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Frontiers in Cellular and Infection... 2023
Topics: Humans; Pancreatitis; Acute Disease; Pancreas; Infections
PubMed: 37026058
DOI: 10.3389/fcimb.2023.1175195 -
World Journal of Gastroenterology Jun 2020With over 100000 hospital admissions per annum, acute pancreatitis remains the leading gastrointestinal cause of hospitalization in the United States and has... (Review)
Review
With over 100000 hospital admissions per annum, acute pancreatitis remains the leading gastrointestinal cause of hospitalization in the United States and has far-reaching impact well beyond. It has become increasingly recognized that drug-induced pancreatitis (DIP), despite accounting for less than 3% of all cases, represents an important and growing though often inconspicuous cause of acute pancreatitis. Nevertheless, knowledge of DIP is often curtailed by the limited availability of evidence needed to implicate given agents, especially for non-prescription medications. Indeed, the majority of available data is derived from case reports, case series, or case control studies. Furthermore, the mechanism of injury and causality for many of these drugs remain elusive as a definitive correlation is generally not established (< 10% of cases). Several classification systems have been proposed, but no single system has been widely adopted, and periodic updates are required in light of ongoing pharmacologic expansion. Moreover, infrequently prescribed medications or those available over-the-counter (including herbal and other alternative remedies) are often overlooked as a potential culprit of acute pancreatitis. Herein, we review the ever-increasing diversity of DIP and the potential mechanisms of injury with the goal of raising awareness regarding the nature and magnitude of this entity. We believe this manuscript will aid in increasing both primary and secondary prevention of DIP, thus ultimately facilitating more expedient diagnosis and a decrease in DIP-related morbidity.
Topics: Acute Disease; Case-Control Studies; Hospitalization; Humans; Pancreatitis; Pharmaceutical Preparations; United States
PubMed: 32587438
DOI: 10.3748/wjg.v26.i22.2902 -
Abdominal Radiology (New York) May 2020Acute pancreatitis (AP) is caused by acute inflammation of the pancreas and adjacent tissue and is a common source of abdominal pain. The current CT and MRI evaluation... (Review)
Review
Acute pancreatitis (AP) is caused by acute inflammation of the pancreas and adjacent tissue and is a common source of abdominal pain. The current CT and MRI evaluation of AP is mostly based on morphologic features. Recent advances in image acquisition and analysis offer the opportunity to go beyond morphologic features. Advanced MR techniques such as diffusion-weighted imaging, as well as T1 and T2 mapping, can potentially quantify signal changes reflective of underlying tissue abnormalities. Advanced analytic techniques such as radiomics and artificial neural networks (ANNs) offer the promise of uncovering imaging biomarkers that can provide additional classification and prognostic information. The purpose of this article is to review recent advances in imaging acquisition and analytic techniques in the evaluation of AP.
Topics: Artificial Intelligence; Diagnostic Imaging; Humans; Pancreatitis; Prognosis; Severity of Illness Index
PubMed: 31428811
DOI: 10.1007/s00261-019-02192-z -
Anaesthesia, Critical Care & Pain... Aug 2022
Topics: Acute Disease; Humans; Pancreatitis
PubMed: 35803576
DOI: 10.1016/j.accpm.2022.101123 -
Gastroenterology Nursing : the Official... 2019Acute pancreatitis is an inflammatory process of the pancreas, which can range from a localized inflammatory process to a systemic response, resulting in sepsis and... (Comparative Study)
Comparative Study Review
Acute pancreatitis is an inflammatory process of the pancreas, which can range from a localized inflammatory process to a systemic response, resulting in sepsis and multisystem failure. Pancreatic fluid collections are a complication of pancreatitis. Treatment of these fluid collections is dependent on correct classification. The 2012 Atlanta Criteria divides fluid collections into four categories: acute peripancreatic fluid collections, pancreatic pseudocysts, acute necrotic collections, and walled-off necrosis. Endoscopic ultrasound-guided management of chronic fluid collections is currently the preferred treatment modality. Endoscopy nurses need to be aware of their role in this treatment approach. Continued research in this area will lead to both advancements in equipment and treatment options.
Topics: Drainage; Endoscopy; Endosonography; Female; Humans; Male; Pancreatic Pseudocyst; Pancreatitis; Prognosis; Risk Assessment; Severity of Illness Index; Surgery, Computer-Assisted; Survival Rate; Treatment Outcome
PubMed: 31574068
DOI: 10.1097/SGA.0000000000000396 -
JPMA. the Journal of the Pakistan... May 2024Acute pancreatitis is a common cause of acute abdominal pain and can range from mild oedema to severe necrosis of the pancreas. It has a significant impact on morbidity,... (Review)
Review
Acute pancreatitis is a common cause of acute abdominal pain and can range from mild oedema to severe necrosis of the pancreas. It has a significant impact on morbidity, mortality and financial burden. The global prevalence of pancreatitis is substantial, with the highest rates observed in central and eastern Europe. Diagnosing acute pancreatitis involves considering clinical symptoms, elevated serum amylase and/or lipase levels, and characteristic imaging findings. The causes of acute pancreatitis include obstructive disorders, such as gallstones and biliary sludge, alcohol consumption, smoking, drug-induced pancreatitis, metabolic disorders, trauma, medical procedures, infections, vascular diseases and autoimmune pancreatitis. Appropriate management of acute pancreatitis involves determining the severity of the condition, providing supportive care, addressing the underlying cause, and preventing complications. Advances in classifying the severity of acute pancreatitis and implementing goal-directed therapy have contributed to a decrease in mortality rates. Understanding its prevalence, aetiology and management principles is crucial for clinicians to appropriately diagnose and manage patients with acute pancreatitis.
Topics: Humans; Pancreatitis; Acute Disease; Severity of Illness Index; Gallstones
PubMed: 38783446
DOI: 10.47391/JPMA.9280 -
Abdominal Radiology (New York) May 2020In patients with acute pancreatitis (AP), diagnostic imaging is performed for various reasons, including the detection of the etiology (e.g., biliary obstruction caused... (Review)
Review
In patients with acute pancreatitis (AP), diagnostic imaging is performed for various reasons, including the detection of the etiology (e.g., biliary obstruction caused by gallstones), diagnosis of pancreatitis in an unclear clinical setting, assessment of the severity of the process, and evaluation of its complications. In spite of the potential benefits of these imaging studies in the setting of AP, especially economic consequences but also medical risks are associated with diagnostic imaging, including increase of the effective radiation dose received by patients with AP and rising health care costs, frequently without impact on management. The rising incidence of acute pancreatitis in the Western world is escalating its financial burden with national health care expenses of over 2.5 billion dollars annually. Despite evidence-based national recommendations on utilization of diagnostic imaging in patients with AP, unnecessary imaging studies are still frequently performed, especially in the early hospital course. The purpose of this article is, therefore, to review the imaging guidelines for acute pancreatitis with regards to when and when not to image, with the aim to minimize inappropriate utilization.
Topics: Decision Making; Humans; Pancreatitis; Practice Guidelines as Topic; Severity of Illness Index; Unnecessary Procedures
PubMed: 31712865
DOI: 10.1007/s00261-019-02319-2 -
Current Opinion in Gastroenterology Sep 2021Approximately 20-30% of children who experience one episode of acute pancreatitis will have at least one additional episode. For some children, pancreatitis recurs... (Review)
Review
PURPOSE OF REVIEW
Approximately 20-30% of children who experience one episode of acute pancreatitis will have at least one additional episode. For some children, pancreatitis recurs multiple times and in a few years is followed by the diagnosis of chronic pancreatitis. Identifying risk factors for recurrent episodes and disease progression is critical to developing therapeutic interventions.
RECENT FINDINGS
Obesity is driving an increase in biliary stone disease and severe acute pancreatitis. Recurrent acute pancreatitis (RAP) may lead to the development of diabetes through autoimmune mechanisms. Cystic fibrosis or CFTR-related disorders may present as RAP and CFTR modulator therapy can increase or decrease the risk of acute pancreatitis in these populations. Children with Crohn disease have a three-fold risk of acute pancreatitis over the general population while children with ulcerative colitis are at increased risk for pediatric autoimmune pancreatitis, a disorder that may be distinct from autoimmune pancreatitis described in adults. Obstructive jaundice in the absence of identified mechanical factors may be a presenting sign of pediatric autoimmune pancreatitis.
SUMMARY
Pediatric RAP is a painful condition that leads to gland destruction and functional insufficiency. Risk factors are being clarified but preventive treatments remain elusive.
Topics: Acute Disease; Adult; Child; Cystic Fibrosis Transmembrane Conductance Regulator; Demography; Humans; Pancreatitis; Recurrence; Risk Factors
PubMed: 34120130
DOI: 10.1097/MOG.0000000000000764 -
SARS-CoV-2 and the pancreas: What do we know about acute pancreatitis in COVID-19 positive patients?World Journal of Gastroenterology Sep 2022Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can cause pancreatic damage, both directly to the pancreas angiotensin-converting enzyme 2 receptors (the...
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can cause pancreatic damage, both directly to the pancreas angiotensin-converting enzyme 2 receptors (the transmembrane proteins required for SARS-CoV-2 entry, which are highly expressed by pancreatic cells) and indirectly through locoregional vasculitis and thrombosis. Despite that, there is no clear evidence that SARS-CoV-2 is an etiological agent of acute pancreatitis. Acute pancreatitis in coronavirus disease 2019 (COVID-19) positive patients often recognizes biliary or alcoholic etiology. The prevalence of acute pancreatitis in COVID-19 positive patients is not exactly known. However, COVID-19 positive patients with acute pancreatitis have a higher mortality and an increased risk of intensive care unit admission and necrosis compared to COVID-19 negative patients. Acute respiratory distress syndrome is the most frequent cause of death in COVID-19 positive patients and concomitant acute pancreatitis. In this article, we reported recent evidence on the correlation between COVID-19 infection and acute pancreatitis.
Topics: Acute Disease; Angiotensin-Converting Enzyme 2; COVID-19; Humans; Pancreas; Pancreatitis; SARS-CoV-2
PubMed: 36185634
DOI: 10.3748/wjg.v28.i36.5240 -
Digestive Diseases and Sciences Jun 2022Clinically significant ascites in acute pancreatitis (AP) is rarely encountered and is a result of multifactorial pathogenesis. Early reactionary ascites in AP usually... (Review)
Review
Clinically significant ascites in acute pancreatitis (AP) is rarely encountered and is a result of multifactorial pathogenesis. Early reactionary ascites in AP usually does not require any treatment and resolves spontaneously in majority of patients. A diagnostic analysis should be performed in case of ascites developing in the latter stages with increasing pain or worsening organ failure. Low serum albumin-ascites gradient ascites with amylase > 1000 U/l is highly suggestive of pancreatic ascites that is usually associated with duct disruption. A combination of nasojejunal feeding, subcutaneous octreotide, endoscopic drainage and rarely, surgery are employed in managing this difficult to treat condition. There is a need of further studies to better understand the clinical role of ascites as well as contribution of other factors like hypoalbuminemia and portal hypertension to its development in AP.
Topics: Acute Disease; Amylases; Ascites; Humans; Pancreatic Diseases; Pancreatitis
PubMed: 34036465
DOI: 10.1007/s10620-021-07063-6