Etiology, clinical features and management of acute recurrent pancreatitis

Deng, Yi; Wang, Rui; Wu, Hao; Tang, Chaowei; Chen, Xin Zu

doi:10.1111/1751-2980.12180

Cited by 15 publications

(7 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Patients with recurrent acute pancreatitis do not have continuous pain requiring treatment, clinical evidence of endocrine or exocrine pancreatic insufficiency, or permanent histologic changes such as calcification or fibrosis [25]. Studies suggest that 10–30% of patients with acute pancreatitis develop recurrent acute pancreatitis [1, 26–28].…”

Section: Discussionmentioning

confidence: 99%

The Value of Secretin-Enhanced MRCP in Patients With Recurrent Acute Pancreatitis

Sandrasegaran

Tahir

Barad

et al. 2017

American Journal of Roentgenology

View full text Add to dashboard Cite

OBJECTIVE The purpose of this study is to assess the additional value of secretin-enhanced MRCP over conventional (non–secretin-enhanced) MRCP in diagnosing disease in patients with recurrent acute pancreatitis. MATERIALS AND METHODS A retrospective review of a radiology database found 72 patients with recurrent acute pancreatitis who had secretin-enhanced MRCP and ERCP correlation within 3 months of each other between January 2007 and December 2011. Of these patients, 54 had no history of pancreatic tumor or surgery and underwent MRI more than 3 months after an episode of acute pancreatitis. In addition, 57 age- and sex-matched control subjects with secretin-enhanced MRCP and ERCP correlation and without a diagnosis of recurrent acute pancreatitis or chronic pancreatitis were enrolled as the control group. All studies were anonymized, and secretin-enhanced MRCP images (image set A) were separated from conventional 2D and 3D MRCP and T2-weighted images (image set B). Image sets A and B for each patient were assigned different and randomized case numbers. Two blinded reviewers independently assessed both image sets for ductal abnormalities and group A image sets for exocrine response to secretin. RESULTS There were statistically significantly more patients with recurrent acute pancreatitis with reduced exocrine function compared with patients in the control group (32% vs 9%; p < 0.01) on secretin-enhanced images. Patients with recurrent acute pancreatitis were more likely to have side branch dilation (p = 0.02; odds ratio, 3.6), but not divisum, compared with the control group. Secretin-enhanced images were superior to non–secretin-enhanced images for detecting ductal abnormalities in patients with recurrent acute pancreatitis, with higher sensitivity (76% vs 56%; p = 0.01) and AUC values (0.983 vs 0.760; p < 0.01). CONCLUSION Up to one-third of patients with recurrent acute pancreatitis showed exocrine functional abnormalities. Secretin-enhanced MRCP had a significantly higher yield for ductal abnormalities than did conventional MRI and should be part of the MRCP protocol for investigation of patients with recurrent acute pancreatitis.

show abstract

Section: Discussionmentioning

confidence: 99%

The Value of Secretin-Enhanced MRCP in Patients With Recurrent Acute Pancreatitis

Sandrasegaran

Tahir

Barad

et al. 2017

American Journal of Roentgenology

View full text Add to dashboard Cite

show abstract

“…[ 11 ] Clinical studies assessing the impact of HTG on the severity of AP have also shown conflicting results. [ 15 16 17 18 19 ]…”

Section: Introductionmentioning

confidence: 99%

Clinical Study of 224 Patients with Hypertriglyceridemia Pancreatitis

Zhang

Zhen

et al. 2015

Chinese Medical Journal

View full text Add to dashboard Cite

Background:Hypertriglyceridemia (HTG) is the most common etiology of acute pancreatitis (AP) after alcohol and gallstone-induced disease. Elevation of serum triglyceride (TG) levels to ≥1000 mg/dl in a patient with AP strongly indicates HTG as the cause. The absolute risk of pancreatitis based on serum TG ≤1000 mg/dl has not been clearly defined. The aims of this study were to address the role of elevated TG levels between 500 and 1000 mg/dl in the clinical course of HTG pancreatitis (HTGP); and assess the relationship between the level of serum TG and disease severity.Methods:A total of 224 HTGP patients between 2007 and 2011 were divided into two subgroups. Totally, 122 patients in Group A had serum TG >1000 mg/dl; 102 patients in Group B had maximal TG levels between 500 and 1000 mg/dl accompanied by lactescent serum; 100 patients with biliary AP and 99 patients with alcoholic AP hospitalized during the study period were enrolled as controls. The clinical and biochemical data were analyzed.Results:The clinical presentation of HTG-induced pancreatitis was similar to other causes. Severe form of AP in Group A was higher than Group B (χ2 = 4.002, P = 0.045). The severity with HTGP was significantly higher as compared to biliary AP (χ2 = 33.533, P = 0.000) and alcoholic AP (χ2 = 7.179, P = 0.007). Systemic complications with HTGP were significantly higher than biliary AP (χ2 = 58.763, P = 0.000).Conclusions:The study demonstrated that TG level ≥500 mg/dl should raise a high degree of suspicion, especially if no other etiology of AP is apparent. The severity of HTGP seems to correlate directly with TG level. HTGP seems be more severe than other causes of AP.

show abstract

“…Recently HTG is accepted as a major cause of RAP particularly in China. Deng et al reported that HTG accounted for 21% of RAP and biliary factor was still the leading causes of RAP in a region of China [19]. A multicenter study showed the recurrence rate of HTG-AP was obviously higher than other causes (15.29%, 7.73% and 9.75% for HTG-AP, biliary AP and alcoholic AP respectively) [6].…”

Section: Discussionmentioning

confidence: 99%

Suboptimal management of hypertriglyceridemia in the outpatient setting is associated with the recurrent pancreatitis

Yan

Zhao

Chen

2019

Preprint

View full text Add to dashboard Cite

Background Hyperlipemia is a well-established etiology of acute pancreatitis (AP). However, few data are available in the medical literature about the management of triglyceride levels in the outpatient setting in patients with hypertriglyceridemic acute pancreatitis (HTG-AP). We evaluated the blood triglyceride levels and the follow-up of triglyceride management in patients with HTG-AP.Methods This retrospective study enrolled patients with HTG-AP from January 2013 to March 2019 in Affiliated Hospital of Southwest Medical of University. By reviewing the hospitalization records and the follow-up data, the clinical features, blood triglyceride levels, lipid-lowering medications use and blood triglyceride levels monitoring after hospital discharge were analyzed.Results 133 patients (46 women, 87 men; median age at presentation 37.4 years) diagnosed with HTG-AP were enrolled in the study. 32 cases (24.1%) presented with recurrent acute pancreatitis (RAP). Patients who had RAP were younger and had higher blood triglyceride levels compared with that of single attack ( P < 0.05). No difference of serum amylase levels, hospitalization duration and mortality rate were observed between non-RAP and RAP. Lipid monitoring was only observed in 12.8% of patients and 10 patients(7.5%) took medications to control blood triglyceride levels after hospital discharge. The follow-up of triglyceride levels in the outpatient setting were higher in RAP patients than that of non-recurrent cases ( P < 0.05). Among the patients who had measured their triglyceride levels after discharge, 83.3% of patients with RAP had at least 1 follow-up of triglyceride level that higher than 500 mg/dL, while no patient had one HTG-AP attack displayed triglyceride levels higher than 500 mg/dL.Conclusions Triglyceride levels after hospital discharge higher than 500 mg/dL may be associated with an increasing risk of relapse of clinical acute pancreatitis events. Inappropriate management of triglyceride control in the outpatient setting may be associated with an increasing risk of relapse of clinical HTG-AP events.

show abstract

Etiology, clinical features and management of acute recurrent pancreatitis

Abstract: The etiological factors of ARP are similar to those of acute pancreatitis at the first attack. The management of ARP should be fully considered based on etiological investigation.

Cited by 15 publications

References 29 publications

The Value of Secretin-Enhanced MRCP in Patients With Recurrent Acute Pancreatitis

The Value of Secretin-Enhanced MRCP in Patients With Recurrent Acute Pancreatitis

Clinical Study of 224 Patients with Hypertriglyceridemia Pancreatitis

Suboptimal management of hypertriglyceridemia in the outpatient setting is associated with the recurrent pancreatitis

Contact Info

Product

Resources

About