Recent Trends In Diagnosis and Treatment of Acute Pancreatitis
Yahya Abdel Hamid Saied;
Abstract
Acute pancreatitis is an inflammatory disorder of the pancreas, causing sudden and severe abdominal pain. The pancreas is an organ that lies in the back of the mid-abdomen. It is responsible for insulin production and the manufacture and secretion of digestive enzymes. Most attacks of acute pancreatitis do not lead to complications, and most people recover uneventfully with medical care. However, a small proportion of people have a more serious illness that requires intensive medical care. In all cases, it is essential to determine the underlying cause of acute pancreatitis and, if possible, to treat this conditions to prevent a recurrence.
Gallstone pancreatitis is the most common cause of AP. Because the gallbladder and pancreas share a drainage duct, gallstones that lodge in this duct can prevent the normal flow of pancreatic enzymes and trigger acute pancreatitis.
Alcoholic pancreatitis is seen more frequently in men. Ethanol causes spasm of the sphincter of Oddi, and more importantly, it is a metabolic toxin to pancreatic acinar cells. It also transiently decreases pancreatic blood flow, possibly causing focal ischemic injury to the gland.
As regards pathogenesis of acute pancreatitis, the principle mechanism for it is premature activation of the pancreatic enzymes within the pancreas that leads to organ injury and pancreatitis, also inflammatory mediators (IL-1, IL-6, TNF and others) should be taken in consideration as it causes increases in the pancreatic vascular permeability leading to hemorrhage, edema and eventually pancreatic necrosis.
Clinical diagnosis:
Symptoms of pancreatitis usually include severe constant epigastric pain radiating to the back and flanks and vomiting. Signs may include pyrexia, abdominal distension and peritonism. The classical signs of discoloration of the flanks (Grey-Turner's sign), peri-umbilicus (Cullen's sign) and inguinal ligament (Fox's sign) are not always seen and are a result of retroperitoneal hemorrhage tracking along tissue planes. In addition, symptoms and signs of end-organ involvement may be evident, including respiratory distress, shock, oliguria, jaundice and delirium. It is also possible for SAP to be painless
Gallstone pancreatitis is the most common cause of AP. Because the gallbladder and pancreas share a drainage duct, gallstones that lodge in this duct can prevent the normal flow of pancreatic enzymes and trigger acute pancreatitis.
Alcoholic pancreatitis is seen more frequently in men. Ethanol causes spasm of the sphincter of Oddi, and more importantly, it is a metabolic toxin to pancreatic acinar cells. It also transiently decreases pancreatic blood flow, possibly causing focal ischemic injury to the gland.
As regards pathogenesis of acute pancreatitis, the principle mechanism for it is premature activation of the pancreatic enzymes within the pancreas that leads to organ injury and pancreatitis, also inflammatory mediators (IL-1, IL-6, TNF and others) should be taken in consideration as it causes increases in the pancreatic vascular permeability leading to hemorrhage, edema and eventually pancreatic necrosis.
Clinical diagnosis:
Symptoms of pancreatitis usually include severe constant epigastric pain radiating to the back and flanks and vomiting. Signs may include pyrexia, abdominal distension and peritonism. The classical signs of discoloration of the flanks (Grey-Turner's sign), peri-umbilicus (Cullen's sign) and inguinal ligament (Fox's sign) are not always seen and are a result of retroperitoneal hemorrhage tracking along tissue planes. In addition, symptoms and signs of end-organ involvement may be evident, including respiratory distress, shock, oliguria, jaundice and delirium. It is also possible for SAP to be painless
Other data
| Title | Recent Trends In Diagnosis and Treatment of Acute Pancreatitis | Other Titles | الطرق الحديثة لتشخيص و علاج الإلتهابات الحادة بالبنكرياس | Authors | Yahya Abdel Hamid Saied | Issue Date | 2014 |
Recommend this item
Similar Items from Core Recommender Database
Items in Ain Shams Scholar are protected by copyright, with all rights reserved, unless otherwise indicated.