Necrotizing pancreatitis: Diagnose, treat, consult

Chua, Tiffany; Walsh, R. Matthew; Baker, Mark E.; Stevens, Tyler

doi:10.3949/ccjm.84a.16052

Cited by 17 publications

(12 citation statements)

References 34 publications

(35 reference statements)

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“…Interestingly, in our study, mortality was only 8%, and multiorgan failure was the main cause of death . Moreover, mortality in our series was far lower than that of the general population . Perhaps the reduced inflammatory response due to the relative immunosuppression in the elderly may account for a less common development of severe disease.…”

Section: Discussioncontrasting

confidence: 57%

“…In the majority of patients, the disease presents as a mild, self‐limiting condition; in such a case, the overall mortality rate is 7% . AP develops into severe disease in 20% of cases, with mortality rates of up to 15–20% . Outcomes of AP in the elderly seem to be worse than in younger people as higher mortality rates and longer hospital stay had been reported .…”

Section: Introductionmentioning

confidence: 99%

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Outcome of acute pancreatitis in octogenarians: A retrospective study

et al. 2019

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Background and Aim Acute pancreatitis (AP) is a common disease, but data on outcomes in octogenarians are scarce in the literature. The aim of this study is to analyze results from patients aged 80 years old and over who were treated for AP at a single center. Methods Patients aged 80 years and older diagnosed with AP from April 2010 to October 2015 were considered. Demographics, American Society of Anesthesiologists (ASA) score, Charlson Comorbidity Index (CCI), serum biochemistry at 24 and 48 h after admission, and revised Atlanta severity score were analyzed and correlated with hospital mortality rate and length of stay using the multiple regression and Kaplan–Meier tests. Results A total of 100 consecutive patients were included in the study. There were 52 women, and the mean age was 87.5 years (range 80–95). Gallstones were the most common cause of AP (69.7%). The ASA score was ≥III in 51 patients. Eight patients had severe, disease and all of them died in hospital. A CCI > 4 was associated with higher disease severity and mortality (P < 0.00001). The median hospital stay was 9 days (range 1–59). Longer hospital stay was associated with serum C‐reactive protein ≥242 mg/L (P = 0.01) and serum albumin ≤30 g/L (P = 0.01) at 48 h. Over a 5‐year period, 22% of patients were readmitted to hospital with recurrent AP. Gallstones were the main cause of disease (63.6%). Conclusions AP in octogenarians has low mortality. Higher death rate is associated with disease severity. In the presence of gallstone disease, cholecystectomy is recommended whenever possible as the risk of disease recurrence is significant.

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Section: Discussioncontrasting

confidence: 57%

Section: Introductionmentioning

confidence: 99%

Outcome of acute pancreatitis in octogenarians: A retrospective study

et al. 2019

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“…Discuțiile pe tema clasificării pancreatitei încep în 1963, la conferința de la Marsilia, în contextul trasării granițelor între pancreatită acută și cronică, considerate entități distincte la vremea aceea (8). Ulterior, în 1984, clasificările au fost revizuite și acceptate ca aceste forme clinice sunt în continuitate, cu o evoluție lentă în pancreatită cronică (1,2,3,8).…”

Section: Introducereunclassified

“…Termenul de pancreatită cronică este folosit în mod tradițional și descrie un sindrom de inflamație cronică a țesutului pancreatic, care este cel mai des observată la indivizii consumatori de etanol și fumători şi mai rar la persoane predispuse genetic (9,10,11). Acest proces inflamator ireversibil, persistent, duce la cicatrizarea progresivă a țesutului pancreatic, cu durere, disfuncție a glandei pancreatice endocrine (ca efect principal al pierderii insulelor Langerhans), insuficiență pancreatică exocrină (deficiență de enzime digestive produse de pancreas, cu efect în timpul şi eficiența digestivă) și creșterea riscului de cancer pancreatic, în special de adenocarcinom ductal (8).…”

Section: Introducereunclassified

Pancreatita acută recurentă poate avea indicație operatorie?

E¹,

Popa²,

Ierima³

et al. 2019

Ro Med J.

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“…Although the disease is usually mild, approximately 20% of affected individuals may develop its severe form with pancreatic necrosis and progressive multiorgan failure. This leads to a septic state in approximately 40-70% of the patients and secondary multiorgan failure [2]. Complications of acute pancreatitis constitute an indication for surgical treatment; as a result of surgical intervention, 100% mortality may be reduced to 24-39%, or even down to 6-12% [3].…”

Section: Introductionmentioning

confidence: 99%

Gallbladder sludge in a pregnant woman as a cause of severe complicated hemorrhagic-necrotizing pancreatitis with a spectacular manifestation

2017

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Pancreatitis is an obvious but a rare event in pregnancy. From mild disease to multiorgan failure and sepsis acute pancreatitis has numerous causes and an often unpredictable outcome. The authors present a case of 22-year-old pregnant woman with severe pancreatitis due to biliary sludge. An unusual clinical manifestation of pancreatitis in our patient is worth emphasizing: massive bleeding from upper alimentary tract and concomitant two pancreatic fistulas. The bleeding is a manifestation of the pancreatic juiceinduced injury to the splenic artery, whereas the fistulas are consequence of the disconnected duct syndrome and superficial necrosis of the pancreatic head. After two and a half years lasting treatment the patient was on regular oral diet with supplementation of pancreatic enzymes, and showed normal glycaemia level. She returned to fully physical activity.

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Necrotizing pancreatitis: Diagnose, treat, consult

Cited by 17 publications

References 34 publications

Outcome of acute pancreatitis in octogenarians: A retrospective study

Outcome of acute pancreatitis in octogenarians: A retrospective study

Pancreatita acută recurentă poate avea indicație operatorie?

Gallbladder sludge in a pregnant woman as a cause of severe complicated hemorrhagic-necrotizing pancreatitis with a spectacular manifestation

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