Pancreatic Necrosis: A Challenging Complication of Acute Pancreatitis

Singh, Mastan; Kathuria, Sachin; Saxena, Ashish; Kumar, L Ananada; Jain, Saurabh; Rasool, Shahnawaz

doi:10.15406/icpjl.2018.06.00146

Cited by 3 publications

(4 citation statements)

References 39 publications

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“…Initial clinical response to pancreatitis is SIRS which can develop in sepsis with MODS. SIRS usually happen in the first week and its progression is a critical step in the prognosis of AP [16]. Most of our patients had SIRS score two or more (95%) and 45% had SIRS score 3 and 4 at the time of admission.…”

Section: Disscusionmentioning

confidence: 66%

The role of interleukin-4 and interleukin-5 Th2 cytokines in assessing severity and prognosis of acute pancreatitis

Doklestić

Ivančević

Lončar³

et al. 2021

Srp Arh Celok Lek

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Introduction/Objective. Acute pancreatitis (AP) is relatively common disease which in most patients has favorable course. However, in approximately 20% patients, the course of the disease is more severe with high mortality (40-50%). The evaluation of disease severity is now primarily based on protocols that includes clinical, laboratory, and radiographic diagnostic procedures, APACHE II score, Ranson score, CT index, and CT necrosis score. Key cells in the immunopathogenesis of AP are T-lymphocytes, and recent studies indicate the role of Th2 and their effector cytokines: interleukin (IL) -4 and: interleukin (IL) -5. The purpose of our study was to determine the potential clinical value of IL-4 and IL-5 as biochemical markers for predicting development of severe, necrotizing form of acute pancreatitis with systemic complication such as systemic inflammatory response syndrome (SIRS). Methods. This prospective study included 240 patients hospitalized at The Clinic for Emergency Surgery of Clinical Center of Serbia as AP. Levels of IL-4 and IL-5 in serum were detected using commercial Bender Med Systems (BMS716FF) kits. Results. IL-4 and IL-5 were statistically significant increased on the second day of hospitalization with maximum values on the third day. In patients with severe AP complicated with necrosis and/or sepsis values were rising all through the seventh day. Conclusion. Levels of IL-4 and IL-5 in peripheral blood correlate with SIRS, Ranson score and clinical outcome in AP patients, therefore these cytokines are potential early biomarkers of disease progression and related complications.

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Section: Disscusionmentioning

confidence: 66%

The role of interleukin-4 and interleukin-5 Th2 cytokines in assessing severity and prognosis of acute pancreatitis

Doklestić

Ivančević

Lončar³

et al. 2021

Srp Arh Celok Lek

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“…26 Severe systemic inflammatory processes that occur in acute pancreatitis with infection can also result in multiorgan damage, including acute prerenal renal failure, which require dialysis. 27 In this case, complications were found in PFC infection form and pancreatic necrotic tissue, which caused sepsis and AKI, so the patient performed dialysis three times. Peripancreatic pseudocyst with increasing size was also found based on CT-scan result, SIRS sign with the source of subdiaphragmatic abscess infection, and colon perforation that causes generalized peritonitis and fistulation within pseudocysts PFC with colon enerdesendes and flexural lienalis.…”

Section: Discussionmentioning

confidence: 84%

“…Severe Acute Pancreatitis Caused by Gallstones in a Young Adult Several complications varying from mild to severe can occur in patients with acute pancreatitis. Complications that can generally occur can be classified into infective complications, vascular complications, gastrointestinal complications, and organ failure complications due to SIRS (Sethi & Godhi, 2018;Singh et al, 2018). Peripancreatic fluid accumulation and pseudocyst formation are typical in acute pancreatitis.…”

Section: Discussionmentioning

confidence: 99%

Severe Acute Pancreatitis Caused by Gallstones in a Young Adult

Maimunah

Ramafita

2021

InaJGHE

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Acute pancreatitis is a pancreatic exocrine disorder consisting of various degrees of inflammation and is correlated with the parenchymal gland's damage due to auto-digestion of pancreatic enzymes. One of the causes of acute pancreatitis is gallstones. Acute pancreatitis has a typical clinical picture of abdominal pain with sedentary and blunt characteristics located in the epigastrium or periumbilical and often radiates to the back or chest, waist, and lower abdomen. Here presented a case of a 20-year-old male diagnosed with severe acute pancreatitis caused by gallstones who experienced various complications including acute necrotizing pancreatitis, colon perforation that caused generalized peritonitis and fistulation, as well as sepsis. The patient felt the main complaints, including intermittent abdominal pain, decreased appetite, nausea, and weakness. The treatment given is adequate conservative therapy and surgery for fluid and abscesses drainage, correction of fistulations, and perforation of hollow organs.

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“…Severe acute pancreatitis leads to pancreatic necrosis in 15-25% of patients with acute pancreatitis. As such, it represents one of the most severe complications of severe acute pancreatitis with a mortality rate of 20-30% [57].…”

Section: The Clinical Relevance Of This Diagnostic Test Accuracy Reviewmentioning

confidence: 99%

The Evaluation of Inflammatory Biomarkers in Predicting Progression of Acute Pancreatitis to Pancreatic Necrosis: A Diagnostic Test Accuracy Review

Riaz

Islam²,

Rasheed

et al. 2022

Healthcare

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Acute pancreatitis is the acute inflammation of the pancreas; 30% of cases may progress to pancreatic necrosis. The aim of this study was to assess the diagnostic accuracy of inflammatory biomarkers (C-reactive protein (CRP), procalcitonin (PCT), and lactate dehydrogenase (LDH)) in detecting pancreatic necrosis in adults with confirmed acute pancreatitis within 14 days of symptom onset and without organ failure. A systematic search was conducted across the Cumulative Index of Nursing and Allied Health (CINAHL), Cochrane, Embase, PubMed, and Web of Science until May 30, 2022, with the following keywords: acute disease, biomarkers, C-reactive protein, calcitonin, differential, diagnosis, lactate dehydrogenase, pancreatitis, acute necrotizing, necrosis, sensitivity, specificity. Statistical analysis was conducted in RevMan 5.4.1 (Cochrane). Five studies pooling 645 participants were included of which 59.8% were males, with a mean age of 49 years. CRP was the best cutoff at 279 mg/L (χ2 = 47.43, p < 0.001), followed by 200 mg/L (χ2 = 36.54, p < 0.001). LDH was cut off at 290 units/L (χ2 = 51.6, p < 0.001), whereas PCT did not display the most reliable results at 0.05 ng/mL. Inflammatory biomarkers are scalable diagnostic tools that may confer clinical value by decreasing the mortality of acute pancreatitis sequelae.

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Pancreatic Necrosis: A Challenging Complication of Acute Pancreatitis

Cited by 3 publications

References 39 publications

The role of interleukin-4 and interleukin-5 Th2 cytokines in assessing severity and prognosis of acute pancreatitis

The role of interleukin-4 and interleukin-5 Th2 cytokines in assessing severity and prognosis of acute pancreatitis

Severe Acute Pancreatitis Caused by Gallstones in a Young Adult

The Evaluation of Inflammatory Biomarkers in Predicting Progression of Acute Pancreatitis to Pancreatic Necrosis: A Diagnostic Test Accuracy Review

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