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3.5.2 - Acute Pancreatitis

from Section 3.5 - Acute Gastrointestinal Failure

Published online by Cambridge University Press:  27 July 2023

Ned Gilbert-Kawai
Affiliation:
The Royal Liverpool Hospital
Debashish Dutta
Affiliation:
Princess Alexandra Hospital NHS Trust, Harlow
Carl Waldmann
Affiliation:
Royal Berkshire Hospital, Reading
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Summary

Key Learning Points

  1. 1. Diagnosis requires two of the following criteria: abdominal pain consistent with acute pancreatitis, serum amylase/lipase over three times the reference range or findings suggestive of acute pancreatitis on cross-sectional imaging.

  2. 2. Severe acute pancreatitis is characterised by organ failure persisting for over 48 hours, and carries a mortality risk of 15–20 per cent.

  3. 3. Management is predominantly supportive. Operative intervention has a role only in the later stages of the disease.

  4. 4. Prophylactic antibiotics are not recommended; however, they may be indicated in the event of a secondary infection.

  5. 5. Enteral nutrition can be given via nasogastric or nasojejunal routes, and is preferred to parenteral nutrition.

Type
Chapter
Information
Intensive Care Medicine
The Essential Guide
, pp. 208 - 210
Publisher: Cambridge University Press
Print publication year: 2021

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References

References and Further Reading

Banks, PA, Bollen, TL, Dervenis, C, et al. Classification of acute pancreatitis–2012: revision of the Atlanta classification and definitions by international consensus. Gut 2013;62:102.CrossRefGoogle ScholarPubMed
Forsmark, C, Vege, SS, Wilcox, CM. Acute pancreatitis. N Engl J Med 2016;375:1972–81.CrossRefGoogle ScholarPubMed
Meier, R, Ockenga, J, Pertkiewicz, M, et al. ESPEN Guidelines on enteral nutrition: pancreas. Clin Nutr 2006;25:275–84.CrossRefGoogle ScholarPubMed
Mirtallo, JM, Forbes, A, McClave, SA, et al. International consensus guidelines for nutrition therapy in pancreatitis. JPEN J Parenter Enteral Nutr 2012;36:284–91.CrossRefGoogle ScholarPubMed
Sah, R, Dawra, RK, Saluja, AK. New insights into the pathogenesis of pancreatitis. Curr Opin Gastroenterol 2013;29:523–30.CrossRefGoogle ScholarPubMed

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