a key role in the occurrence and development of AP or have clinical significance [ 9 , 20 , 27 , 35 – 52 ]. These indexes are easy to obtain in the clinic, and the detection method is convenient.…”

Section: Discussionmentioning

confidence: 99%

Establishment of Early Multi-Indicator Prediction Models of Moderately Severe Acute Pancreatitis and Severe Acute Pancreatitis

et al. 2022

Gastroenterology Research and Practice

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Background. It is critical to accurately identify patients with severe acute pancreatitis (SAP) and moderately SAP (MSAP) in a timely manner. The study was done to establish two early multi-indicator prediction models of MSAP and SAP. Methods. Clinical data of 469 patients with acute pancreatitis (AP) between 2015 and 2020, at the First Affiliated Hospital of Fujian Medical University, and between 2012 and 2020, at the Affiliated Union Hospital of Fujian Medical University, were retrospectively analyzed. The unweighted predictive score (unwScore) and weighted predictive score (wScore) for MSAP and SAP were derived using logistic regression analysis and were compared with four existing systems using receiver operating characteristic curves. Results. Seven prognostic indicators were selected for incorporation into models, including white blood cell count, lactate dehydrogenase, C-reactive protein, triglyceride, D-dimer, serum potassium, and serum calcium. The cut-offs of the unwScore and wScore for predicting severity were set as 3 points and 0.513 points, respectively. The unwScore ( AUC = 0.854 ) and wScore ( AUC = 0.837 ) were superior to the acute physiology and chronic health evaluation II score ( AUC = 0.526 ), the bedside index for severity in AP score ( AUC = 0.766 ), and the Ranson score ( AUC = 0.693 ) in predicting MSAP and SAP, which were equivalent to the modified computed tomography severity index score ( AUC = 0.823 ). Conclusions. The unwScore and wScore have good predictive value for MSAP and SAP, which could provide a valuable clinical reference for management and treatment.

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“…2 3 Based on the presence of sterile or infected necrosis, mortality in patients with more severe AP can range from 10 to 30 percent. 4 There are multiple causes of AP. Cholelithiasis (35–40%) is the most common cause, followed by alcohol (30%).…”

Section: Introductionmentioning

confidence: 99%

Relationship of Arterial Changes in Acute Pancreatitis on CT Angiography with Modified CT Severity Index

Vermani

Kaushal

Kaur

et al. 2021

Journal of Gastrointestinal and Abdominal Radiology

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Purpose To evaluate the prevalence of arterial changes in patients with acute pancreatitis (AP) on computed tomography angiography (CTA) and determine their association with etiology of AP, presence of necrosis, collections and severity of AP. Materials and Methods A total of 50 patients (20 women, 30 men; mean age: 43.04 ± 13.98; age range: 18–77 years) with AP underwent contrast-enhanced computed tomography (CECT) scan and CTA of abdomen, which was evaluated for necrosis and fluid collection (s). On CTA, splanchnic arterial structures were assessed for vascular complications. Association between vascular changes and presence of necrosis, fluid collections, etiology of AP and severity of AP (as assessed by modified computed tomography severity index CTSI) was determined. Results Arterial complications were seen in 28 percent (14/50). The most frequently involved artery was superior pancreaticoduodenal artery (12 percent), followed by splenic artery (8 percent) and right gastric artery (8 percent; Fig. 1). No significant association was seen between arterial changes and gallstone or alcohol-induced AP. Arterial changes showed a significant association with presence of acute necrotizing pancreatitis (ANP), presence of collections and severe AP (CTSI 8–10) (p < 0.05 for each). Conclusion Arterial changes on CTA are frequently seen in patients of AP having ANP. There is a significant association between arterial changes and presence of necrosis, collections and severe AP.

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Diagnosis, objective assessment of severity, and management of acute pancreatitis

Cited by 358 publications

References 89 publications

Acute Pancreatitis: Bench to the Bedside

Acute Pancreatitis: Bench to the Bedside

Establishment of Early Multi-Indicator Prediction Models of Moderately Severe Acute Pancreatitis and Severe Acute Pancreatitis

Relationship of Arterial Changes in Acute Pancreatitis on CT Angiography with Modified CT Severity Index

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