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Biliary emergencies: pancreatitis, cholangitis, and more.
Robert M S Mitchell1, Michael F Byrne
1Division of Gastroenterology, Duke University Medical Center, Durham, NC 27710, USA. mitch080@mc.duke.edu
Seminars in Gastrointestinal Disease
|August 2, 2003
Summary
Acute pancreatitis, often caused by gallstones, requires early severity assessment and management. Aggressive treatment is critical for severe cases, especially infected pancreatic necrosis, to reduce high mortality rates.
Area of Science:
- Gastroenterology
- Internal Medicine
Background:
- Acute pancreatitis is commonly caused by gallstones, but other factors exist.
- Management strategies vary based on attack severity and underlying cause.
Observation:
- Most acute pancreatitis cases are self-limiting.
- Infected pancreatic necrosis carries a significant mortality risk (up to 25%).
Findings:
- Early assessment of severity and prompt, aggressive management are crucial for patient outcomes.
- The article reviews the roles of ERCP, surgery, enteral feeding, and antibiotics.
Implications:
- Understanding controversial causes like pancreas divisum and sphincter of Oddi dysfunction is important for recurrent pancreatitis.
- Hereditary and familial pancreatitis also warrant consideration in etiology.