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Acute pancreatitis, categories, score

Sumitra Hagjer, Nitesh Kumar
INTRODUCTION: Severe acute pancreatitis has a high mortality and its early identification is important for management and risk stratification. The bedside index for severity in acute pancreatitis (BISAP) is a simple scoring system done at admission which predicts the severity of pancreatitis. Procalcitonin is an inflammatory marker which is raised very early and helps in early prediction of the severity of disease. This study aims to evaluate the BISAP score and Procalcitonin in prognostication of acute pancreatitis...
April 21, 2018: International Journal of Surgery
Hanna Sternby, Robert C Verdonk, Guadalupe Aguilar, Alexandra Dimova, Povilas Ignatavicius, Lucas Ilzarbe, Peeter Koiva, Eila Lantto, Tonis Loigom, Anne Penttilä, Sara Regnér, Jonas Rosendahl, Vanya Strahinova, Sophia Zackrisson, Kristina Zviniene, Thomas L Bollen
BACKGROUND: For consistent reporting and better comparison of data in research the revised Atlanta classification (RAC) proposes new computed tomography (CT) criteria to describe the morphology of acute pancreatitis (AP). The aim of this study was to analyse the interobserver agreement among radiologists in evaluating CT morphology by using the new RAC criteria in patients with AP. METHODS: Patients with a first episode of AP who obtained a CT were identified and consecutively enrolled at six European centres backwards from January 2013 to January 2012...
September 2016: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Sameer Raghuwanshi, Rajesh Gupta, Mahendra Mohan Vyas, Rakesh Sharma
INTRODUCTION: Pancreatitis is one of most complex and clinically challenging of all abdominal disorders. USG and abdominal CT are the most commonly used diagnostic imaging modalities for the evaluation of pancreas. Computed Tomography (CT) is highly accurate and sensitive than USG in both diagnosing as well as demonstrating the extent. Early assessment of the cause and severity of acute pancreatitis is of utmost importance for prompt treatment and close monitoring of patient with severe disease...
June 2016: Journal of Clinical and Diagnostic Research: JCDR
Irshad Ahmad Banday, Imran Gattoo, Azher Maqbool Khan, Jasima Javeed, Ghanshyam Gupta, Mohmad Latief
BACKGROUND: Acute Pancreatitis is a very common condition leading to the emergency visits in both developed and developing countries. Computed Tomography plays a pivotal role in the diagnosis and subsequent management of pancreatitis. The modified CT severity index includes a simplified assessment of pancreatic inflammation and necrosis as well as an assessment of extra pancreatic complications. AIM: To study role of modified computed tomography severity index in evaluation of acute pancreatitis and its correlation with clinical outcome...
August 2015: Journal of Clinical and Diagnostic Research: JCDR
Dong Wu, Bo Lu, Hong Yang, Jingnan Li, Jiaming Qian
OBJECTIVE: To evaluate the clinical value of the three-category classification of severe acute pancreatitis (SAP). METHODS: Clinical data of 337 traditional SAP patients, who were admitted to Peking Union Medical College Hospital (PUMCH) from January 2001 to December 2012, were retrospectively studied. These patients were classified into moderately severe acute pancreatitis (MSAP) and severe acute pancreatitis (SAP) according to the latest 2013 Atlanta Classification...
December 2014: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
Lu Ke, Zhi-hui Tong, Wei-qin Li, Congye Wu, Ning Li, John A Windsor, Jie-shou Li, Maxim S Petrov
Critical acute pancreatitis (CAP) has recently emerged as the most ominous severity category of acute pancreatitis (AP). As such there have been no studies specifically designed to evaluate predictors of CAP. In this study, we aimed to evaluate the accuracy of 4 parameters (Acute Physiology and Chronic Health Evaluation [APACHE] II score, C-reactive protein [CRP], D-dimer, and intra-abdominal pressure [IAP]) for predicting CAP early after hospital admission. During the study period, data on patients with AP were prospectively collected and D-dimer, CRP, and IAP levels were measured using standard methods at admission whereas the APACHE II score was calculated within 24 hours of hospital admission...
November 2014: Medicine (Baltimore)
Tao Jin, Wei Huang, Xiao-Nan Yang, Ping Xue, Muhammad A Javed, Kiran Altaf, Robert Sutton, Qing Xia
BACKGROUND: Recent international multidisciplinary consultation proposed the use of local (sterile or infected pancreatic necrosis) and/or systemic determinants (organ failure) in the stratification of acute pancreatitis. The present study was to validate the moderate severity category by international multidisciplinary consultation definitions. METHODS: Ninety-two consecutive patients with severe acute pancreatitis (according to the 1992 Atlanta classification) were classified into (i) moderate acute pancreatitis group with the presence of sterile (peri-) pancreatic necrosis and/or transient organ failure; and (ii) severe/critical acute pancreatitis group with the presence of sterile or infected pancreatic necrosis and/or persistent organ failure...
June 2014: Hepatobiliary & Pancreatic Diseases International: HBPD INT
Masashi Taguchi, Tatsuhiko Kubo, Mitsuyoshi Yamamoto, Keiji Muramatsu, Hideo Yasunaga, Hiromasa Horiguchi, Kenji Fujimori, Shinya Matsuda, Kiyohide Fushimi, Masaru Harada
OBJECTIVE: This study aimed to investigate the relationship between body mass index (BMI) and risk of death in patients with acute pancreatitis (AP) using a Japanese national administrative database. METHODS: We analyzed a total of 6002 patients with AP. We collected patient information, including sex, age, BMI, severity of AP based on the Japan Pancreas Society scoring system, and prognosis. We classified BMI into 5 categories (underweight [BMI, <18.5], normal range [18...
August 2014: Pancreas
Tercio De Campos, José Gustavo Parreira, José Cesar Assef, Sandro Rizoli, Barto Nascimento, Gustavo Pereira Fraga
Based on the Atlanta Classification, acute pancreatitis is classified according to its severity in either mild or severe acute pancreatitis. In recent years, several issues regarding acute pancreatitis have been discussed in the literature. These issues include how many categories of severity should be considered; whether or not a patient with organ failure holds similar holds severity of disease and prognosis of a patient with infected necrosis; the role of transient organ failure; and how to evaluate organ failure...
March 2013: Revista do Colégio Brasileiro de Cirurgiões
Ragesh Babu Thandassery, Thakur Deen Yadav, Usha Dutta, Sreekanth Appasani, Kartar Singh, Rakesh Kochhar
OBJECTIVE: Atlanta classification divides patients with acute pancreatitis (AP) into mild and severe disease. A 4-category severity classification has been proposed based on the presence or absence of local and systemic determinants, giving rise to mild, moderate, severe, or critical AP. The aim of this study was to validate this new 4-category system of severity classification by examining markers of severity and outcome. METHODS: Data from 151 consecutive patients with AP from January 2009 to December 2010 [mean age (SD), 41...
April 2013: Pancreas
M Wenten, J A Gaebler, M Hussein, E M Pelletier, D B Smith, P Girase, R A Noel, D K Braun, G L Bloomgren
AIMS: Previously, a retrospective cohort study found no increased risk of acute pancreatitis with current or recent use of exenatide twice daily compared with use of other anti-diabetic drugs. This follow-up study investigated incident acute pancreatitis, with the use of a different data source and analytic method, in patients exposed to exenatide twice daily compared with patients exposed to other anti-diabetic medications. METHODS: A large US health insurance claims database was used...
November 2012: Diabetic Medicine: a Journal of the British Diabetic Association
Keun Young Shin, Wan Suk Lee, Duk Won Chung, Jun Heo, Min Kyu Jung, Won Young Tak, Young Oh Kweon, Chang Min Cho
BACKGROUND/AIMS: Obesity tends to be associated with increased mortality and morbidity in acute pancreatitis. However, in Asian populations, higher morbidity and mortality have been reported in patients with low body mass indexes (BMIs). This study was undertaken to evaluate the relation between obesity and outcome, and to investigate the occurrence of complications by overweightedness in acute pancreatitis. METHODS: The medical records of 403 patients with acute pancreatitis were reviewed retrospectively, and Ranson's scores, modified Glasgow scores, Acute Physiology and Chronic Health Evaluation (APACHE) II scores and computed tomography severity indexes were calculated...
September 2011: Gut and Liver
Stephen A McClave, Daren K Heyland, Paul E Wischmeyer
BACKGROUND: Infectious complications and associated mortality are a major concern in acute pancreatitis. Enteral administration of probiotics could prevent infectious complications, but convincing evidence is scarce. Our aim was to assess the effects of probiotic prophylaxis in patients with predicted severe acute pancreatitis. METHODS: In this multicentre randomised, double-blind, placebo-controlled trial, 298 patients with predicted severe acute pancreatitis (Acute Physiology and Chronic health Evaluation [APACHE II] score > or =8, Imrie score > or =3, or C-reactive protein >150 mg/L) were randomly assigned within 72 h of onset of symptoms to receive a multispecies probiotic preparation (n = 153) or placebo (n = 145), administered enterally twice daily for 28 days...
July 2009: JPEN. Journal of Parenteral and Enteral Nutrition
J M Buscaglia, B W Simons, B J Prosser, D S Ruben, S A Giday, P Magno, J O Clarke, E J Shin, A N Kalloo, S V Kantsevoy, K L Gabrielson, S B Jagannath
BACKGROUND AND STUDY AIMS: Pancreatitis complicates 1% - 22% of endoscopic retrograde cholangiopancreatography procedures. The study aims were to develop a reproducible animal model of post-ERCP pancreatitis (PEP), and investigate the impact of endoscopic technique on severity of PEP. PATIENTS AND METHODS: ERCP was carried out in six male hound dogs. Pancreatitis was induced by one of three escalating methods: 1) pancreatic acinarization with 20 - 30 mL of contrast; 2) acinarization + ductal balloon occlusion + sphincterotomy; 3) acinarization + intraductal synthetic bile injection + ductal balloon occlusion + sphincterotomy...
June 2008: Endoscopy
M G H Besselink, H C van Santvoort, E Buskens, M A Boermeester, H van Goor, H M Timmerman, V B Nieuwenhuijs, T L Bollen, B van Ramshorst, B J M Witteman, C Rosman, R J Ploeg, M A Brink, A F M Schaapherder, C H C Dejong, P J Wahab, C J H M van Laarhoven, E van der Harst, C H J van Eijck, M A Cuesta, L M A Akkermans, H G Gooszen et al.
OBJECTIVE: To evaluate whether enteral prophylaxis with probiotics in patients with predicted severe acute pancreatitis prevents infectious complications. DESIGN: Multicentre, randomised, double-blind, placebo-controlled trial. METHOD: A total of 296 patients with predicted severe acute pancreatitis (APACHE II score > or = 8, Imrie score > or = 3 or C-reactive protein concentration > 150 mg/l) were included and randomised to one of two groups...
March 22, 2008: Nederlands Tijdschrift Voor Geneeskunde
Marc Gh Besselink, Hjalmar C van Santvoort, Erik Buskens, Marja A Boermeester, Harry van Goor, Harro M Timmerman, Vincent B Nieuwenhuijs, Thomas L Bollen, Bert van Ramshorst, Ben Jm Witteman, Camiel Rosman, Rutger J Ploeg, Menno A Brink, Alexander Fm Schaapherder, Cornelis Hc Dejong, Peter J Wahab, Cees Jhm van Laarhoven, Erwin van der Harst, Casper Hj van Eijck, Miguel A Cuesta, Louis Ma Akkermans, Hein G Gooszen
BACKGROUND: Infectious complications and associated mortality are a major concern in acute pancreatitis. Enteral administration of probiotics could prevent infectious complications, but convincing evidence is scarce. Our aim was to assess the effects of probiotic prophylaxis in patients with predicted severe acute pancreatitis. METHODS: In this multicentre randomised, double-blind, placebo-controlled trial, 298 patients with predicted severe acute pancreatitis (Acute Physiology and Chronic Health Evaluation [APACHE II] score > or =8, Imrie score > or =3, or C-reactive protein >150 mg/L) were randomly assigned within 72 h of onset of symptoms to receive a multispecies probiotic preparation (n=153) or placebo (n=145), administered enterally twice daily for 28 days...
February 23, 2008: Lancet
Boudewijn De Waele, Bert Vanmierlo, Yves Van Nieuwenhove, Georges Delvaux
OBJECTIVES: Body overweight and obesity have been associated with an increased morbidity in acute pancreatitis, but conflicting results were reported in the literature with regard to the type and frequency of complications. We investigated the occurrence of complications in different classes of overweight in a homogeneous group of patients with gallstone pancreatitis. METHODS: Data were collected prospectively from 250 patients with biliary pancreatitis to allow calculation of the Blamey (Glasgow) and Acute Physiology and Chronic Health Evaluation (APACHE II) scores...
May 2006: Pancreas
G M Colombo, T Sacco, M Cicchinelli
Acute abdominal pain is one of the most frequent conditions in patients presenting to the Emergency Department (ED). Acute pancreatitis (AP) is a common abdominal disorder with problematic diagnosis because of the lack of a gold standard diagnostic test. Determination of serum amylase levels was considered a screening test, but recent studies have shown an important group of emergency department patients who have normoamylasemia. Other clinical laboratory tests, such as urinary screening, could be useful to decrease misdiagnosed cases of AP in an emergency situation, whereas, to confirm the clinical suspicious, radiological imaging may add specificity...
April 2005: Minerva Medica
Generoso Uomo
The aging process influences and modifies the clinical picture and treatment modalities of inflammatory pancreatic diseases in elderly patients. The two major categories of inflammatory exocrine pancreatic diseases seen in the elderly are acute pancreatitis (AP) and chronic pancreatitis (CP). In elderly patients with AP, the presence of concomitant diseases affecting renal, hepatic and cardiopulmonary function make the early clinical assessment of the severity of AP inaccurate at the time of admission to hospital...
2003: Drugs & Aging
G Pupelis, E Autrums, K Snippe, I Melbarde-Gorkusa
BACKGROUND: Sustained increase of the intra- abdominal pressure is recently recognized as a potential risk factor of early organ dysfunction in patients with severe acute pancreatitis. Assessment of the possible mutual relevance between increased intra-abdominal pressure and early organ dysfunction is important for optimisation of the treatment strategy in this category of patients. PATIENTS AND METHODS: 71 patients with severe acute pancreatitis were entered in this prospective study...
November 2002: Zentralblatt Für Chirurgie
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