Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0030305 (pancreatitis)
 16,014 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Pancreatic necrosis occurs in 15% of acute pancreatitis. The presence of infection is the most important factor in the evolution of pancreatitis. The diagnosis of infection is still challenging. Mortality in infected necrosis is 20%; in the presence of organic dysfunction, mortality reaches 60%. In the last three decades, there has been a real revolution in the treatment of infected pancreatic necrosis. However, the challenges persist and there are many unsolved questions: antibiotic treatment alone, tomography-guided percutaneous drainage, endoscopic drainage, video-assisted extraperitoneal debridement, extraperitoneal access, open necrosectomy? A step up approach has been proposed, beginning with less invasive procedures and reserving the operative intervention for patients in which the previous procedure did not solve the problem definitively. Indication and timing of the intervention should be determined by the clinical course. Ideally, the intervention should be done only after the fourth week of evolution, when it is observed a better delimitation of necrosis. Treatment should be individualized. There is no procedure that should be the first and best option for all patients. The objective of this work is to critically review the current state of the art of the treatment of infected pancreatic necrosis.
 ...
PMID:Management of infected pancreatic necrosis: state of the art. 2901 83

Acute pancreatitis (AP) is one of the most common acute surgical diseases of the abdominal organs. In 1992 at the International Symposium the classification of AP was established in Atlanta (USA). Over time new knowledge and experience required adjustment in the classification of Atlanta-92. In 2011, an updated classification of AP was presented at the Congress of Pancreatologists in Cochin (India). The severity of AP is determined by local and systemic criteria. Local criteria are sterile or infected Pancreas necrosis . Transient or chronic multiple organ failure belong to Systemic criteria. Acute Pancreatitis severity are divided into mild, moderate and severe types. There are early (1-st week) and late (>1 week) clinical phases of AP. Morphological forms of Apare divided into edematous and necrotic pancreatitis (sterile or infected). Computed tomography (CT) imaging plays an important role in diagnosis and staging of acute pancreatitishas. Local complications of AP are divided into four types, depending on the presence of pancreatic necrosis and the time elapsed since the onset of pancreatitis. With edematous pancreatitis, an acute accumulation of peripancreatic (unencapsulated) fluid formed in the first 4 weeks. A pseudocyst (encapsulated) forms after 4 weeks. With necrotic pancreatitis, acute necrotic congestion (forms in the first 4 weeks), limited necrosis (encapsulated) forms after 4 weeks. Based on these data, the radiologist becomes one of the key members of the multidisciplinary team for the diagnosis and treatment of AP. The principles of treatment methods of AP are established. With mild-edematous pancreatitis, a conservative approach is used. In severely infected pancreatic necrosis, the general principle remains: repeated revisions, sanations, removal of necrotic foci. Thus, the accuracy of prognosis of pancreatic necrosis can be improved while using clinical, laboratory and instrumental data. Nowadays, a single classification of AP has been created, a big step has been taken in the diagnosis of pancreatic necrosis. Methods of the treatment and prevention of complications of AP have been identified, although there is no yet full consensus on these issues and established recommendations.
 ...
PMID:[THE CURRENT STATE OF TREATMENT OF ACUTE PANCREATITIS (REVIEW)]. 3284 Nov 74


<< Previous 1 2 3