Combination Of Drainage Research Articles

Urban storm water prediction by applying machine learning techniques and geomorphological characteristics

ABSTRACT The Storm Water Management Model (SWMM) is a reliable software program for simulating stormwater runoff in combined drainage facilities. However, it faces challenges in efficiency, especially when executing real-time forecasting. This research explores an alternative machine learning (ML) approach to predict water levels in sewer and street drainage systems utilizing SWMM data for model training. The goal is to construct a hybrid ML model for urban flooding prediction, considering hydrological conditions, geomorphologic properties, and drainage facility features. A robust training method is introduced to deliberate complex flow conditions. The suggested approach achieves favourable performance in predictive accuracy and computational efficiency. Findings include: (1) similarity between ML and SWMM flooding depth on street nodes increases from 62.3% to 96.2% with the proposed training; (2) the proposed model is about 50 times faster than SWMM in urban flood simulations; (3) reliable predictions from the ML model are demonstrated through four accuracy metrics.

Study on drainage consolidation characteristics and pore-pressure reversal control of water-rich loess under the combined action of electroosmosis–vacuum

The phenomenon of “pore pressure reversal” occurs in the later stage of electroosmosis–vacuum combined drainage of water-rich loess, which causes the mutual interference of water flow directions in the later stage of the drainage process. Based on the theory of porous media and unsaturated soil mechanics, this study establishes a mathematical model for the coupling of the electric, pore pressure, and displacement fields in the drainage consolidation process of water-rich loess under the combined action of electroosmosis and vacuum. The conservation equations of energy, momentum, and mass are coupled under a solid-liquid-gas three-phase system, considering nonlinear variations of parameters, such as electrical permeability coefficients, electrical conductivity, and hydraulic permeability coefficients. Subsequently, the drainage consolidation process of water-rich loess under different electroosmosis and vacuum combination methods is simulated using finite element software. Moreover, applying vacuum loads in a graded manner and conducting electroosmosis at a later stage of the loading procedure can effectively delay the generation of the “pore pressure reversal” phenomenon and the formation of silt layers.

Characteristics and Management of Drainage Infrastructure in Medan Sunggal District, Medan City

Climate change, characterized by high-intensity rainfall, coupled with inadequate drainage systems, small and shallow river dimensions, and a lack of community awareness, has caused flooding and inundation in Medan Sunggal District. This study aims to understand the characteristics and management of drainage infrastructure in Medan Sunggal Subdistrict, Medan City, to identify its characteristics and implement suitable management efforts. The research adopts a positivism paradigm with a positivistic approach, relying on empirical facts (sensual empiricism). The research methodology used is purely qualitative descriptive, focusing on an in-depth understanding related to the characteristics, context, and research subjects. Data collection methods include Guest Tour and comparative techniques. The results of this study show that the characteristics of drainage infrastructure in the study area form a network pattern. The types of channels in the study area are primary channels, secondary channels, and tertiary channels. They consist of artificial channels with open concrete construction, located above the ground with a combined drainage system. While most of the physical conditions are good, some exhibit minor damage. A significant portion of the drainage water is stagnant. Flood-prone areas constitute 41%, areas with infrequent flooding are at 43%, and areas that have never experienced flooding are at 16%. Management recommendations for the study area include providing green open spaces, creating biopore infiltration holes, constructing detention and retention ponds, using paving blocks/grass blocks, conducting maintenance (normalization and rehabilitation) of drainage, and involving the community in each management aspect.

ХИРУРГИЧЕСКОЕ ЛЕЧЕНИЕ ВНЕКИШЕЧНОГО АМЕБИАЗА С РАЗВИТИЕМ АБСЦЕССА ПРАВОЙ ДОЛИ ПЕЧЕНИ

Background. Due to the polymorphism, low prevalence in RB and in turn the difficulty of diagnosis, the treatment of extraintestinal amoebiasis is an important issue of surgery. Objective. To demonstrate the results of surgical treatment of a patient with amebic liver abscess. Material and methods. The article presents its own clinical observation of the surgical treatment of amebic liver abscess. The patient underwent drainage of the right liver lobe abscess under the laparoscopic control according to the method developed in the clinic. Results. The patient was discharged in satisfactory condition for further out-patient follow-up by the surgeon and infectious disease doctor at the place of residence. There were no repeated appeals and admissions. Conclusions. Clinical observation indicates the need for combined treatment of amoebic liver abscesses using external drainage in combination with conservative therapy, including the use of broad-spectrum antibiotics and metronidazole.

Liver Abscess Caused by Klebsiella Pneumoniae, Series of Cases with Different Management

Abstract We present two cases of liver abscess caused by Klebsiella pneumoniae with different management, one of them resolved under antibiotherapy without theraputic drainage. Klebsiella pneumoniae is a gram-negative, lactose-fermenting, rod-shaped bacterium that is part of natural intestinal flora and one of the common causes of nosocomial infections. The liver is one of the viscera in which abscesses frequently occur and is associated with intraabdominal or hepatobiliary diseases. The first patient was admitted to „Prof. Dr. Agrippa Ionescu” Hospital with sepsis due to liver abcess. The CT examination revealed a liver lesion in segments VI-VII, limited by a hypodense margin with fluid-parafluid content (with maximal axial diameters 54/32 mm), without any other focal hepatic lesions. Laboratory workup revealed neutrophilia and lymphopenia, anemia, trombocytopenia, increased inflammatory syndrome, a high level of procalcitonin and blood cultures positives with Klebsiella pneumoniae sensitive. Based on the information presented, the diagnosis established was liver abscess caused by Klebsiella pneumoniae with favorable outcome under initial empirical antibiotherapy with Vancomycin and Meropenem, de-escalated later to I.V. Ceftriaxone, due to the result of the antibiogram. At the 14 day mark, an abdominal CT reveals a slight dimentional progression. Percutaneous ecographic guided drainage was considered but the patient denied it.The patient was released with the antibiotherapy recomandation of 14 more days of orally administered Cefixime. After 4 weeks of antibiotherapy treatment, the patient is ecographically reassesed. The liver abscess is observed to have achieved complete remission without drainage, despite the classical literature recommended protocol. The second case, a male patient admitted with sepsis due to multiple liver abscess (the largest one 100/50 mm with negative blood cultures and unfavorable outcome, despite maximal empirical therapy. Percutaneous ecographic guided drainage was performed and Klebsiella pneumoniae was isolated from the drainage samples .Under target antibiotherapy with Ertapenem for 4 weeks the outcome was very good with complete resolution of the hepatic lesions. Hepatic abscess is associated with a high mortality rate and several complications, despite its low incidence. Prompt recognition is important for effective management and achieving good outcomes. Usually, the liver abscess is treated by either percutaneous drainage or surgical drainage in combination with antibiotics.The key to succesful outcomes is early diagnosis, institution of appropriate therapy and attentive evolution monitoring.More prospective trials with large cohorts are needed to refine our understanding of this serious condition.

Gestational Antibioma of the Breast: A Rare Case Presentation

Breast is an important organ of the female human body. It is composed of skin, subcutaneous tissue and breast tissue. Mastitis is defined as inflammation of the breast tissue. It is painful with high fever, chills and red, tender, hot, and swollen areas of the breast. The causes are mainly inflammatory or infectious. Staphylococcus aureus is the most common bacteria involved in this condition. If left under-treated or untreated, infective mastitis can lead to breast abscess or septicemia. Management of breast abscess consists of aspiration or mini incision and drainage in combination with appropriate antibiotic therapy. An antibioma is defined as a hard edematous swelling consisting of sterile pus following treatment of an abscess with long-term antibiotics. The established treatment for antibioma is to surgically incise and drain it like an abscess under analgesics and antimicrobial therapy. Breast infection is most commonly associated with lactation with an incidence rate of 10 percent to 33 percent women. Lactational mastitis has an incidence rate of 2-3 percent of lactating women with 5-11 percent of these patients developing into an abscess. The mean age of incidence is 32 years. On the other hand, non-lactating breast abscesses has a peak incidence in the fourth decade of life. But this condition is rare during gestation with only a few reported cases in literature. We present one such rare case of gestational antibioma in second trimester.

Local fibrinolisis in nontraumatic intraventricular hemorrhages

The management of patients with hemorrhagic stroke is an important problem in modern neurology and neurosurgery. The proportion of hemorrhagic stroke is only 15% of all cases of acute cerebrovascular accident, but mortality reaches 50% (and with intraventricular hemorrhages up to 80%), and disability is over 75%. Minimally invasive methods are being developed to reduce intraoperative damage to brain and improve the prognosis for the patient. One of them is ventricular external drainage (EVD) in combination with local fibrinolysis (LF). Intraventricular injection of thrombolytics allows the acceleration of the process of lysis and evacuation of blood. In this clinical observation, a 52-year-old female patient was admitted to the clinic with intracerebral hematoma and intraventricular hemorrhage, complicated by acute occlusive hydrocephalus. In the case of this patient, the use of external ventricular drainage in combination with local fibrinolysis made it possible to quickly resolve occlusive hydrocephalus, reduce the risk of death and increase the patient's rehabilitation potential.

Management of Idiopathic Granulomatous Mastitis: A Single Institution Experience.

There are multiple management modalities for idiopathic granulomatous mastitis, but the treatment of choice is still under debate. This study aims to evaluate the diagnosis and outcomes of different management modalities in patients with idiopathic granulomatous mastitis and to identify the risk factors associated with recurrence. This is a single-group cohort study that included those patients who had idiopathic granulomatous mastitis. Ultrasonography was conducted for all of the cases using LOGIQ E9 with an ML6-15 transducer (5-15 MHz). A core needle biopsy was conducted to take samples from the cases for histopathological examination. The patients were put on steroid therapy. Whenever the cases did not respond to the steroid therapy, treatment with a combination of low-dose steroids and methotrexate was started. In the lack of response to conservative treatments, surgical interventions were started. Sixty-three cases with a confirmed histopathological diagnosis of granulomatous mastitis were included. The mean age of patients was 35.7 years. The history of more than one childbirth was positive in a large portion of the cases (82.5%). The lesion side was unilateral in 58.7% of the cases. A large proportion of the lesions were classified as BIRADS category 2. The best treatment outcome was yielded by a combination of low-dose steroids and incision and drainage. The factors of age, lesion area (cm2), skin thickening, and white blood cell count enhanced the chance of recurrence. Incision and drainage in combination with a low dose of steroids can give an acceptable outcome with a low rate of recurrence.

Can Woodchip Bioreactors Be Used at a Catchment Scale? Nitrate Performance and Sediment Considerations

Highlights Novel three-bed, cascading-inlet bioreactor treated agricultural drainage from a 249-ha catchment. Nitrate removal rates and load reduction efficiencies were similar to those of traditional single-field bioreactors. Sedimentation problems reduced bed life; a sediment sensing and exclusion system solved them. This scale provides opportunities for centralized management and nutrient reduction verification. Abstract. Denitrifying bioreactors, a structural practice deployed at the field scale to meet water quality goals, have been underutilized and require additional evaluation at the small catchment scale. The objective of this study was to quantify the performance of a large, multi-bed denitrifying bioreactor system sized to treat agricultural drainage runoff (combined drainage discharge and surface runoff) from a 249-ha catchment. Three woodchip bioreactor beds, 7.6 m wide by 41 m long by 1.5 m deep, with cascading inlets, were constructed in 2016 in southern Minnesota, U.S. The beds received runoff for one water year from a catchment area that is 91% tile-drained row crops, primarily maize and soybeans. Initial woodchip quality differed among the three beds, affecting flow and nitrate removal rates. Bioreactor flow was unimpeded by sediment for twelve events from September 2016 to July 2017, during which time 55% of the discharge from the catchment was treated in the bioreactor beds. Average daily nitrate removal rates ranged from 2.5 to 6.5 g-N m-3 d-1 for the three bioreactor beds, with nitrate-N load removal of flow through the beds between 19% and 27%. When accounting for untreated by-pass flow, the overall nitrate-N removal of the multi-bed system was 12.5% (713 kg N). During high-flow events, incoming sediment clogged the reactor beds, decreasing their performance. There was 4,520 kg of sediment trapped in one bed, and evidence suggests the other two trapped a similar load. To solve this problem and prolong the bioreactor’s lifespan, we installed a shutoff gate that activated when inflow turbidity exceeded a threshold value. Finally, the findings indicate that catchment-scale denitrifying bioreactors can successfully remove nitrate load from agricultural runoff, but sediment-prevention measures may be required to extend the bioreactor's lifespan. Keywords: Bioreactor, Denitrification, Nitrate removal, Sedimentation, Subsurface drainage.

Comparison and Selection of Sewage Deep Tunnel Engineering Schemes Based on Value Engineering

<p>In recent years, urban development, population expansion, and water pollution have become more and more serious. The main cause of reclaimed water pollution in Wuhan is that the combined drainage system is still retained, which makes the overflow pollution of the drainage system and the problem of regional waterlogging particularly prominent. The use of a sewage deep tunnel system to replace the traditional confluence system can basically eliminate overflow pollution. At the same time, applying value engineering to the decision-making stage of sewage deep tunnels for scheme comparison and optimizationcan effectively reduce costs, increase revenue, and enhance use functions.</p>

A single-center retrospective study comparing safety and efficacy of endoscopic biliary stenting only vs. EBS plus nasobiliary drain for obstructive jaundice.

PurposeBiliary drainage is an important modality for extrahepatic obstructive jaundice both in patients with palliative and resectable. Currently, endoscopic biliary drainage is preferred in clinical practice, including endoscopic nasobiliary drainage (ENBD) and endoscopic biliary stenting (EBS), both of which have their own advantages and disadvantages. The purpose of our study was to compare the safety and efficacy of endoscopic biliary stenting (EBS) only vs. EBS plus nasobiliary drain for obstructive jaundice.MethodsWe consecutively reviewed patients with endoscopic biliary drainage in our institution from November 2014 to March 2021. Combined (ENBD plus stent) and single approach (EBS only) were defined as combined approach and single modality, respectively, and all eligible patients were divided into a combined approach group and a single modality group. We compared combined vs. single modality approaches to investigate whether there were statistical differences in liver chemistries, postoperative adverse events, and stent patency time.ResultsIn 271 patients, a total of 356 times endoscopic biliary drainages were performed. All eligible patients were divided into the combined approach group (n = 74) and the single modality group (n = 271). The combined approach was associated with a lower incidence of postoperative cholangitis and bleeding and greater improvement in liver chemistries, although it was not statistically significant. However, it was superior to the single modality group in terms of hospital stay (12.7 ± 5.2 vs. 14.5 ± 7.9 days, p = 0.020 < 0.05) and stent patency time (8.1 ± 3.9 vs. 4.3±2.7 months, p = 0.001 < 0.05).ConclusionEndoscopic combined (ENBD plus stent) drainage is a more advantageous biliary drainage method that is characterized by more adequate biliary drainage, a lower incidence of postoperative adverse events, and longer effective biliary drainage time.

Costs and benefits of combined sewer overflow management strategies at the European scale.

Combined sewer overflows (CSOs) may represent a significant source of pollution, but they are difficult to quantify at a large scale (e.g. regional or national), due to a lack of accessible data. In the present study, we use a large scale, 6-parameter, lumped hydrological model to perform a screening level assessment of different CSO management scenarios for the European Union and United Kingdom, considering prevention and treatment strategies. For each scenario we quantify the potential reduction of CSO volumes and duration, and estimate costs and benefits. A comparison of scenarios shows that treating CSOs before discharge in the receiving water body (e.g. by constructed wetlands) is more cost-effective than preventing CSOs. Among prevention strategies, urban greening has a benefit/cost ratio one order of magnitude higher than grey solutions, due to the several additional benefits it entails. We also estimate that real time control may bring on average a CSO volume reduction of just above 20%. In general, the design of appropriate CSO management strategies requires consideration of context-specific conditions, and is best made in the context of an integrated urban water management plan taking into account factors such as other ongoing initiatives in urban greening, the possibility to disconnect impervious surfaces from combined drainage systems, and the availability of space for grey or nature-based solutions.

Clinical and radiological characteristics and considerations in the surgical management of a giant omental cyst: a case report

BackgroundOmental cysts are rare benign tumours. They occur due to malformation of the mesenteric lymphatic spaces which fail to communicate with the systemic lymphatic drainage. Diagnosis is challenging due to its rarity, indolent clinical progress, and non-specific clinical presentation in a normally well child. This case highlights the important clinical and radiological features of a giant omental cyst and a different perspective of management using combined ultrasound-guided percutaneous drainage with laparoscopic surgical excision.Case presentationWe report a case of a giant omental cyst in a 3-year-old boy who presented with gradual abdominal distension over 3 months. He was initially treated for constipation. He had no abdominal pain or history of trauma. There was a non-shifting dullness and fluid thrill on abdominal examination. Persistent distention led to further imaging with ultrasound and computer tomography scan which revealed a giant cystic lesion occupying the whole abdominal cavity. A diagnosis of a giant omental cyst was made. The initial ultrasound-guided percutaneous drainage with gradual decompression of the cyst facilitated a safe and complete laparoscopic excision of the cyst. He recovered well after surgery.ConclusionAttention to important clinical and radiological features helps in the diagnosis of a giant omental cyst. Management with combined ultrasound-guided pigtail drainage and laparoscopic excision is safe and feasible.

Ecological regimes of soils of the Novgorod region drained by open drainage

In the natural and climatic conditions of the Novgorod region, the ecological regimes of lands drained by various open drainage structures were studied: channels through 70 m (control), runoff hollows in combination with the strips of cultivation, reclamation, and closed drainage. During the operation (1992-2021) of open drainage structures, the agrochemical state of soils changed: the exchange acidity decreased; the humus content increased by 2-3 %, with the exception of a combination of hollows with a reclamation strip (a decrease of 1.5 %); the content of mobile phosphorus and potassium decreased. The formation of groundwater regimes and moisture reserves on drainage systems depends on meteorological conditions, which in the last 5 years have been very diverse: from slightly arid (2020, HTC = 1.1) to excessively moist (2017, HTC = 2.65). The systems of runoff hollows in combination with the reclamation strip provided the lowest groundwater level, while in an extremely wet year they did not rise into the arable horizon. The most favorable moisture regime of the root-inhabited soil layer in excessively humid 2017 and subsequent years was noted on systems of runoff hollows with closed drainage in combination with reclamation strips. During dry periods, which are usually June-July, a lack of moisture in the root layer of the soil was observed on experimental systems of runoff hollows in combination with cultivation and reclamation strips. The most acute moisture deficiency in these periods (0.45 full capacity) was noted on systems combining runoff hollows with cultivation strips. The most favorable soil moisture regime (0.65-0.85 full capacity) was in the combination of hollows with closed drainage and a reclamation strip. The formed new ecological regimes of the soils drained by the hollow-strip method had a significant impact on the hay yield of perennial grasses (Phleum pratense, Festuca pratensis). The increase in yield compared to the control averaged 0.3-0.6 t/ha over 5 years.

Effect of Eight Different Methods for Preventing Incontinence-associated Dermatitis: A Network Meta-analysis

The objective is to systematically evaluate the effects of different methods in the prevention of incontinence-associated dermatitis. Methods is based on Searched PubMed, the Cochrane Library, Web of Science, EMbase, CNKI, VIP and CBM,and the search time limit was all built until January 2019.Two investigators independently screened the literature, extracted the data and evaluated the risk of bias in the included studies. The R 3.5.2 software gemtc package, JAGS 4.3.0, and Stata 13.0 software were used for analysis. Results: A total of 24 articles were included and 2367 patients were included. Mesh meta-analysis results show that the skin protective agent, ostomy bag combined drainage device, ostomy bag, ostomy bag combined with skin protectant, built-in tampon to prevent the incidence of incontinence-related dermatitis is better than conventional care; The effect of devices and ostomy bags on preventing the incidence of incontinence-associated dermatitis is better than that of drainage devices and built-in tampon; the effect of ostomy pouch combined with skin protectant on preventing the incidence of incontinence-associated dermatitis is better than that of built-in tampon. The ranking probability map shows that the ostomy combined drainage device is a better solution to prevent the incidence of incontinence-associated dermatitis. Conclusion: According to the results of mesh meta-analysis and probabilistic ranking, the effect of the laparoscopic combined drainage device bag on preventing the incidence of incontinence-associated dermatitis is better than other methods. Future research should also be focused on the direct comparison of effects between different methods and the evaluation of cost effectiveness.

Combined drainage of the bilic and virsung ducts for the prevention of postoperative complications during pancreatoduodenal resection

Pancreatoduodenal resection is a standard procedure usually performed for benign and malignant tumors of the biliopancretoduodenal zone. The development and implementation of new technologies and techniques has made it possible to significantly reduce postoperative mortality to 5% over the past decade in specialized institutions around the world. But the number of postoperative complications still remains high - from 30% to 60% according to different authors; such as postoperative pancreatic and biliary fistulas, intra-abdominal infection, and late gastric emptying. Among them, pancreatic and biliary fistulas are the most frequent serious complications after pancreatoduodenal resection with a frequency of up to 30-60%, which is the main cause of postoperative mortality. In this work, we analyzed the internal intraoperative combined drainage of the pancreatic and bile ducts in 7 patients.

The Combination of Double Pigtail Plastic Stent, Nasocystic Tube and Percutaneous Catheter in Endoscopic Ultrasound-Guided Transluminal Drainage for Peripancreatic Fluid Collection

Background: Endoscopic ultrasound-guided drainage is first-line treatment of Pancreatic fluid collection. The invention of metallic stents has provided a safer and more efficient approach route for internal drainage. But because of the high cost of metal stents, a large number of patients still choose plastic stents, which can help them from the disease with much lower cost. Patients and Methods: Between March to December in 2017, 20 patients with Peripancreatic fluid collections were prospectively enrolled to receive the double pigtail plastic stent with nasocystic tube and/or percutaneous catheter. Results: There were 20 cases of pseudocyst including 4 cases of infected pseudocyst. The causes of the PFC were mainly gallstones (60%), followed with alcohol (30%) and hyperlipoidemia (10%). Technical success was achieved in 100% of the cases. All patients were completely resolved with the evidence of CT scan and clinical evaluation. The mean time for resolution was 15±20 days. The mean follow-up was 3 months. Conclusion: The combination drainage of double pigtail plastic stent with nasocystic tube and/or percutaneous catheter of pancreatic pseudocyst is feasible and efficacious to most patients. Using a titanium clip could prevent migration occurrence. With the economic benefits of plastic stents, they are still wildly used in developing countries.

Empyema Versus Lung Abscess: A Case Report

Lung abscesses and empyemas are 2 forms of pulmonary infection that can present with similar clinical features. However, empyemas are associated with higher morbidity and mortality, necessitating the need to distinguish one from the other. Plain radiographs can sometimes provide clues to help differentiate the 2 pathologies but more often than not, a computed tomography scan is required to confirm the diagnosis. Correct diagnosis is essential, as the goal standard therapeutic intervention for empyemas may be contraindicated in patients with lung abscesses. Empyemas require percutaneous or surgical drainage in combination with antibiotics, while lung abscesses are generally treated with antibiotics alone as drainage can be associated with various complications. We present a case of a 65-year-old man with parapneumonic empyema diagnosed with characteristic findings on chest computed tomography and treated with surgical drainage and antibiotics. We hope to improve patient outcomes by highlighting the classical radiographic findings that help distinguish empyema and abscess.

Acute and Chronic Pancreatitis

Clinical evaluation and surgical decision making in patients with acute pancreatitis (AP) and chronic pancreatitis (CP) are two of the most complex conditions that a general surgeon faces. Each entity has unique laboratory and radiographic investigations, operations, and postoperative care. The clinical evaluation, history, and physical examination of AP is described. The clinical features necessary for diagnosis are listed, and contrast-enhanced computed tomography is described as the gold standard for diagnosis. This review uses definitions and terminology developed at the Atlanta symposium in 1992. The severity of an episode of AP is described in terms of established scoring systems (APACHE II [Acute Physiology and Chronic Health Evaluation II], Glasgow Coma Scale score, Ranson criteria). AP can range from mild to severe necrotizing, with each described. The clinical course is described in detail. For CP, the history, physical examination, and diagnosis via investigative and imaging studies are described. The anatomic and morphologic subtypes of chronic pancreatitis are listed and the operations directed at patients with CP are detailed, and can involve drainage or combined resection and drainage. This review contains 12 figures, 14 tables, and 48 references. Keywords: Acute pancreatitis, chronic pancreatitis, gallbladder disease, alcoholism, amylase, Whipple procedure

Acute and Chronic Pancreatitis

Clinical evaluation and surgical decision making in patients with acute pancreatitis (AP) and chronic pancreatitis (CP) are two of the most complex conditions that a general surgeon faces. Each entity has unique laboratory and radiographic investigations, operations, and postoperative care. The clinical evaluation, history, and physical examination of AP is described. The clinical features necessary for diagnosis are listed, and contrast-enhanced computed tomography is described as the gold standard for diagnosis. This review uses definitions and terminology developed at the Atlanta symposium in 1992. The severity of an episode of AP is described in terms of established scoring systems (APACHE II [Acute Physiology and Chronic Health Evaluation II], Glasgow Coma Scale score, Ranson criteria). AP can range from mild to severe necrotizing, with each described. The clinical course is described in detail. For CP, the history, physical examination, and diagnosis via investigative and imaging studies are described. The anatomic and morphologic subtypes of chronic pancreatitis are listed and the operations directed at patients with CP are detailed, and can involve drainage or combined resection and drainage. This review contains 12 figures, 14 tables, and 48 references. Keywords: Acute pancreatitis, chronic pancreatitis, gallbladder disease, alcoholism, amylase, Whipple procedure