M1283 What Are the Criteria for Resuming Oral Diet in Acute Pancreatitis and Is There Any Differences in the Course of Disease Due to That Criteria?

This study evaluated whether starting nasojejunal tube feeding within 24 hours of presentation would reduce the rate of death or major complications in patients with acute pancreatitis. This strategy was compared to allowing patients to take an “on demand” oral diet and only initiating nasojejunal tube feeding if there was poor oral intake by 96 hours after presentation. There was no difference between the two groups in any of the measured outcomes, though the study may have been underpowered. We conclude it is acceptable to allow an on-demand oral diet and reserve nasoenteric feeding for patients who have not achieved adequate nutrition by 96 hours after presentation. It is not necessary or beneficial to start nasojejunal tube feeds in the first 24 hours.

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Pancreatoduodenectomy for Periampullary Tumors Presenting with Acute Pancreatitis

Gastroenterology Research and Practice ◽

10.1155/2020/7246895 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Xuefeng Cao ◽

Xixiu Wang ◽

Xiaoliang Xu ◽

Yanmin Lu ◽

Baolei Zhao ◽

...

Keyword(s):

Acute Pancreatitis ◽

Operative Time ◽

Laboratory Data ◽

Biliary Fistula ◽

University Hospital ◽

Control Group ◽

Study Group ◽

Course Of Disease ◽

Periampullary Tumors ◽

Medical University

Background. Periampullary tumors (PT) may rarely present as acute pancreatitis (AP) or acute recurrent pancreatitis (ARP). Unlike other cases of AP and ARP, these conditions necessitate pancreaticoduodenectomy (PD), and timely diagnosis is crucial. Materials and Methods. A retrospective review of clinical, radiological, surgical, and pathological data was conducted for patients admitted to the Binzhou Medical University Hospital during the period from January 2010 to December 2017, for AP or ARP caused by PT. All patients included in the study group had undergone PD. The perioperative data for these patients was compared with data for patients with PT but without AP or ARP who underwent PD during the same period (control group). Results. During the study period, 412 patients with AP or ARP were treated; among this group, 15 patients had PT. Compared with controls, patients in the study group were younger in age and had a longer course of disease, more frequent hospitalizations, and more severe derangements in laboratory data (P<0.05). Operative time and intraoperative blood loss were significantly higher in the study group, but the incidence of postoperative outcomes such as pancreatic/biliary fistula, abdominal infection, postoperative hospital stay, and mortality were similar between groups (P>0.05). Conclusions. Neither AP nor ARP has any adverse impact on the outcomes of PD. However, in the treatment of younger patients suffering from AP or ARP, unexplained pancreatic duct dilation and weight loss should raise the suspicion of PT. EUS and EUS-FNA may be helpful in making the diagnosis.

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Early bacterial infection of the pancreas and course of disease in cerulein-induced acute pancreatitis in rats

Digestive and Liver Disease ◽

10.1016/j.dld.2006.02.019 ◽

2006 ◽

Vol 38 (6) ◽

pp. 423-428 ◽

Cited By ~ 1

Author(s):

G. Manes ◽

S. Kahl ◽

H.-U. Schulz ◽

H. Lippert ◽

E.C. Ferrara ◽

...

Keyword(s):

Acute Pancreatitis ◽

Bacterial Infection ◽

Course Of Disease

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The Antioxidant Profiles, Lysosomal and Membrane Enzymes Activity in Patients with Acute Pancreatitis

Mediators of Inflammation ◽

10.1155/2014/376518 ◽

2014 ◽

Vol 2014 ◽

pp. 1-9 ◽

Cited By ~ 11

Author(s):

Halina Milnerowicz ◽

Radosław Bukowski ◽

Monika Jabłonowska ◽

Milena Ściskalska ◽

Stanisław Milnerowicz

Keyword(s):

Oxidative Stress ◽

Acute Pancreatitis ◽

Healthy Subjects ◽

Control Group ◽

Activity Levels ◽

First Line ◽

Course Of Disease ◽

Antioxidative Status ◽

Gpx Activity

Oxidative stress and inflammatory mediators, such as IL-6, play an important role in the pathophysiology of acute pancreatitis. The study was aimed to assess the degree of the pro/antioxidative imbalance and estimate which antioxidant plays a role in the maintenance of pro/antioxidative balance during acute pancreatitis. The study was investigated in the blood of 32 patients with acute pancreatitis and 37 healthy subjects. IL-6 concentration as early marker of inflammation was determinated. The intensity of oxidative stress was assessed by TBARS concentration. To investigate antioxidative status, the GPx and Cu/Zn SOD activities and the levels of GSH, MT, SH groups, and TRAP were measured. The concentrations of Cu and Zn as ions participating in the maintenance of antioxidant enzymes stability and playing a role in the course of disease were determinated. The activities of GGT, AAP, NAG, andβ-GD as markers of tissue damage were also measured. An increase in IL-6 concentration, which correlated with Ranson criteria, and an increase in GPx activity, levels of MT, TBARS, or GGT, and NAG activities in patients group compared to healthy subjects were demonstrated. A decrease in GSH level in patients group compared to control group was noted. The studies suggest that GPx/GSH and MT play the role of the first line of defence against oxidative stress and pro/antioxidant imbalance in the course of acute pancreatitis.

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Resting energy requirement in early phase of acute pancreatitis as a prognostic criterion of the course of disease

Anesteziologiya i Reanimatologiya ◽

10.17116/anaesthesiology202103184 ◽

2021 ◽

pp. 84

Author(s):

O.G. Sivkov ◽

A.O. Sivkov

Keyword(s):

Acute Pancreatitis ◽

Early Phase ◽

Energy Requirement ◽

Course Of Disease ◽

Prognostic Criterion ◽

Resting Energy

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The clinical diagnostic aspects of acute pancreatic encephalopathy

Medical Journal of the Russian Federation ◽

10.18821/0869-2106-2016-22-4-153-156 ◽

2016 ◽

Vol 22 (3) ◽

pp. 153-156

Author(s):

A. A Strutsenko ◽

I. V Damulin ◽

N. V Mazurtchik ◽

P. P Ogurtsov

Keyword(s):

Acute Pancreatitis ◽

Neurological Disorders ◽

Rare Complication ◽

Clinical Stage ◽

Clinical Manifestations ◽

Diagnostic Algorithm ◽

Course Of Disease ◽

Therapeutic Algorithm ◽

Fast Development ◽

Pancreatic Encephalopathy

The pancreatic encephalopathy is characterized by various focal neurological symptomatic and sporadic fast development of dementia is considered as a rare complication of acute pancreatitis developing in 9-35% of patients with diseases of pancreas. Factually every patient with acute pancreatitis has a risk of development of pancreatic encephalopathy that significantly makes severer course of disease and increases lethality. The review article considers particular aspects of clinical manifestations and probable diagnostic algorithm of neurological disorders observed in patients with acute pancreatitis. The actuality of development of diagnostic algorithm of pancreatic encephalopathy is emphasized. This algorithm will permit ultimately early, probably at pre-clinical stage, discover the mentioned complication of acute pancreatitis with the purpose of not only ultimate early detection of pancreatic encephalopathy but also development of pathogenically conditioned therapeutic algorithm considering all chains of pathogenesis.

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Comparative Analysis of Selected Scales to Assess Prognosis in Acute Pancreatitis

Canadian Journal of Gastroenterology and Hepatology ◽

10.1155/2015/392643 ◽

2015 ◽

Vol 29 (6) ◽

pp. 299-303 ◽

Cited By ~ 3

Author(s):

Dorota Koziel ◽

Stanislaw Gluszek ◽

Jaroslaw Matykiewicz ◽

Piotr Lewitowicz ◽

Zuzanna Drozdzak

Keyword(s):

Acute Pancreatitis ◽

Predictive Value ◽

Area Under The Curve ◽

Scoring Systems ◽

Final Analysis ◽

Severity Index ◽

Apache Ii ◽

Prospective Data ◽

Course Of Disease ◽

Using Data

OBJECTIVE: To evaluate the utility of selected scales to prognosticate the severity and risk for death among patients with acute pancreatitis (AP) according to the revised Atlanta classification published in 2012.METHODS: Prospective data regarding patients hospitalized due to AP were analyzed. The final analysis included a total of 1014 patients. The bedside index for severity in acute pancreatitis (BISAP), Panc 3 scores and Ranson scales were calculated using data from the first 24 h of admission.RESULTS: Mild AP was diagnosed in 822 (81.1%) cases, moderate in 122 (12%) and severe in 70 (6.9%); 38 (3.7%) patients died. The main causes of AP were cholelithiasis (34%) and alcohol abuse (26.7%). Recurrence of AP was observed in 244 (24.1%) patients. In prognosticating the severity of AP, the most useful scale proved to be the Acute Physiology and Chronic Health Evaluation (APACHE) II (area under the curve [AUC] 0.724 [95% CI 0.655 to 0.793]), followed by BISAP (AUC 0.693 [95% CI 0.622 to 0.763]). In prognosticating a moderate versus mild course of AP, the CT severity index proved to be the most decisive (AUC 0.819 [95% CI 0.767 to 0.871]). Regarding prognosis for death, APACHE II had the highest predictive value (AUC 0.726 [95% CI 0.621 to 0.83]); however, a similar sensitivity was observed using the BISAP scale (AUC 0.707 [95% CI 0.618 to 0.797]).CONCLUSIONS: Scoring systems used in prognosticating the course of the disease vary with regard to sensitivity and specificity. The CT severity index scoring system showed the highest precision in prognosticating moderately severe AP (as per the revised Atlanta criteria, 2012); however, in prognosticating a severe course of disease and mortality, APACHE II proved to have the greatest predictive value.

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Childhood Pancreatitis: A Case Series

IIUM Medical Journal Malaysia ◽

10.31436/imjm.v18i1.793 ◽

2019 ◽

Vol 18 (1) ◽

Author(s):

Hamzah Sukiman ◽

Mohd Latiff Iqramie Muhamad Zaki ◽

Mohd Fauzi Sharudin ◽

Mohd Arief Md Sobri

Keyword(s):

Acute Pancreatitis ◽

Abdominal Pain ◽

Rural Communities ◽

Pancreatic Pseudocyst ◽

Serum Amylase ◽

Clinical Course ◽

Demographic Data ◽

Case Series ◽

Local Data ◽

Course Of Disease

Introduction: Acute pancreatitis is relatively rare in children. Published local data on childhood pancreatitis is even vanishingly scarce. Our intent is to evaluate the demography, aetiology, clinical course, and complications of children with acute pancreatitis. Materials and Methods: A singlecentre, retrospective review of patients aged 12 years or younger, admitted between January 2016 to February 2018 with the diagnosis of acute pancreatitis performed. Demographic data, aetiology, and serum amylase on admission were collected. DeBanto score for assessment of severity was calculated (at admission and at 48H) and patients’ clinical outcome was assessed. Results: A total of eight patients, aged between 3 to 12 years (median 8.0 years) were diagnosed with acute pancreatitis. Malays made up the majority (50%) but the Orang Asli is over-represented at 37.5%. Most were idiopathic (50%), but 25% of pancreatitis were caused by helminths. All patients presented with abdominal pain as the primary complaint. Most of them followed a mild course of disease; all but one patient had a DeBanto score of <3. Mean length of stay was 5 days, and two patients went on to develop complications (pancreatic pseudocyst and recurrent pancreatitis). Conclusion: Acute pancreatitis remains an important diagnosis for children presenting with abdominal pain. In addition to commonly described aetiologies, helminthic infestation is an important cause of acute pancreatitis, especially among rural communities in the state of Pahang.

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