Enfermedad biliopancreática aguda en urgencias

Abstract

Acute biliopancreatic disease encompasses acute pancreatitis due to any cause, biliary colic, acute cholecystitis, cholangitis, and choledocholithiasis. They are common diseases with high morbidity and mortality in severe cases. For this reason, the severity classification in the emergency department (ED) is important for better management. In large part, these nosological diseases are caused by gall stones, which are becoming more and more common (5% – 15% of the Western population) in a population with a growing percentage of obesity and overweight. They are more common in individuals over 65 years of age and in women. Despite how common they are, gall stones only cause symptoms in 15% – 20% of patients. In large part, these diseases progress with abdominal pain, generally in the upper half of the abdomen. Therefore, it is important to know how to differentiate one from another in order to start the necessary treatment as early as possible to improve the prognosis. The medical record, a physical examination, a blood test with a liver and pancreatic panel, and an abdominal ultrasound or abdominal computed tomography scan will be necessary for the differential diagnosis of most patients. Initially, in practically all cases, these patients will need a liquid diet; fluid therapy; analgesics; and, only in some cases, empiric antibiotic therapy. The most important aspects of each disease will be summarized herein, focusing especially on the approach in the ED.