[AGA Institute technical review on acute pancreatitis].

División de Gastroenterología, Hepatología y Nutrición, University of Florida, Gainesville, USA.
Revista de gastroenterologia de Mexico 05/2007; 72(3):257-85. DOI: 10.1053/j.gastro.2007.03.065
Source: PubMed
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    ABSTRACT: Acute pancreatitis is a common disease with a benign course in the majority of patients, but it is associated with serious morbidity, and mortality close to 20% in up to 20% of cases. The incidence of acute pancreatitis seems to be rising in western countries. About 75% of all cases are caused by gallstones or alcoholism. The relative rate of gallstones versus alcohol as etiology depends on the age and the area of enrolment. A thorough evaluation allows cause identification in another 10% of cases, leaving about 15–20% as idiopathic. The most common causes, and a growing list of less frequent and sometimes very rare and controversial etiologies, are reviewed in this article. A classification on the pathogenic mechanisms of causes of acute pancreatitis based is used in this Review. The approach, or suggested plan of investigations, to determine the etiology of acute pancreatitis, based on the most recently published Guidelines is outlined.
    Central European Journal of Medicine 08/2014; 9(4):530-542. · 0.21 Impact Factor
  • Source
    Acute and chronic pancreatitis: New concepts and evidence-based approaches, Edited by Testoni, Mariani Arcidiacono, 11/2013: chapter 1: pages 3-9; Minerva Medica., ISBN: 13 978-88-7711-775-5
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    ABSTRACT: Abstract None of the definitions of severity used in acute pancreatitis (AP) is ideal. Many of the scoring systems used to predict and measure its severity are complex, cumbersome and inaccurate. Aim to evaluate the usefulness of the most commonly used early markers for predicting severity, necrosis and mortality in patients with AP, and the need for surgery or Intensive Care Unit (ICU) admission. Material&methods Prospective study was performed from March 2009 to August 2010 based on patients diagnosed with AP seen consecutively at a secondary hospital. The early prognostic markers used were Apache II score ≥8 and Ranson’s score ≥3, RCP>120mg/l and Ht>44% in the first 24 hours. Results 131 patients were prospectively enrolled. Median age was 63 years, 60% were men. The most frequent etiology of AP was biliary (68%). Fifteen patients were admitted to the ICU (11.6%) and five (3.9%) required surgery. Twelve patients (9.2%) had necrosis on CT. Four patients (3%) died, all of them in the Severe AP group. Only hematocrit>44 was predictor of mortality in univariate analysis. Conclusion hematocrit ≥ 44% was a significant predictor of mortality. The other indicators present limitations for predicting severity, necrosis and mortality, especially in the first 24 hours.
    Central European Journal of Medicine 08/2014; 9(4):550-555. · 0.21 Impact Factor


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