Relationship of necrosis to organ failure in severe acute pancreatitis

Tenner, Scott; Sica, Gregory T.; Hughes, Michael D.; Noordhoek, Elizabeth; Shao, Feng; Zinner, Michael J.; Banks, PA

doi:10.1016/s0016-5085(97)70185-9

Cited by 324 publications

(180 citation statements)

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“…Multiple organ dysfunction syndrome (MODS) [4][5][6][7] , the extent of necrotic pancreatic parenchyma and the presence of bacterial infection have been identified as major determinants for death [8,9] . A number of such patients developed pancreatitis-associated intractable organ failure during the early course of SAP, and no effective treatment methods were available, the mortality was up to 40-60% [3,10,11] .…”

Section: Introductionmentioning

confidence: 99%

Clinical characteristics and management of patients with early acute severe pancreatitis: Experience from a medical center in China

Tao¹,

Zhang²,

Zou³

2004

WJG

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AIM:To study clinical characteristics and management of patients with early severe acute pancreatitis (ESAP). METHODS:Data of 297 patients with severe acute pancreatitis (SAP) admitted to our hospital within 72 h after onset of symptoms from January 1991 to June 2003 were reviewed for the occurrence and development of early severe acute pancreatitis (ESAP). ESAP was defined as presence of organ dysfunction within 72 h after onset of symptoms. Sixtynine patients had ESAP, 228 patients without organ dysfunction within 72 h after onset of symptoms had SAP. The clinical characteristics, incidence of organ dysfunction during hospitalization and prognosis between ESAP and SAP were compared.RESULTS: Impairment degree of pancreas (Balthazar CT class) in ESAP was more serious than that in SAP (5.31±0.68 vs 3.68±0.29, P<0.01). ESAP had a higher mortality than SAP (43.4% vs 2.6%, P<0.01), and a higher incidence of hypoxemia (85.5% vs 25%, P<0.01), pancreas infection (15.9% vs 7.5%, P<0.05), abdominal compartment syndrome (ACS) (78.3% vs 23.2%, P<0.01) and multiple organ dysfunction syndrome (MODS)(78.3% vs 10.1%, P<0.01). In multiple logistic regression analysis, the main predisposing factors to ESAP were higher APACHE II score, Balthazar CT class, MODS and hypoxemia. CONCLUSION:ESAP is characterised by MODS, severe pathological changes of pancreas, early hypoxemia and abdominal compartment syndrome. Given the poor prognosis of ESAP, these patients should be treated in specialized intensive care units with special measures such as close supervision, fluid resuscitation, improvement of hypoxemia, reduction of pancreatic secretion, elimination of inflammatory mediators, prevention and treatment of pancreatic infections.Tao HQ, Zhang JX, Zou SC. Clinical characteristics and management of patients with early acute severe pancreatitis: Experience from a medical center in China. World J Gastroenterol 2004; 10(6): 919-921

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Section: Introductionmentioning

confidence: 99%

Clinical characteristics and management of patients with early acute severe pancreatitis: Experience from a medical center in China

Tao¹,

Zhang²,

Zou³

2004

WJG

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“…This phenomenon is certainly related to two major reasons: the retrospective research has limits in our included studies, and the population is linked to the homogeneity in the study. Several studies have proposed organ failure as a significant factor to stratify the severity of disease, and it was closely associated with mortality in infected pancreatic necrosis [30,[38][39][40][41]. In this systematic review, 53.6 % of patients had organ failure, with nine reported single and multisystem organ failures (MSOF) in our study.…”

Section: Discussionmentioning

confidence: 52%

Percutaneous Catheter Drainage in Infected Pancreatitis Necrosis: a Systematic Review

et al. 2016

Indian J Surg

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The primary aim of this study was to present the outcomes of percutaneous catheter drainage (PCD) in patients with infected pancreatitis necrosis. A second aim was to focus on disease severity, catheter size, and additional surgical intervention. A literature search of the PubMed/MEDLINE/Cochrane Library (January 1998 to February 2015) databases was conducted. All randomized, non-randomized, and retrospective studies with data on PCD techniques and outcomes in patients with infected pancreatitis necrosis were included. Studies that reported data on PCD along with other interventions without the possibility to discriminate results specific to PCD were excluded. The main outcomes were mortality, major complications, and definitive successful treatment with percutaneous catheter drainage alone. Fifteen studies of 577 patients were included. There was only one randomized, controlled trial, and most others were retrospective case series. Organ failure before PCD occurred in 55.3 % of patients. With PCD alone, definitive successful treatment was 56.2 % of patients. Additional surgical intervention was required after PCD in 38.5 % of patients. The overall mortality rate was 18 % (104 of 577 patients). Complications occurred in 25

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“…Bu evrede enfeksiyon olmadan da organ sistem yetmezliği meydana gelebilir; ölüm görülebilir ikinci evre ise 15. günden sonra başlar. Enfekte nekroz oluşması ve buna bağlı olarak gelişen septik sorunlarla karakterizedir [7,9,10]. Nekrozlu hastaların %40-70'inde enfekte nekroz meydana gelebilir .…”

Section: Discussionunclassified

Necrotizing pancreatitis with hypertriglyceridemia development result: A cese port

Yetim¹

2011

Ann Clin Anal Med

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ÖzetHipertrigliseridemiden kaynaklanan akut pankreatitlere, kliniklerde nadir rastlanılmaktadır. Akut pankreatik nekroz yaşamı tehdit eden ve tedavisi önem teşkil eden pankreatit formudur. Nekrotizan pankreatit tedavisinde gerektiğinde cerrahi tedavinin kliniğine göre zamanında yapılması gerekir. Olgumuzda hipertrigliseridemi nedenli pankreatik nekroz gelişmiş olup tedavisinde cerrahi müdahale gerekti. Cerrahi tedavi sonrasında hastanın kliniği tamamen düzeldi. Olgumuzu hipertrigliseridemiye bağlı nekrotizan pankreatit gelişen ve cerrahi eksplorasyon yapılan vakayı literatüre eşliğinde tartışmayı amaçladık. Anahtar KelimelerHipertrigliseridemi, Nekrotizan Pankreatit,Cerrahi. AbstractAcute pancreatitis due to hypertriglyceridemia is a relatively rare clinical entity. Acute pancreatic necrosis is a life threatening form of acute pancreatitis in which early recognition and treatment is important. Necrotising pancreatitis should be treated immediately. We presented a case of pancreatic necrosis due to hypert¬riglyceridemia which required surgical intervention. We performed necrosectomy. After surgery the patient recovered. We presented the case in order to mention necrotising pancreatitis arising from hypertriglyceridemia and requiring surgical exploration.

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Relationship of necrosis to organ failure in severe acute pancreatitis

Cited by 324 publications

References 1 publication

Clinical characteristics and management of patients with early acute severe pancreatitis: Experience from a medical center in China

Clinical characteristics and management of patients with early acute severe pancreatitis: Experience from a medical center in China

Percutaneous Catheter Drainage in Infected Pancreatitis Necrosis: a Systematic Review

Necrotizing pancreatitis with hypertriglyceridemia development result: A cese port

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