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Query: UMLS:C0001339 (acute pancreatitis)
 10,593 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The aim of this study was to determine the relationship between pancreatic necrosis and organ failure in acute pancreatitis. Two hundred seventeen patients with acute pancreatitis were prospectively included. All of them had been examined by computed tomography (CT) within 72 hours of admission. Initial organ failure was defined according to the Atlanta classification (arterial pO2 <60 mm Hg, serum creatinine >2 mg/dL after rehydration). Organ failure during the total hospital stay was defined as necessity for artificial ventilation and/or dialysis treatment, independent of initial organ failure. One hundred seventy-five (81%) patients had interstitial and 52 (19%) necrotizing pancreatitis. Forty-two (19%) had initial organ failure and 54 (25%) organ failure during the total hospital stay. There was a significant correlation between the incidence of initial pancreatic necrosis and initial organ failure as well as initial pancreatic necrosis and organ failure during hospital stay (p < 0.001). However, 24 (57%) of the 42 patients with pancreatic necrosis had no initial organ failure, and 19 (45%) no organ failure during hospital stay, and vice versa, 24 (14%) patients had initial and 31 (18%) organ failure during the total hospital stay in the absence of pancreatic necrosis. Initial organ failure and organ failure during the total hospital stay were independent of the extent of pancreatic necrosis. The incidence of initial organ failure and organ failure during the total hospital stay increased significantly with the CT score (p < 0.001). However, 24 (15%) and 31 (18%) of the patients with interstitial pancreatitis had initial organ failure and organ failure during the total hospital stay, respectively. Patients with pancreatic necrosis are not necessarily at risk of having initial organ failure or organ failure during the total hospital stay and vice versa. Thus, these groups should be considered separately in therapy studies.
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PMID:No strict correlation between necrosis and organ failure in acute pancreatitis. 1076 60

Organ failure is the most important determinant of the severity of acute pancreatitis (AP). Soluble fms-like tyrosine kinase 1 (sFlt-1) is positively associated with organ failure in sepsis. Our aim was to evaluate the diagnostic utility of automated sFlt-1 measurements for early prediction of AP severity. Adult patients (66) with AP were recruited, including 46 with mild (MAP), 15 with moderately-severe (MSAP) and 5 with severe AP (SAP). Serum and urine samples were collected twice. Serum sFlt-1 was measured with automated electrochemiluminescence immunoassay. Serum concentrations of sFlt-1 were significantly higher in patients with MSAP and SAP as compared to MAP. SAP patients had the highest concentrations. At 24 and 48 h, sFlt-1 positively correlated with inflammatory markers (leukocyte count, C-reactive protein), kidney function (creatinine, urea, cystatin C, serum and urine neutrophil gelatinase-associated lipocalin, urine albumin/creatinine ratio), D-dimer and angiopoietin-2. sFlt-1 positively correlated with the bedside index of severity in AP (BISAP) score and the duration of hospital stay. Serum sFlt-1 above 139 pg/mL predicted more severe AP (MSAP + SAP). In the early phase of AP, sFlt-1 is positively associated with the severity of AP and predicts organ failure, in particular kidney failure. Serum sFlt-1 may be a practical way to improve early assessment of AP severity.
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PMID:Serum Soluble Fms-Like Tyrosine Kinase 1 (sFlt-1) Predicts the Severity of Acute Pancreatitis. 2792 26

Acute pancreatitis may be associated with both local and systemic complications. Systemic injury manifests in the form of organ failure, which is seen in approximately 20% of all cases of acute pancreatitis and defines "severe acute pancreatitis." Organ failure typically develops early in the course of acute pancreatitis, but also may develop later due to infected pancreatic necrosis-induced sepsis. Organ failure is the most important determinant of outcome in acute pancreatitis. We review here the current understanding of the risk factors, pathophysiology, timing, impact on outcome, and therapy of organ failure in acute pancreatitis. As we discuss the pathophysiology of severe systemic injury, the distinctions between markers and mediators of severity are highlighted based on evidence supporting their causality in organ failure. Emphasis is placed on clinically relevant end points of organ failure and the mechanisms underlying the pathophysiological perturbations, which offer insight into potential therapeutic targets to treat.
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PMID:Organ Failure Due to Systemic Injury in Acute Pancreatitis. 3076 87

Acute pancreatitis is one of the most common causes of hospitalisation from gastrointestinal diseases. The causes of pancreatitis vary between countries. Acute pancreatitis is classified based on Revised Atlanta classification 2013 as mild, moderately severe and severe acute pancreatitis. Acute pancreatic severity can be stratified by scoring systems such as Ranson's score, BISAP score, APACHE-II score, SOFA score. In severe acute pancreatitis, to diagnose, abdominal pain raised amylase or lipase, supported imaging finding and organ failure. Organ failure can be diagnosed by using Modified Marshall Scoring System. Management is started conservatively, which are fluid resuscitation, enteral nutrition, analgesics, and antibiotics. Surgical management is indicated when infected pancreas necrosis is detected. In this review, we will discuss the current management based on recent research.
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PMID:Management of Severe Acute Pancreatitis. 3194 38