The changing character of acute pancreatitis: Epidemiology, etiology, and prognosis

Lowenfels, Albert B.; Maisonneuve, Patrick; Sullivan, Terri N.

doi:10.1007/s11894-009-0016-4

Cited by 187 publications

(120 citation statements)

References 44 publications

(21 reference statements)

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“…The incidence of acute pancreatitis in our country is still not known. A 100% increase in overall hospitalization of patients with acute pancreatitis in the US is noted during last two decades [9]. Similarly, an increase of 75% is noted in The Netherlands between 1992 and 2004 with further increase of 9.9% in 2010 [10].…”

Section: Original Article Peer Reviewed | Open Accessmentioning

confidence: 93%

Complications of acute pancreatitis in tertiary care hospital

Akhter

Khan

Ahmed

et al. 2017

Int J Hepatobiliary Pancreat Dis

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Aims: The aim of this study was to determine the complications of acute pancreatitis in tertiary care hospital. Methods: Hundred patients diagnosed with acute pancreatitis were analyzed in this prospective cohort study from July 2015 to July 2016. Complications were studied. Cholelithiasis was found to be the most common cause of acute pancreatitis in our setting. Results: Acute pancreatitis is defined as reversible inflammation of pancreatic parenchyma which is characterized by the presence of interstitial edema, acute inflammatory cell infiltrate and varying degree of cellular apoptosis, necrosis and hemorrhage. Cholelithiasis and alcohol were found to be the most common causes of acute pancreatitis. Alcohol, Smoking, some medications are the major risk factors. The major complications of acute pancreatitis are pseudocyst, pleural effusion, sepsis, shock or internal bleeding, fluid collection, ascites. Conclusion: Acute pancreatitis is one of the most common gastrointestinal ailments with high morbidity and mortality worldwide and at our set up too. Like any other disease occurrence of complications may worsen the prognosis of acute pancreatitis. Acute fluid collection around pancreas came out to be the common complication.

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Section: Original Article Peer Reviewed | Open Accessmentioning

confidence: 93%

Complications of acute pancreatitis in tertiary care hospital

Akhter

Khan

Ahmed

et al. 2017

Int J Hepatobiliary Pancreat Dis

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“…The late phase, starts 14 d after the onset of the disease and is marked by infected necrosis of the gland, septic systemic complications and multiorgan failure syndrome, causing a significant increase in mortality [9,10] . Reports from various countries have shown an increase in AP incidence [11,12] , perhaps in relation to rising obesity rates, which would increase the development of gallstone pancreatitis [13] . Moreover, although fatalities associated with AP have decreased over time, the population mortality rate has remained unchanged [10,14] .…”

Section: Introductionmentioning

confidence: 99%

Cardiocirculatory pathophysiological mechanisms in severe acute pancreatitis

García

Calvo²

2010

WJGPT

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Acute pancreatitis (AP) is a common and potentially lethal acute inflammatory process. Although the majority of patients have a mild episode of AP, 10%-20% develop a severe acute pancreatitis (SAP) and suffer systemic inflammatory response syndrome (SIRS) and/or pancreatic necrosis. The main aim of this article is to review the set of events, first localized in the pancreas, that lead to pancreatic inflammation and to the spread to other organs contributing to multiorganic shock. The early pathogenic mechanisms in SAP are not completely understood but both premature activation of enzymes inside the pancreas, related to an impaired cytosolic Ca 2+ homeostasis, as well as release of pancreatic enzymes into the bloodstream are considered important events in the onset of pancreatitis disease. Moreover, afferent fibers within the pancreas release neurotransmitters in response to tissue damage. The vasodilator effects of these neurotransmitters and the activation of pro-inflammatory substances play a crucial role in amplifying the inflammatory response, which leads to systemic manifestation of AP. Damage extension to other organs leads to SIRS, which is usually associated with cardiocirculatory physiology impairment and a hypotensive state. Hypotension is a risk factor for death and is associated with a significant hyporesponsiveness to vasoconstrictors. This indicates that stabilization of the patient, once this pathological situation has been established, would be a very difficult task. Therefore, it seems particularly necessary to understand the pathological mechanisms involved in the first phases of AP to avoid damage beyond the pancreas. Moreover, efforts must also be directed to identify those patients who are at risk of developing SAP.

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“…) являются ведущими, так как, кроме собственного цитотоксического эффекта, способны потенцировать реакции Фентона, Хабера-Вайса, Осипова, обусловли-вающих ветвление цепи реакций перекисного окисления липидов (ПОЛ) [6,7]. Продукты указанных реакций обладают деструктивным и токсическим потенциалом.…”

Section: +unclassified

Deferoxamine as Pathogenetically Valid Preparation for Complex Therapy of Patients with Acute Pancreatitis

Orlov¹,

Lukach²,

Долгих³

et al. 2015

Novosti Khirurgii

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ГБОУ ВПО «Омский государственный медицинский университет», Российская ФедерацияЦель. Изучить взаимосвязь между тяжестью системной воспалительной реакции, органными рас-стройствами и параметрами обмена железа при септическом течении острого панкреатита и определить эффективность коррекции нарушений метаболизма железа дефероксамином с целью профилактики орган-ных расстройств и септического процесса.Материал и методы. Обследовано и пролечено 63 пациента с осложненным течением острого пан-креатита, поступивших в отделение реанимации и интенсивной терапии. 31 пациент получал стандартную интенсивную терапию, а в программу терапии 32 других пациентов был включен дефероксамин в дозе 6-12 мг/кг. Троекратно (при поступлении, через одни и трое суток) в плазме крови оценивали биохимические критерии по шкале Ranson´s, определяли активность супероксиддисмутазы и каталазы эритроцитов, со-держание в сыворотке крови общего билирубина и его фракций, трансферрина, сывороточного железа, ферритина, свободного гемоглобина. Тяжесть эндотоксемии оценивали по содержанию веществ низкой и средней молекулярной массы (ВНСММ) в плазме и на эритроцитах.Результаты. Выявлено, что наиболее прямая и тесная корреляционная связь отмечалась между уров-нем в крови свободного гемоглобина и концентрацией общего билирубина. Аналогичная зависимость определена между концентрацией ферритина, отражающего запасы железа в организме, и концентрацией в плазме крови ВНСММ. Кроме этого, аналогично высокая прямая связь определялась между концентра-цией ферритина и тяжестью общего состояния пациентов, оцениваемой по шкале APACHE II. Включение в программу интенсивной терапии при тяжелых формах острого панкреатита дефероксамина, позволило уменьшить частоту нарушений системной гемодинамики и дыхания, поражения печени и почек, в 3 раза снизить частоту панкреатогенного сепсиса и флегмон забрюшинного пространства, уменьшить на 19,6% летальность.Заключение. Использование в программе интенсивной терапии дефероксамина патогенетически обосновано, поскольку, связывая избыток ионов железа в плазме крови, этот препарат предупреждает раз-витие тяжелых, порой летальных, осложнений острого панкреатита.Ключевые слова: острый панкреатит, обмен железа, дефероксамин, синдром системной воспалительной реакции, полиорганная недостаточность, флегмон забрюшинного пространства, летальность Objectives. To study the correlation between the severity of systemic inflammatory reaction, polyorganic failure and iron metabolism parameters in a course of severe acute pancreatitis, to determine the efficacy of iron metabolism disorders correction with deferoxamine to prevent organ failure and septic process.Methods. 63 patients with complicated acute pancreatitis have been examined in the resuscitation and intensive care unit. 31 patients received standard intensive therapy, whereas deferoxamine therapy was applied for other 32 patients (6-12 mg/kg/day). Ranson's criteria (RC) were used to determine the severity of the attack of AP thrice (on admission to the hospital, after the 1 st day and the 3 rd...

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The changing character of acute pancreatitis: Epidemiology, etiology, and prognosis

Cited by 187 publications

References 44 publications

Complications of acute pancreatitis in tertiary care hospital

Complications of acute pancreatitis in tertiary care hospital

Cardiocirculatory pathophysiological mechanisms in severe acute pancreatitis

Deferoxamine as Pathogenetically Valid Preparation for Complex Therapy of Patients with Acute Pancreatitis

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