The Role of Organ Failure and Infection in Necrotizing Pancreatitis

Abstract

Among patients with necrotizing pancreatitis, the effects of organ failure on mortality are more critical than those of infection. Bacteremia, age, American Society of Anesthesiologists class, persistent organ failure in the first week, and pancreatic necrosis were identified as the predictors of mortality.

Late infection of pancreatic necrosis: A separate entity in necrotizing pancreatitis with low mortality

“…To our knowledge, this study is the first to evaluate the outcomes of different onset times of infected necrosis. The above mentioned results also support the earlier conclusion we made in our previous study that infection possessed a minor function in necrotizing pancreatitis [19]. First, from the pathophysiological aspect, SIRS is caused by the activation of an inflammatory cascade mediated by cytokines, such as tumor necrosis factor and interleukin-6 (IL-6), mononuclear cells, and the complement system.…”

Circulating Histone Levels Reflect Disease Severity in Animal Models of Acute Pancreatitis

“…4 The main cause of mortality is MOF with acute lung injury being the earliest and most common manifestation. 5,6 On the other hand, infected pancreatic necrosis with or without organ failure predominantly accounts for late mortality. 2 These clinical manifestations are very similar to that in other critical illnesses, such as severe sepsis 7 and trauma, 8 in which cellular breakdown products, such as high mobility box 1, 9 mitochondrial DNA, 10 and extracellular histones 11 may play a significant role.…”

Imaging of Acute Pancreatitis

“…One study suggested that the ultimate outcome may depend more on the presence of multisystem organ failure than on the presence of infection. 53 …”