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Related Concept Videos

Acute Pancreatitis I: Introduction01:25

Acute Pancreatitis I: Introduction

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Acute pancreatitis is the sudden inflammation of the pancreas caused by the early activation of digestive enzymes, leading to the autodigestion of pancreatic tissue. This results in local inflammation and, in severe cases, systemic complications.EtiologyUnderstanding the underlying causes is crucial, as identifying the etiology guides treatment and anticipates complications. Acute pancreatitis can be triggered by various factors, typically grouped into the following clinical categories.Biliary...
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Acute Pancreatitis I: Introduction01:27

Acute Pancreatitis I: Introduction

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Pancreatitis is inflammation of the pancreas, an organ located behind the stomach. It can be either acute or chronic.
Acute pancreatitis is characterized by rapid inflammation of the pancreas, often caused by factors like gallstone blockage or excessive alcohol consumption. Chronic pancreatitis, on the other hand, is a slow, progressive inflammation that may result from long-term alcohol abuse, obstructions in the pancreatic duct, or genetic factors.
The causes of acute pancreatitis include:
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Acute Pancreatitis II: Pathophysiology01:21

Acute Pancreatitis II: Pathophysiology

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The pathophysiology of acute pancreatitis centers on injury to pancreatic acinar cells, which initiates a cascade of harmful intracellular events.This injury leads to premature activation of trypsinogen to trypsin in the pancreas. Trypsin then activates other digestive enzymes, such as chymotrypsin, elastase, and phospholipase A2, which begin breaking down pancreatic tissue. The resulting autodigestion causes local inflammation, tissue swelling, hemorrhage, and fat necrosis.Injured acinar cells...
26
Chronic Pancreatitis I: Introduction01:25

Chronic Pancreatitis I: Introduction

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Chronic pancreatitis is a long-standing, relapsing inflammation of the pancreas, characterized by irreversible damage to the gland. It results in progressive destruction of the pancreatic parenchyma, fibrosis, and eventual loss of both exocrine and endocrine function. The disease may evolve gradually after multiple episodes of acute pancreatitis or develop independently.EtiologyChronic pancreatitis can arise from a variety of causes:Alcohol use is the leading cause, accounting for 70–80%...
22
Chronic Pancreatitis I: Introduction01:24

Chronic Pancreatitis I: Introduction

897
The pancreas, an elongated and flat gland situated behind the stomach, serves a vital function in digesting food and managing blood sugar levels.
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...
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Chronic Pancreatitis II: Pathophysiology01:21

Chronic Pancreatitis II: Pathophysiology

19
Chronic pancreatitis is a progressive and irreversible inflammation of the pancreas, most often caused by long-term alcohol abuse, but it can also be related to ductal obstruction, smoking, or genetic factors.Chronic pancreatitis occurs when the pancreas is repeatedly exposed to harmful agents like alcohol, smoking, ductal obstruction, or genetic predisposition. These factors lead to the release of toxic metabolites and inflammatory cytokines, sustaining chronic inflammation in the pancreatic...
19

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Sodium Taurocholate Induced Severe Acute Pancreatitis in C57BL/6 Mice
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Current knowledge of hypertriglyceridemic pancreatitis.

Pedro Valdivielso1, Alba Ramírez-Bueno2, Nils Ewald3

  • 1Department of Medicine and Dermatology, University of Malaga, Spain; Servicio de Medicina Interna, Hospital Virgen de la Victoria, Malaga, Spain.

European Journal of Internal Medicine
|October 2, 2014
PubMed
Summary

Severe hypertriglyceridemia (HTG) is a common cause of acute pancreatitis (AP). Identifying patients at risk and establishing clear management guidelines for HTG-induced AP remain critical challenges.

Keywords:
Acute pancreatitisApheresisChylomicronemiaHyperlipidemiaHypertriglyceridemiaPlasmapheresis

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Area of Science:

  • Endocrinology and Metabolism
  • Gastroenterology
  • Lipidology

Background:

  • Severe hypertriglyceridemia (HTG) is a significant cause of acute pancreatitis (AP), accounting for up to 10% of cases.
  • Patients with triglyceride (TG) levels >1000 mg/dL have a 15-20% risk of developing hypertriglyceridemia-induced acute pancreatitis (HTGP-AP).
  • The precise predictors for developing pancreatitis in severe HTG patients are not well-defined.

Purpose of the Study:

  • To review the current understanding of hypertriglyceridemia-induced acute pancreatitis (HTGP-AP).
  • To highlight the pathophysiological mechanisms, clinical features, and management strategies for HTGP-AP.
  • To emphasize the need for standardized international guidelines and further research, particularly randomized controlled trials.

Main Methods:

  • Literature review and synthesis of existing studies on HTG and AP.
  • Analysis of pathophysiological concepts, including lipase hydrolysis, free fatty acid formation, hyperviscosity, and ischemia.
  • Evaluation of current therapeutic interventions and the evidence supporting them.

Main Results:

  • HTGP-AP shares clinical features with other AP etiologies but may present with higher severity and complication rates.
  • Established treatments include dietary changes, antihyperlipidemic agents, insulin, and heparin.
  • Plasmapheresis shows potential benefits, but its impact on morbidity and mortality requires further investigation through controlled trials.

Conclusions:

  • There is a lack of clear evidence identifying which severe HTG patients will develop pancreatitis.
  • Current management strategies lack universally accepted clinical guidelines.
  • An international, multicenter approach is necessary to establish evidence-based guidelines for HTGP-AP management.