Abstract
DOI = 10.3329/jom.v9i2.1439 J MEDICINE 2008; 9 : 96-104
Highlights
The patterns of mortality and morbidity in acute pancreatitis have changed over time
Inclusion criteria were English language literature from 1960 onwards, relating latest terminology allocated for acute pancreatitis and its complications, advancement of management with introduction of newer drugs and their clinical trial as well as some meta analysis, guidelines provided by British Gastroenterological society, American College of Physician with their update and recently recommended audit standard for management of acute pancreatitis
It implies preservation of pancreatic blood supply.Severe acute pancreatitis is associated with organ failure and/or local complications such as necrosis, pseudocyst or abscess
Summary
Local involvement of pancreatitis includes phlegmon (18%), pancreatic abscess (3%), pancreatic pseudocyst (10%) and thrombosis of the central portal system.[21]. The Atlanta Meeting[5] discouraged the term phlegmon and replaced it with pancreatic necrosis When this damage is not cleared, further inflammation ensues, declaring itself by increased pain, fever and tenderness. An abscess is a well-defined collection of pus occurring after the acute inflammation has subsided.A pseudocyst develops as a result of pancreatic necrosis and the escape of activated pancreatic secretions through pancreatic ducts. This fluid coalesces and becomes encapsulated by an inflammatory reaction and fibrosis These patients usually have pain and hyperamylasemia, but may be asymptomatic. Metabolic Hypocalcemia, hyperglycemia, hypertriglyceridemia, acidosis Respiratory Hypoxemia, atelectasis, effusion, pneumonitis Acute respiratory distress syndrome (ARDS) Renal Renal artery or vein thrombosis Renal failure Circulatory Arrhythmias Hypovolemia and shock; myocardial infarct Pericardial effusion, vascular thrombosis Gastrointestinal Ileus Gastrointestinal hemorrhage from stress ulceration; gastric varices (secondary to splenic vein thrombosis) Gastrointestinal obstruction Hepatobiliary Jaundice Portal vein thrombosis Neurologic Psychosis or encephalopathy (confusion, delusion and coma) Cerebral emboli Blindness (angiopathic retinopathy with hemorrhage) Hematologic Anemia DIC (disseminated intravascular coagulopathy) Leucocytosis Dermatologic
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