Critical Care Management of Severe Acute Pancreatitis

Chapter

Abstract

Acute pancreatitis is a common gastrointestinal disease that results in a significant physical, psychosocial, and financial toll [2, 3]. It has become the leading gastroenterology discharge diagnosis in the United States and its incidence appears to be increasing [2, 4, 5]. The cost of caring for these patients is greater than 2 billion dollars annually, and the cost of a single survivor of severe acute pancreatitis has been estimated at $129,000 [3, 6]. There is a spectrum of disease from the mild edematous form to severe acute necrotizing pancreatitis with associated multiple organ system dysfunction. The most common form of the disease is mild with a 3–4-day self-limited course and a low mortality and occurs in nearly 80 % of patients [7, 8]. Unfortunately, 20 % of patients will develop severe acute pancreatitis with a fulminant clinical course. Those with the severe form of the disease often require prolonged intensive care unit (ICU) and hospital lengths of stay, invasive support and procedures for organ failure, and management of pancreatic necrosis and mortality rates that approach 30 % [8–11].

Keywords

Systemic inflammatory response syndrome Choledocholithiasis Ranson’s criteria Atlanta classification Intra-abdominal hypertension Endoscopic retrograde cholangiopancreatography Hypertriglyceridemia 

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© Springer International Publishing Switzerland 2016

Open Access This chapter is distributed under the terms of the Creative Commons Attribution Noncommercial License, which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

Authors and Affiliations

  1. 1.Acute Care Surgery, R. Adams Cowley Shock Trauma CenterUniversity of Maryland School of MedicineBaltimoreUSA
  2. 2.Acute Care Surgery, R Adams Cowley Shock Trauma CenterUniversity of Maryland Medical CenterBaltimoreUSA

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