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Related Experiment Videos

Severe acute pancreatitis: when to be concerned?

Paul Georg Lankisch1, Torsten Blum, Patrick Maisonneuve

  • 1Department of Internal Medicine, Municipal Clinic of Lüneburg, Lüneburg, Germany. paulgeorg.lankisch@klinikum-lueneburg.de

Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [Et Al.]
|May 16, 2003
PubMed
Summary

Early recognition of severe acute pancreatitis is crucial. Simple, inexpensive parameters can help identify organ failure and necrotizing pancreatitis, potentially avoiding costly CT scans in many cases.

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Area of Science:

  • Gastroenterology and Hepatology
  • Medical Imaging
  • Critical Care Medicine

Background:

  • Acute pancreatitis severity dictates patient outcomes.
  • Distinguishing between interstitial and necrotizing pancreatitis is vital.
  • Contrast-enhanced CT scans for necrosis are costly and not universally available.

Purpose of the Study:

  • To review simple, inexpensive parameters for diagnosing severe acute pancreatitis (organ failure and necrosis).
  • To guide clinicians on when to suspect severe disease and consider CT scans.
  • To identify parameters that may obviate the need for early CT scans.

Main Methods:

  • Literature review of existing parameters for assessing acute pancreatitis severity.
  • Analysis of clinical and laboratory markers for organ failure and pancreatic necrosis.

Related Experiment Videos

  • Evaluation of the negative predictive value of various parameters.

    • Main Results:

    • Certain parameters (e.g., alcohol etiology, early admission, rebound tenderness, high lipase, elevated hematocrit/glucose) suggest need for CT.
    • Other parameters (e.g., non-alcohol etiology, delayed admission, absence of tenderness, normal hematocrit/glucose) have high negative predictive value (>90%).
    • These negative predictive parameters may negate the need for early contrast-enhanced CT unless the patient's condition worsens.

    Conclusions:

    • Simple, readily available parameters can aid in early identification of severe acute pancreatitis.
    • Contrast-enhanced CT may be avoidable in early stages for some patients based on these parameters.
    • Further research is needed for simple, valid parameters to reliably differentiate necrotizing from interstitial pancreatitis.