Mo1408 Natural Course of Acute Peripancreatic Fluid Collection in Moderately Severe or Severe Acute Pancreatitis: Multicenter, Prospective Study

2016 ◽  
Vol 150 (4) ◽  
pp. S703
Author(s):  
Dong Wook Lee ◽  
Min Keun Kim ◽  
Jin Tae Jung ◽  
Joong Goo Kwon ◽  
Ho Gak Kim ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Prospective Study ◽  
Severe Acute Pancreatitis ◽  
Fluid Collection ◽  
Natural Course ◽  
Multicenter Prospective Study

Antibiotic prophylaxis in severe acute pancreatitis: Randomized multicenter prospective study with meropenem

2003 ◽  
Vol 124 (4) ◽  
pp. A85 ◽  
Author(s):  
Sona Hejtmankova ◽  
Petr Cech ◽  
David Hoskovec ◽  
Rodomil Kostka ◽  
Jan Leffler ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Prospective Study ◽  
Antibiotic Prophylaxis ◽  
Severe Acute Pancreatitis ◽  
Multicenter Prospective Study

scholarly journals Assessment of Prophylactic Carbapenem Antibiotics Administration for Severe Acute Pancreatitis: An Updated Systematic Review and Meta-Analysis

Digestion ◽  
2022 ◽  
pp. 1-9
Author(s):  
Daxin Guo ◽  
Wei Dai ◽  
Jingyi Shen ◽  
Mengting Zhang ◽  
Yetan Shi ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Organ Failure ◽  
Severe Acute Pancreatitis ◽  
Pancreatic Pseudocyst ◽  
Meta Analysis ◽  
Fluid Collection ◽  
Cochrane Library ◽  
Intensive Care Unit Treatment ◽  
Significant Difference ◽  
And Control

<b><i>Background:</i></b> The effectiveness of prophylactic antibiotics in severe acute pancreatitis (SAP) remains a debatable issue. This meta-analysis aimed to determine the efficacy of prophylactic carbapenem antibiotics in SAP. <b><i>Methods:</i></b> This meta-analysis of prophylactic carbapenem antibiotics for SAP was conducted in PubMed, EMBASE, Web of Science, MEDLINE, and Cochrane Library up to February 2021. The related bibliographies were manually searched. The primary outcomes involved infected pancreatic or peripancreatic necrosis, mortality, complications, infections, and organ failure. <b><i>Results:</i></b> Seven articles comprised 5 randomized controlled trials and 2 retrospective observational studies, including 3,864 SAP participants. Prophylactic carbapenem antibiotics in SAP were associated with a statistically significant reduction in the incidence of infections (odds ratio [OR]: 0.27; <i>p</i> = 0.03) and complications (OR: 0.48; <i>p</i> = 0.009). Nevertheless, no statistically significant difference was demonstrated in the incidence of infected pancreatic or peripancreatic necrosis (OR: 0.74; <i>p</i> = 0.24), mortality (OR: 0.69; <i>p</i> = 0.17), extrapancreatic infection (OR: 0.64, <i>p</i> = 0.54), pulmonary infection (OR: 1.23; <i>p</i> = 0.69), blood infection (OR: 0.60; <i>p</i> = 0.35), urinary tract infection (OR: 0.97; <i>p</i> = 0.97), pancreatic pseudocyst (OR: 0.59; <i>p</i> = 0.28), fluid collection (OR: 0.91; <i>p</i> = 0.76), organ failure (OR: 0.63; <i>p</i> = 0.19), acute respiratory distress syndrome (OR: 0.80; <i>p</i> = 0.61), surgical intervention (OR: 0.97; <i>p</i> = 0.93), dialysis (OR: 2.34; <i>p</i> = 0.57), use of respirator or ventilator (OR: 1.90; <i>p</i> = 0.40), intensive care unit treatment (OR: 2.97; <i>p</i> = 0.18), and additional antibiotics (OR: 0.59; <i>p</i> = 0.28) between the experimental and control groups. <b><i>Conclusions:</i></b> It is not recommended to administer routine prophylactic carbapenem antibiotics in SAP.

scholarly journals Prognostic Indicator in Severe Acute Pancreatitis

2018 ◽  
Vol 3 (05) ◽  
Author(s):  
Dr. Ajay Khanolkar ◽  
Dr. Manish Khare
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Surgical Intervention ◽  
Financial Burden ◽  
Fluid Collection ◽  
Prognostic Indicator ◽  
Apache Ii ◽  
Management Decision ◽  
Apache Ii Score ◽  
Local Complication

Aim of study: - To assess the utility of each as prognostic indicator in Severe Acute Pancreatitis. Material and Methods: This prospective study entitled “To assess the utility of each as prognostic indicator in Severe Acute Pancreatitis” was carried out on patients hospitalized for acute pancreatitis in the surgery department at Chandulal Chandrakar Memorial Medical College and CM Hospital, Bhilai from March 2015 to October 2017.50 patients with the diagnosis of first attack of acute pancreatitis of both sexes and all age groups were selected for the study. Conclusion:- On the basis of observation and result of the study, it can be safely stated that APACHE II Scoring is quick, safe, reproducible, ongoing and cost effective. It can be done by resident or intelligent nursing staff. Give an idea regarding improving or worsening of patients. APACHE II Scoring system when complimented by high quality CECT abdomen can further refine the results and give an idea of likelihood of patients developing local complication. Thus it can also be used along with CECT abdomen for Risk Stratification of subset of patients who are likely to develop local complication who might need surgical intervention. CECT on 3rd day adds nothing to management. It has a tendency to over predict the regional complication, which are in anyway apart of natural course of history of disease (acute fluid collection). Management decision could not be based on CECT abdomen on 3rd day alone, since it is not needed to make a diagnosis of acute pancreatitis it should be abundant, thus reducing the financial burden of patients and institute. CECT abdomen done after 2nd week in the course of illness along with APACHE II Score and clinical finding are better guide for management and surgical intervention.

scholarly journals Colonic Necrosis in a 4-Year-Old with Hyperlipidemic Acute Pancreatitis

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
Tiffany J. Patton ◽  
Timothy A. Sentongo ◽  
Grace Z. Mak ◽  
Stacy A. Kahn
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Severe Acute Pancreatitis ◽  
Pancreatic Pseudocyst ◽  
Fluid Collection ◽  
Initial Presentation ◽  
Metabolic Abnormalities ◽  
Pediatric Case ◽  
Severe Pancreatitis ◽  
Colonic Necrosis

Here we report the case of a 4-year-old male with severe acute pancreatitis due to hyperlipidemia, who presented with abdominal pain, metabolic abnormalities, and colonic necrosis. This colonic complication was secondary to the extension of a large peripancreatic fluid collection causing direct serosal autodigestion by pancreatic enzymes. Two weeks following the initial presentation, the peripancreatic fluid collection developed into a mature pancreatic pseudocyst, which was percutaneously drained. To our knowledge, this is the youngest documented pediatric case of colonic necrosis due to severe pancreatitis and the first descriptive pediatric case of a colonic complication due to hyperlipidemia-induced acute pancreatitis.

scholarly journals Severe acute pancreatitis: eight fundamental steps revised according to the ‘PANCREAS’ acronym

2020 ◽  
Vol 102 (8) ◽  
pp. 555-559 ◽  
Author(s):  
CA Gomes ◽  
S Di Saverio ◽  
M Sartelli ◽  
E Segallini ◽  
N Cilloni ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Venous Pressure ◽  
Fluid Collection ◽  
Vena Cava ◽  
Previous Treatment ◽  
Infectious Complications ◽  
Epidural Block ◽  
Pancreatic Fluid Collection ◽  
The Individual

Severe acute pancreatitis remains a life-threatening condition, responsible for many disorders of homeostasis and organ dysfunction. By means of a mnemonic ‘PANCREAS’, eight important steps in the management of severe acute pancreatitis are highlighted. These steps follow the principle of goal-directed therapy and should be borne in mind after diagnosis and during clinical treatment. The first step is perfusion: the goal is to reach a central venous pressure of 12–15mmHg, urinary output 0.5–1ml/kg/hour and inferior vena cava collapse index greater than 48%. Next is analgesia: multimodal, systemic and combined pharmacological agent and epidural block are possibilities. Third is nutrition: precocity, enteral feeding in gastric or post-pyloric position. Parenteral nutrition works best in difficult cases to achieve the individual total caloric value. Fourth is clinical: mild, moderate or severe pancreatitis according to the Atlanta criteria. Radiology is fifth: abdominal computed tomography on the fourth day for prognosis or to modify management. Endoscopy is sixth: endoscopic retrograde cholangiopancreatography (cholangitis, unpredicted clinical course and ascending jaundice); management of pancreatic fluid collection and ‘walled-off necrosis’. Antibiotics come next: infectious complications are common causes of morbidity. The only rational indication for antibiotics is documented pancreatic infection. The last step is surgery: the dogma is represented by the ‘three Ds’ (delay, drain, debride). The preferred method is a minimally invasive step-up approach, which allows for gradually more invasive procedures when the previous treatment fails.

Su1890 Local and Systemic Complications of Acute Pancreatitis According to the Revised Atlanta Classification: A Nation-Wide Multicenter Prospective Study

2015 ◽  
Vol 148 (4) ◽  
pp. S-545
Author(s):  
Enrique de-Madaria ◽  
José Pamies-Guilabert ◽  
Guillermo García ◽  
José L. de Benito ◽  
Jennifer Hinojosa-Guadix ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Prospective Study ◽  
Systemic Complications ◽  
Multicenter Prospective Study ◽  
Local And Systemic Complications

scholarly journals Early complications and prognosis with multiple organ system failure score

2021 ◽  
Vol 8 (2) ◽  
pp. 668
Author(s):  
Kaushik Das ◽  
Junaid M. Shaikh ◽  
Ketika Potey ◽  
Sarojini P. Jadhav
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Fluid Collection ◽  
Scoring Systems ◽  
Multiple Organ ◽  
Organ System ◽  
System Failure ◽  
Early Complications ◽  
Organ System Failure ◽  
Management Of Complications

Background: Acute pancreatitis is a common surgical entity with a wide clinical spectrum ranging from mild pancreatitis to severe acute pancreatitis with lethal complications. A number of scoring systems have been devised to predict and manage complications associated with severe acute pancreatitis. The objective of this study was to study the demographics, early complications of acute pancreatitis with their outcome, and to assess the efficacy of multi organ system failure score.  Methods: This was a descriptive study including 120 patients of acute pancreatitis done over a period of 2 years. The management of complications and their outcome were recorded in detail. A multi organ system failure score was used to predict and assess the severity of acute pancreatitis. Results: Total 120 patients were evaluated with mean age of 40 years and male preponderance. Alcohol consumption was the most common etiological factor. Acute fluid collection was the most common local complication while shock was the most common systemic complication. MOSF scoring system had a sensitivity, specificity and positive predictive value of 96%, 92.8% and 90.5% respectively. Mortality was 5.8% seen in patients with MOSF score above 5.Conclusions: The management of early complications of acute pancreatitis is mainly conservative, with surgical management limited to only a few selected patients. MOSF score is a valuable tool to predict and assess the severity of acute pancreatitis and should be used for monitoring of high risk patients.

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