Imaging of acute pancreatitis and its complications. Part 2: Complications of acute pancreatitis

Türkvatan, Aysel; Erden, Ayşe; Türkoğlu, Mehmet Akif; Seçil, Mustafa; Yüce, Gökhan

doi:10.1016/j.diii.2013.12.018

Cited by 39 publications

(27 citation statements)

References 41 publications

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“…Two separate pathophysiologic processes lead to vascular complications. First, inflammatory reactions can lead to splenic vein thrombosis, the most common vascular complication (23). Second, pancreatic enzymes can cause vessel erosion and lead to either spontaneous arterial hemorrhage or pseudoaneurysm of (in order of decreasing frequency) the splenic, gastroduodenal, and pancreaticoduodenal arteries (24).…”

Section: Infection and Local Complicationsmentioning

confidence: 99%

Revised Atlanta Classification for Acute Pancreatitis: A Pictorial Essay

Foster¹,

Jensen²,

Bakis³

et al. 2016

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The 2012 revised Atlanta classifi cation is an update of the original 1992 Atlanta classifi cation, a standardized clinical and radiologic nomenclature for acute pancreatitis and associated complications based on research advances made over the past 2 decades. Acute pancreatitis is now divided into two distinct subtypes, necrotizing pancreatitis and interstitial edematous pancreatitis (IEP), based on the presence or absence of necrosis, respectively. The revised classifi cation system also updates confusing and sometimes inaccurate terminology that was previously used to describe pancreatic and peripancreatic collections. As such, use of the terms acute pseudocyst and pancreatic abscess is now discouraged. Instead, four distinct collection subtypes are identifi ed on the basis of the presence of pancreatic necrosis and time elapsed since the onset of pancreatitis. Acute peripancreatic fl uid collections (APFCs) and pseudocysts occur in IEP and contain fl uid only. Acute necrotic collections (ANCs) and walled-off necrosis (WON) occur only in patients with necrotizing pancreatitis and contain variable amounts of fl uid and necrotic debris. APFCs and ANCs occur within 4 weeks of disease onset. After this time, APFCs or ANCs may either resolve or persist, developing a mature wall to become a pseudocyst or a WON, respectively. Any collection subtype may become infected and manifest as internal gas, though this occurs most commonly in necrotic collections. In this review, the authors present a practical image-rich guide to the revised Atlanta classifi cation system, with the goal of fostering implementation of the revised system into radiology practice, thereby facilitating accurate communication among clinicians and reinforcing the radiologist's role as a key member of a multidisciplinary team in treating patients with acute pancreatitis.

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Section: Infection and Local Complicationsmentioning

confidence: 99%

Revised Atlanta Classification for Acute Pancreatitis: A Pictorial Essay

Foster¹,

Jensen²,

Bakis³

et al. 2016

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“…The results underscore the important function of ROS-producing cells in the progression of the experimental AP and suggest these cells as a specific target for future studies with antioxidants . Persistent organ failure is major determinant of mortality in AP (Turkvatan et al 2014). Liver tissue is susceptible to oxidative stress because of its high oxygen consumption and modest antioxidant defenses (Shiba et al 2014).…”

Section: Introductionmentioning

confidence: 99%

The carvacrol ameliorates acute pancreatitis-induced liver injury via antioxidant response

et al. 2015

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Acute pancreatitis (AP) may cause significant persistent multi-organ dysfunction. Carvacrol (CAR) possesses a variety of biological and pharmacological properties. The aim of the present study was to analyze the hepatic protection of CAR on AP induced by cerulein and to explore the underlying mechanism using in vivo studies. The rats were randomized into groups to receive (1) no therapy; (2) 50 lg/kg cerulein at 1-h intervals by four intraperitoneal injection (i.p.); (3) 50, 100 and 200 mg/kg CAR by one i.p.; and (4) cerulein ? CAR after 2 h of cerulein injection. 12 h later, serum was provided to assess the blood AST, ALT and LDH values. Also, liver tissues were obtained for histological and biochemical measurements. Liver oxidative stress markers were evaluated by changes in the amount of lipid peroxides measured as MDA and changes in tissue antioxidant enzyme levels, SOD, CAT and GSHPx. Histopathological examination was performed using scoring systems. Oxidative damage to DNA was quantitated in studied tissues of experimental animals by measuring the increase in 8-hydroxydeoxyguanosine (8-OHdG) formations. We found that the increasing doses of CAR decreased pancreatitisinduced MDA and 8-OH-dG levels. Moreover, the liver SOD, CAT and GSH-Px activities in the AP ? CAR group were higher than that of the rats in the AP group. In the treatment groups, AST, ALT and LDH were reduced. Besides, necrosis, coagulation and inflammation in the liver were alleviated (p \ 0.05). We suggest that CAR could be a safe and potent new drug candidate for treating AP through its antioxidative mechanism of action for the treatment of a wide range of disorders related to hepatic dysfunction.

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“…Its wide diversity involving local tissues to spreading inflammation involving systemic involvement increases the mortality many fold. (8)(9)(10) It may run a totally benign course in more than 80% of cases but in 10-20% it has a wildfire like course which may proceed fast as to reach to a point of no return in a very short span having great emotional, physical and a drastic financial burden over the entire family. (11) Many such elderly patients with pain in abdomen are treated as acute MI or duodenal ulcers and eventually this misdiagnosis loses the initial period where patients could be effectively treated and saved.…”

Section: Introductionmentioning

confidence: 99%

Biliary Pancreatitis : Deadly Threat to the Elderly : Is It a Real Threat ?

Malik¹

2015

IJHS

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Abstract:Objective/Introduction: Gallstone pancreatitis is a deadly disease and especially so in the elderly. This study highlights the incidence, pattern and management of acute biliary pancreatitis in the elderly patients to find out the outcome of management.Methods: All patients of acute abdomen regardless of the age and gender of the patients were admitted in our unit at Liaquat University of Medical and Health Sciences and different private hospitals in Hyderabad during 3 years commencing from June 2009 to June 2011. The data was collected on a proforma by the author as soon as the patients were received from the emergency. After admission the patients with the diagnosis of acute biliary pancreatitis on initial workup were inducted in this study. The variables studied included the incidence, severity and management outcome in patients 55 years and above compared to younger patients below 55 years.Results: A total number of 650 patients regardless of gender with acute severe abdominal pain were brought to the emergency of which 131(20.15%) were diagnosed as acute biliary pancreatitis after initial work up. Out of the total patients diagnosed as acute pancreatitis, 63(48.09%) patients were <55 years of age and remaining 68(51.90%) patients were >55 years of age. The overall mortality in this study was 20.63 %( n=13) in elderly patients (> 55 years of age) in both the sexes despite all possible treatment measures. Conclusion:Elderly people respond poorly to the acute insult to pancreatitis.

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Imaging of acute pancreatitis and its complications. Part 2: Complications of acute pancreatitis

Cited by 39 publications

References 41 publications

Revised Atlanta Classification for Acute Pancreatitis: A Pictorial Essay

Revised Atlanta Classification for Acute Pancreatitis: A Pictorial Essay

The carvacrol ameliorates acute pancreatitis-induced liver injury via antioxidant response

Biliary Pancreatitis : Deadly Threat to the Elderly : Is It a Real Threat ?

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