Emphysematous Pancreatitis in the Elderly

Su, Yu‐Jang; Lai, Yen‐Chun; Chou, Chin-Yao; Yang, Hsiu‐Wu; Chang, Chen‐Wang

doi:10.1016/j.amjms.2020.03.007

Cited by 5 publications

(8 citation statements)

References 18 publications

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“…AP may result from bile duct or gallstone-related pancreatitis, a recent history of alcohol abuse or consumption, usage of some medications, hypertriglyceridemia, extracorporeal shock wave lithotripsy, post-endoscopic retrograde cholangiopancreatography (ERCP), genetic causes, trauma that causes pancreatic duct injury, hypercalcemia, and infections; idiopathic factors have also been hypothesized to cause AP[ 1 , 8 , 9 ]. COVID-19-AP has been associated with a significant increment (2.5-fold) in the incidence of idiopathic pancreatitis compared to patients without COVID-19.…”

Section: Etiologies Of Non-covid-19 Related and Covid-19-related Apmentioning

confidence: 99%

“…Comparison of the symptoms of patients with AP with and without COVID-19 revealed major differences in the rates of fever (63%) and respiratory symptoms (40%) (Table 1 ). The typical symptoms of AP include fever, epigastric abdominal pain, nausea, vomiting, diarrhea, or shock[ 8 , 22 ]. We found the majority of COVID-19 patients with AP suffered respiratory symptoms.…”

Section: Symptoms Of Covid-19-related Apmentioning

confidence: 99%

“…General principles including nil by mouth are always suggested to prevent the release of inflammatory mediators after ingestion for AP; in addition to pain control and nutritional support, fluid supplementation is the main component of therapy[ 8 ]. If necrotic gas-forming changes or hemorrhage occur, then curettage of the necrotic tissues is necessary.…”

Section: Management Of Covid-19-related Apmentioning

confidence: 99%

“…If necrotic gas-forming changes or hemorrhage occur, then curettage of the necrotic tissues is necessary. The surgical treatment strategy includes early administration of antibiotics and percutaneous drainage of collected fluid, followed by surgical resection of the infected necrotic tissue[ 8 ]. Gas-forming bacteria may reach the pancreatic bed via the bloodstream, lymphatic channels, fistula of the nearby bowel, translocate from the transverse colon, or reflux via the opening of the ampulla of Vater[ 1 ].…”

Section: Management Of Covid-19-related Apmentioning

confidence: 99%

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Surgical intervention for acute pancreatitis in the COVID-19 era

Su¹,

Chen²

2022

World J Clin Cases

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Approximately 15%-19% of patients with severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infections develop gastrointestinal symptoms. Acute pancreatitis (AP) has been reported in 0.1% of patients with coronavirus disease 2019 (COVID-19). Biliary AP was most common (78.4%) before the COVID-19 pandemic; idiopathic AP is most common in patients with COVID-19 (up to 57.1%). The number of emergency department presentations decreased by 23.3% during the pandemic and many governments made national recommendations to delay nonurgent endoscopic procedures, leading to decrements of 22% in combined esophagogastroduodenoscopy (EGD) and colonoscopy and 20% in EGD after the COVID-19 pandemic. The symptoms and signs of COVID-19-related AP are fever (63%), abdominal pain (58%), respiratory symptoms (40%), nausea and vomiting (39%), and headache (4%). Approximately 5-10% of patients develop necrotizing or hemorrhagic AP, and patients who required surgical intervention had a higher mortality risk. Compared to 2019, the rates of elective surgery decreased by 41.8% in 2020; including cholecystectomy (40.1% decrease) and pancreas (111.1% decrease). Surgical volumes also decreased by 18.7% in 2020; device-assisted laparoscopic and robot-assisted procedures reduced by 45.4% and 61.9% during the COVID-19 Lockdown in 2020.

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Section: Etiologies Of Non-covid-19 Related and Covid-19-related Apmentioning

confidence: 99%

Section: Symptoms Of Covid-19-related Apmentioning

confidence: 99%

Section: Management Of Covid-19-related Apmentioning

confidence: 99%

Section: Management Of Covid-19-related Apmentioning

confidence: 99%

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Surgical intervention for acute pancreatitis in the COVID-19 era

Su¹,

Chen²

2022

World J Clin Cases

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“…Consequently, determining the etiology of acute pancreatitis is important for developing a therapeutic strategy, optimizing management protocols, and secondary prevention. A systematic review of 42 articles of on emphysematous pancreatitis found that alcohol was the main cause in nonelderly emphysematous pancreatitis patients, and gallstone was the most common culprit in elderly patients [6]. Retrospective studies in China and Saudi Arabia showed that biliary acute pancreatitis was most commonly seen among elderly patients [3,7].…”

Section: Introductionmentioning

confidence: 99%

Comparative analysis of epidemiology, etiology, and outcomes between elderly and young and middle-aged acute pancreatitis patients: a retrospective, single-center study

Luo²,

Chen³

et al. 2020

European Journal of Gastroenterology &Amp; Hepatology

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Objective The aim of this study was to analyze the etiology and epidemiology of the patients with first-attack acute pancreatitis of two-age groups. Methods This is a retrospective comparative study of 2965 patients aged 18 years and older with first-attack acute pancreatitis between 2013 and 2018 in the Affiliated Hospital of Southwest Medical University. Patients divided into the elderly group (age > or = 60 years) and the young and middle-aged group (age <60 years). The etiology tendency and clinical characteristics were analyzed. Results In the elderly group, the proportions of women to men was higher compared with the young and middle-aged group (1.48 vs. 0.69, P < 0.001). The primary etiology of acute pancreatitis in two groups were biliary tract diseases. The main etiology of the young and middle-aged group among men was alcohol and among women was biliary disease. Comparing with the young and middle-aged group, the elderly patients had a higher proportion of hypertension, ischemic heart disease, and cerebrovascular disease (P < 0.001). Meanwhile, the proportions of system inflammatory reaction syndrome, multiple organ dysfunction syndrome (MODS), and shock were also higher in the elderly group (P < 0.001). Mortality in the elderly group and the young and middle-aged group was 1.69 and 0.72%, respectively. Conclusions Biliary tract diseases were the predominant etiological factor in two groups. The two groups had different etiological proportions according to gender, complications, comorbidities, and outcomes. Furthermore, elderly patients are more likely to with complications, comorbidities, and highly mortality rate. We should pay more attention to realize the characteristics of acute pancreatitis at different ages.

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Construction and validation of a nomogram for predicting survival in elderly patients with severe acute pancreatitis: a retrospective study from a tertiary center

Zhu,

Lu,

Ling

et al. 2024

BMC Gastroenterol

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Purpose There is a lack of adequate models specifically designed for elderly patients with severe acute pancreatitis (SAP) to predict the risk of death. This study aimed to develop a nomogram for predicting the overall survival of SAP in elderly patients. Methods Elderly patients diagnosed with SAP between January 1, 2017 and December 31, 2022 were included in the study. Risk factors were identified through least absolute shrinkage and selection operator regression analysis. Subsequently, a novel nomogram model was developed using multivariable logistic regression analysis. The predictive performance of the nomogram was evaluated using metrics such as the receiver operating characteristic curve, calibration curve, and decision curve analysis (DCA). Results A total of 326 patients were included in the analysis, with 260 in the survival group and 66 in the deceased group. Multivariate logistic regression indicated that age, respiratory rate, arterial pH, total bilirubin, and calcium were independent prognostic factors for the survival of SAP patients. The nomogram demonstrated a performance comparable to sequential organ failure assessment (P = 0.065). Additionally, the calibration curve showed satisfactory predictive accuracy, and the DCA highlighted the clinical application value of the nomogram. Conclusion We have identified key demographic and laboratory parameters that are associated with the survival of elderly patients with SAP. These parameters have been utilized to create a precise and user-friendly nomogram, which could be an effective and valuable clinical tool for clinicians.

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Emphysematous Pancreatitis in the Elderly

Cited by 5 publications

References 18 publications

Surgical intervention for acute pancreatitis in the COVID-19 era

Surgical intervention for acute pancreatitis in the COVID-19 era

Comparative analysis of epidemiology, etiology, and outcomes between elderly and young and middle-aged acute pancreatitis patients: a retrospective, single-center study

Construction and validation of a nomogram for predicting survival in elderly patients with severe acute pancreatitis: a retrospective study from a tertiary center

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