November 12, 2014
Notes: Delfino, Marcello
Franze, Gian Pietro
Monda, Vincenzo Maria
Expert Opin Drug Saf. 2014 Feb;13(2):151-6. doi: 10.1517/14740338.2014.853036. Epub 2013 Nov 13.
Author Address: Hospital and Community Pharmaceutical Assistance, Department of Pharmacy, Local Health Authority of Ferrara , Ferrara , Italy.
Reference Type: Journal Article
Record Number: 4645Author: de-Madaria, E.
Title: [Latest advances in acute pancreatitis]
Journal: Gastroenterol Hepatol
Volume: 36 Suppl 2
Short Title: [Latest advances in acute pancreatitis]
Alternate Journal: Gastroenterologia y hepatologia
ISSN: 0210-5705 (Print)
Original Publication: Ultimos avances en pancreatitis aguda.
Accession Number: 24160959
Keywords: Acute Disease
Abstract: The present article analyzes the main presentations on acute pancreatitis (AP) in Digestive Disease Week 2013. Perfusion computed tomography allows early diagnosis of pancreatic necrosis. Neutrophil gelatinase-associated lipocalin predicts the development of acute renal failure, severe AP and death. Factors associated with greater fluid sequestration in AP are alcoholic etiology, an elevated hematocrit, and the presence of criteria of systemic inflammatory response syndrome; fluid sequestration is associated with a worse outcome. True pseudocysts (fluid collections without necrosis for more than 4 weeks) are a highly infrequent complication in AP. Patients with necrotic collections have a poor prognosis, especially if associated with infection. A meta-analysis on fluid therapy suggests that early aggressive fluid administration is associated with higher mortality and more frequent respiratory complications. According to a meta-analysis, enteral nutrition initiated within 24 hours of admission improves the outcome of AP compared with later initiation of enteral nutrition. Pentoxifylline could be a promising alternative in AP; a double-blind randomized study showed that this drug reduced the length of hospital and intensive care unit stay, as well as the need for intensive care unit admission. The association of octreotide and celecoxib seems to reduce the frequency of organ damage compared with octreotide alone. Mild AP can be managed in the ambulatory setting through hospital-at-home units after a short, 24-hour admission.