Zusammenfassung
Grundlagen
Die klinischen Symptome der akuten Pankreatitis sind häufig charakteristisch und diagnoseweisend.
Methodik
Die folgende Übersicht behandelt die klinischen Aspekte der akuten Pankreatitis.
Ergebnisse
Seit Einführung der Serumamylasebestimmung in die klinische Routine 1929, liegt die Treffsicherheit der Diagnose bei 80 bis 90% in den ersten 24 Studen.
Schlußfolgerungen
Die korrekte Einschätzung des Schweregrades der Erkrankung oder die Vorhersage der während ihres Verlaufs auftretenden Komplikationen ist weit schwieriger als die Stellung der Diagnose akute Pankreatitis.
Summary
Background
The clinical symptoms and signs of acute pancreatitis are often characteristic and suggest the correct diagnosis.
Methods
The following review outlines the clinical aspects of acute pancreatitis.
Results
Since routine serum measurements of amylase activity were established in 1929, the diagnostic accuracy has risen to 80 to 90% within the first 24 hours.
Conclusions
A correct clinical evaluation of the severity of an episode of pancreatitis or the prediction of complications during its course has been found to be considerably more difficult than the initial diagnosis of the disease.
Literatur
Blackstone MO: Can alcohol cause true acute pancreatitis? Gastroenterology 1990;99:1544–1546.
Acosta JL, Ledesma CL: Gallstone maigration as a cause for acute pancreatitis. N Engl J Med 1974:290:484–487.
Opie EL: The etiology of acute hemorrhagic pancreatitis. Johns Hopkins Hosp Bull 1901;12:182–188.
Lerch MM, Saluja AK, Dawra R, Ramarao P, Saluja M, Steer ML: Acute necrotizing pancreatitis in the opossum: earliest morphologic changes involve acinar cells. Gastroenterology 1992;103:205–213.
Lerch MM, Saluja AK, Rünzi M, Dawra R, Saluja M, Steer ML: Pancreatic duct obstruction triggers acute necrotizing pancreatitis in the opossum. Gastroenterology 1993;104:853–861.
Hernandez CA, Lerch MM: Sphincter stenosis and gallstone migration through the biliary tract. Lancet 1993;341:1371–1373.
Lerch MM, Weidenbach H, Hernandez CA, Preclik G, Adler G: Pancreatic outflow obstruction as the critical event for human gallstone-induced pancreatitis. Gut 1994;35:1501–1503.
Opie EL: The relation of cholelithiasis to disease of the pancreas and to fat-necrosis. Johns Hopkins Hosp Bull 1901;12:19–21.
Lerch MM, Adler G: Acute pancreatitis. Curr Opinion Gastroenterol 1992;8:817–823.
Lerch MM, Hernandez CA, Adler G: Acute pancreatitis. New Engl J Med 1994;331:948–949.
Ros E, Navarro S, Bru C, Garcia-Puges A, Valderrama R: Occult microlithiasis in idiopathic acute pancreatitis: prevention of relapses by cholecystectomy or ursodeoxycholic acid therapy. Gastroenterology 1991;101:1701–1709.
Lee SP, Nicholls JF, Park HZ: Biliary sludge as a cause of acute pancreatitis. N Engl J Med 1992;326:589–593.
Conolly KJ, Allan JD, Fitch H, Jackson-Pope L, McLaren C, Canetta R, Groopman JE: Phase I study of 2′, 3′ dideoxyunosine administered orally twice daily to patients with AIDS or AIDS-related complex and hematologic intolerance to zidovudine. Am J Med 1991;91:471–478.
Dickson AP, Imrie CW: The incidence and prognosis of body wall ecchymosis in acute pancreatitis. Surg Gynecol Obstet 1984;159:343–347.
Cullen TS: A new sign in ruptured extrauterine pregnancy. Am J Obstet 1918;7:457.
Mullin GT, Caperton EM, Crespin EM: Arthritis and skin lesions resembling erythema nodosum in pancreatic disease. Ann Int Med 1968;68:87–92.
Purtscher O: Noch unbekannte Befunde nach Schädeltrauma. Vers Dtsch Ophthalmol Ges 1910;36:294–301.
Mautner RK, Siegel LA, Giles TD, Kayser J: Electrocardiographic changes in acute pancreatitis. South Med J 1982;75:317–320.
Lefer AM, Barenholz Y: Pancreatic hydrolases and the formation of a myocardial depressant factor in shock. Am J Physiol 1972:223:1103–1109.
Rothermilch NO, von Hamm E: Pancreatic enzephalopathy. J. Clin Endocrin 1941;1:873–881.
Lerch MM, Riehl J, Buechsel R, Kierdorf H, Winkeltau G, Matern S: Bedside ultrasound in the decision making for emergency surgery—its role in medical intensive care patients. Am J Emerg Med 1992;10:35–38.
Beger HG, Krautzberger W, Bittner R, Büchler M, Block, S: Bacterial contamination of pancreatic necrosis. A prospective clinical study. Gastroenterology 1986;91:433–438.
Beger HG, Uhl W: Severe pancreatitis. The surgical approach. Clin Int Care 1990;1:223–227.
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Lerch, M.M., Schmid, R. Klinik der akuten Pankreatitis. Acta Chir Austriaca 27, 186–189 (1995). https://doi.org/10.1007/BF02616519
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DOI: https://doi.org/10.1007/BF02616519