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Acute Pancreatitis

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Evidence-Based Critical Care

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Abstract

Acute pancreatitis is the most common gastrointestinal diagnosis requiring hospital admission, with over 250,000 patients requiring hospitalization and a cost to the US health system of over 2.5 million dollars every year. While infrequently a fatal diagnosis, mortality from complications of acute pancreatitis is estimated around 1%, thus it requires timely diagnosis, treatment, and monitoring for complications. Diagnosis can be made using a combination of clinical history, laboratory results, and characteristic imaging findings, primarily using contrast-enhanced computed tomography. Acute pancreatitis is most commonly due to heavy alcohol use or gallstones, though there are other causes that must be considered and treated. Management is focused on adequate volume resuscitation, correction of electrolyte abnormalities, pain control, and monitoring for end-organ damage and complications, including shock, pancreatic abscess, and pancreatic pseudocyst. New evidence supporting early enteral nutritional support is changing our practice treating this common and potentially life-threatening condition.

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References

  1. Tenner S, Baillie J, DeWitt J, Vege SS. American College of Gastroenterology. American College of Gastroenterology guideline: management of acute pancreatitis. Am J Gastroenterol. 2013;108(9):1400–15. 16

    Article  CAS  Google Scholar 

  2. Bollen TL, van Santvoort HC, Besselink MG, van Leeuwen MS, Horvath KD, Freeny PC, et al. The Atlanta classification of acute pancreatitis revisited. Br J Surg. 2008;95(1):6–21.

    Article  CAS  Google Scholar 

  3. Winslet M, Hall C, London NJ, Neoptolemos JP. Relation of diagnostic serum amylase levels to aetiology and severity of acute pancreatitis. Gut. 1992;33(7):982–6.

    Article  CAS  Google Scholar 

  4. Keim V, Teich N, Fiedler F, Hartig W, Thiele G, Mossner J. A comparison of lipase and amylase in the diagnosis of acute pancreatitis in patients with abdominal pain. Pancreas. 1998;16(1):45–9.

    Article  CAS  Google Scholar 

  5. Peery AF, Dellon ES, Lund J, Crockett SD, McGowan CE, Bulsiewicz WJ, et al. Burden of gastrointestinal disease in the United States: 2012 update. Gastroenterology. 2012;143(5):1179–87.e1–3.

    Article  Google Scholar 

  6. Wu BU, Johannes RS, Sun X, Tabak Y, Conwell DL, Banks PA. The early prediction of mortality in acute pancreatitis: a large population-based study. Gut. 2008;57(12):1698–703.

    Article  CAS  Google Scholar 

  7. Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD, Sarr MG, et al. Classification of acute pancreatitis – 2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013;62(1):102–11.

    Article  Google Scholar 

  8. Wall I, Badalov N, Baradarian R, Iswara K, Li JJ, Tenner S. Decreased mortality in acute pancreatitis related to early aggressive hydration. Pancreas. 2011;40(4):547–50.

    Article  Google Scholar 

  9. Trikudanathan G, Navaneethan U, Vege SS. Current controversies in fluid resuscitation in acute pancreatitis: a systematic review. Pancreas. 2012;41(6):827–34.

    Article  Google Scholar 

  10. Wu BU, Hwang JQ, Gardner TH, Repas K, Delee R, Yu S, et al. Lactated Ringer’s solution reduces systemic inflammation compared with saline in patients with acute pancreatitis. Clin Gastroenterol Hepatol. 2011;9(8):710–7.e1.

    Article  Google Scholar 

  11. Mazaki T, Ishii Y, Takayama T. Meta-analysis of prophylactic antibiotic use in acute necrotizing pancreatitis. Br J Surg. 2006;93(6):674–84.

    Article  CAS  Google Scholar 

  12. Basurto Ona X, Rigau Comas D, Urrutia G. Opioids for acute pancreatitis pain. Cochrane Database Syst Rev. 2013;7:CD009179.

    Google Scholar 

  13. Sekimoto M, Takada T, Kawarada Y, Hirata K, Mayumi T, Yoshida M, et al. JPN guidelines for the management of acute pancreatitis: epidemiology, etiology, natural history, and outcome predictors in acute pancreatitis. J Hepato-Biliary-Pancreat Surg. 2006;13(1):10–24.

    Article  Google Scholar 

  14. Yadav D, O’Connell M, Papachristou GI. Natural history following the first attack of acute pancreatitis. Am J Gastroenterol. 2012;107(7):1096–103.

    Article  Google Scholar 

  15. Schepers NJ, Besselink MG, van Santvoort HC, Bakker OJ, Bruno MJ, Dutch Pancreatitis Study Group. Early management of acute pancreatitis. Best Pract Res Clin Gastroenterol. 2013;27(5):727–43.

    Article  Google Scholar 

  16. Moon JH, Cho YD, Cha SW, Cheon YK, Ahn HC, Kim YS, et al. The detection of bile duct stones in suspected biliary pancreatitis: comparison of MRCP, ERCP, and intraductal US. Am J Gastroenterol. 2005;100(5):1051–7.

    Article  Google Scholar 

  17. Olah A, Romics L Jr. Enteral nutrition in acute pancreatitis: a review of the current evidence. World J Gastroenterol. 2014;20(43):16123–31.

    Article  CAS  Google Scholar 

  18. Braunschweig C, Gomez S, Sheean PM. Impact of declines in nutritional status on outcomes in adult patients hospitalized for more than 7 days. J Am Diet Assoc. 2000;100(11):1316–22. quiz 23–4

    Article  CAS  Google Scholar 

  19. Marik PE, Zaloga GP. Meta-analysis of parenteral nutrition versus enteral nutrition in patients with acute pancreatitis. BMJ. 2004;328(7453):1407.

    Article  Google Scholar 

  20. Li JY, Yu T, Chen GC, Yuan YH, Zhong W, Zhao LN, et al. Enteral nutrition within 48 hours of admission improves clinical outcomes of acute pancreatitis by reducing complications: a meta-analysis. PLoS One. 2013;8(6):e64926.

    Article  CAS  Google Scholar 

  21. Chang YS, Fu HQ, Xiao YM, Liu JC. Nasogastric or nasojejunal feeding in predicted severe acute pancreatitis: a meta-analysis. Crit Care. 2013;17(3):R118.

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Pulmonary Sciences and Critical Care Medicine, University of Colorado School of Medicine, Denver, CO, USA

    Margaret F. Ragland

  2. Pulmonary, Critical Care, Allergy, and Immunology, NorthShore University HealthSystem, Evanston, IL, USA

    Curtis H. Weiss

Authors
  1. Margaret F. Ragland
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  2. Curtis H. Weiss
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Correspondence to Margaret F. Ragland .

Editor information

Editors and Affiliations

  1. Division of Pulmonary and Critical Care, University of Michigan, Ann Arbor, MI, USA

    Robert C. Hyzy

  2. Division of Pulmonary and Critical Care, University of Michigan, Ann Arbor, MI, USA

    Jakob McSparron

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Ragland, M.F., Weiss, C.H. (2020). Acute Pancreatitis. In: Hyzy, R.C., McSparron, J. (eds) Evidence-Based Critical Care. Springer, Cham. https://doi.org/10.1007/978-3-030-26710-0_69

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  • DOI: https://doi.org/10.1007/978-3-030-26710-0_69

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-26709-4

  • Online ISBN: 978-3-030-26710-0

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