Prognostic factors in sterile pancreatic necrosis

Karimgani, I.; Porter, Kathaleen A.; Langevin, R.Eugene; Banks, Peter A.

doi:10.1016/0016-5085(92)91189-b

Cited by 163 publications

(100 citation statements)

References 25 publications

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“…APACHE-II score is an optimal index for evaluating the development of acute pancreatitis and the touchstone of clinical comparative studies [18]. Karimgani et al [19] observed APACHE-II scores in 26 patients with acute pancreatitis on admission and at 48 h and found a significant difference between the survival and death groups (6.90 ± 0.80 vs. 13 ± 2.50 and 8.90 ± 1.10 vs. 16.50 ± 3, respectively; p < 0.05). Because vital organs are involved in severe pancreatitis, APACHE-II scores show an obvious increase in the early stage (0 -48 h) and the increase becomes faster at 24 to 48 h. A continued increase in APACHE-II scores after discharge usually indicates disease progression.…”

Section: Discussionmentioning

confidence: 99%

Clinical effects of low-molecular-weight heparin combined with ulinastatin in children with acute pancreatitis

Han¹,

Guo²,

Yin³

2016

Trop. J. Pharm Res

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Section: Discussionmentioning

confidence: 99%

Clinical effects of low-molecular-weight heparin combined with ulinastatin in children with acute pancreatitis

Han¹,

Guo²,

Yin³

2016

Trop. J. Pharm Res

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“…Severity evaluation can also be accomplished by diagnostic imaging, such as the Balthazar criteria, after the evaluation of the images from a contrast-enhanced computerized tomography (CT). In this scenario, findings of non-perfused areas after at least 24 to 48 hours from the initial symptoms is perhaps one of the most valuable, indicating the presence of pancreatic necrosis, a condition whose extension is directly related to the severity of organ dysfunction and to the risk of infection development [14].…”

Section: Diagnosis Of Severe Ap and Of Nhapmentioning

confidence: 99%

Necrotizing Pancreatitis: Update and When to Operate

Refinetti¹,

Martinez²

2012

CMD

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About 20% of the cases of acute pancreatitis present in a severe form, known as necrotizing pancreatitis. Although this entity was first described centuries ago, many questions about it remain open and as a consequence, many studies are currently published addressing this subject nowadays. We performed a throughout research in the literature, with special attention to the articles published in the last five years and indexed to the PubMed. The following headings were used: Pancreatitis, Surgical procedures, Necrosis. The initial research rendered about 1800 articles, and the ones published in the last five years were evaluated. Some older, but remarkable articles were also included given their importance to this matter. As we further describe, treatment of acute pancreatitis involves a great number of questions, among which the most important are the ones related to the terminology of pancreatic collections, prognostic markers, use of antibiotics, type of diet employed and the approach to infected necrosis. Many radical changes could be seen over the last years on all these topics and a constant updating must be necessarily done by the ones involved in the treatment of this disease.

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“…39 Patients at highest risk for complications are those with necrosis involving more than 50% of the gland based on MRI or contrast-enhanced CT scan. 59,60 Patients with pancreatic infection may have infected necrosis, pancreatic abscess, and/or infected pseudocysts. 39 The microbes most frequently involved are gram-negative organisms including Escherichia coli, Enterococcus, and Klebsiella.…”

Section: Natural History and Complicationsmentioning

confidence: 99%

Acute pancreatitis

Munsell

Buscaglia

2010

Journal of Hospital Medicine

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Acute pancreatitis is a common disease most frequently caused by gallstone disease or excess alcohol ingestion. Diagnosis is usually based on characteristic symptoms, often in conjunction with elevated serum pancreatic enzymes. Imaging is not always necessary, but may be performed for many reasons, such as to confirm a diagnosis of pancreatitis, rule out other causes of abdominal pain, elucidate the cause of pancreatitis, or to evaluate for complications such as necrosis or pseudocysts. Though the majority of patients will have mild, self‐limiting disease, some will develop severe disease associated with organ failure. These patients are at risk to develop complications from ongoing pancreatic inflammation such as pancreatic necrosis, fluid collections, pseudocysts, and pancreatic duct disruption. Validated scoring systems can help predict the severity of pancreatitis, and thus, guide monitoring and intervention.Treatment of acute pancreatitis involves supportive care with fluid replacement, pain control, and controlled initiation of regular food intake. Prophylactic antibiotics are not recommended in acute pancreatitis if there is no evidence of pancreatic infection. In patients who fail to improve, further evaluation is necessary to assess for complications that require intervention such as pseudocysts or pancreatic necrosis. Endoscopy, including ERCP and EUS, and/or cholecystectomy may be indicated in the appropriate clinical setting. Ultimately, the management of the patient with severe acute pancreatitis will require a multidisciplinary approach. Journal of Hospital Medicine 2010;5:241–250. © 2010 Society of Hospital Medicine.

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Prognostic factors in sterile pancreatic necrosis

Cited by 163 publications

References 25 publications

Clinical effects of low-molecular-weight heparin combined with ulinastatin in children with acute pancreatitis

Clinical effects of low-molecular-weight heparin combined with ulinastatin in children with acute pancreatitis

Necrotizing Pancreatitis: Update and When to Operate

Acute pancreatitis

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