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Acute Pancreatitis

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Pancreas and Biliary Disease

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Abstract

Acute pancreatitis (AP) is an inflammatory disorder of the pancreas that can result in a moderately severe or severe disease with high morbidity and/or mortality. Gall stones and alcohol account for nearly 70 % of the cases. Local complications include acute peripancreatic fluid collections and acute necrotic collections that can evolve into pseudocyst and walled off necrosis respectively. Persistent organ failure and presence of local complications are associated with higher mortality and morbidity. Currently there is no effective tool to predict severity of the disease at the onset of illness. The Revised Atlanta Classification classifies AP into three groups—mild with no local complications or organ failure, moderately severe with local complications and/or transient organ failure, and severe with persistent organ failure. While there is no targeted treatment for AP, management is focused at providing support for organ failure and at treating complications. Aggressive intravenous hydration is essential in the initial 12–24 h that can significantly alter the outcome of AP. Enteral feeding to prevent infectious complications is necessary in AP. Infected necrosis is associated with high mortality and requires minimally invasive routes of intervention in the majority of patients. With aggressive management, 70–80 % patients with AP require brief hospitalization and improve quickly. However, 15–30 % patients go on to develop moderately severe or severe disease with high rate of mortality. Advances in understanding the pathogenesis of AP, development of effective prediction strategies, and targeted therapeutic options (drugs) can lead to further improvement in the outcomes in AP.

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Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Raghuwansh P. Sah & Santhi Swaroop Vege M.D.

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  1. Raghuwansh P. Sah
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  2. Santhi Swaroop Vege M.D.
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Correspondence to Santhi Swaroop Vege M.D. .

Editor information

Editors and Affiliations

  1. Division of Gastroenterology & Hepatology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA

    Kulwinder Dua

  2. Division of Gastroenterology & Hepatology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA

    Reza Shaker

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© 2016 Springer International Publishing Switzerland

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Sah, R.P., Vege, S.S. (2016). Acute Pancreatitis. In: Dua, K., Shaker, R. (eds) Pancreas and Biliary Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-28089-9_2

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  • DOI: https://doi.org/10.1007/978-3-319-28089-9_2

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-28087-5

  • Online ISBN: 978-3-319-28089-9

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