Abstract
The diagnosis of acute pancreatitis is based on clinical symptoms and signs as well as on increases of serum concentrations of amylase or lipase. Major increases of serum pancreatic enzymes (more than three- to fivefold of the upper normal limit) almost prove the diagnosis of acute pancreatitis in particular when the patient presents with a typical clinical picture. The diagnosis may be further supported by imaging procedures such as ultrasound and computed tomography (CT). However, these imaging techniques as well as all the further laboratory and technical measurements are not needed to confirm the diagnosis but are done in order to assess the severity of pancreatitis and its prognosis.
Keywords
Acute Pancreatitis Surgical Patient Medical Patient Severe Acute Pancreatitis Septic Complication
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References
- 1.Balthazar EJ, Robinson DL, Megibow AJ, Ranson JHC (1990) Acute pancreatitis: values of CT in establishing prognosis. Radiology 174:331–336PubMedGoogle Scholar
- 2.Beger HG, Bittner R, Block S, Büchler M (1986) Bacterial contamination of pancreatic necrosis. Gastroenterology 91:433–438PubMedGoogle Scholar
- 3.Block S, Maier W, Bittner R, Büchler M, Malfertheiner P, Beger HG (1986) Identification of pancreas necrosis in severe acute pancreatitis: imaging procedures versus clinical staging. Gut 27:1035–1042PubMedCrossRefGoogle Scholar
- 4.Büchler M, Malfertheiner P, Schoetensack C, Uhl W, Beger HG (1986) Sensitivity of antiproteases, complement factors and C-reactive protein in detecting pancreatic necrosis. Results of a prospective clinical study. Int J Pancreatol 1:227–235PubMedGoogle Scholar
- 5.Büchler M, Malfertheiner P, Uhl W, Beger HG (1987) C-reaktives Protein als Entzündungs- und Nekrosemarker in der Gastroenterologie. Med Klin 82: 180–185Google Scholar
- 6.Büchler M, Malfertheiner P, Schädlich H, Nevalainen TJ, Friess H, Beger HG (1989) Role of phospholipase A2 in human acute pancreatitis. Gastroenterology 97:1521–1526PubMedGoogle Scholar
- 7.Geokas MC, Rinderknecht H, Walberg CB, Weissmann R (1974) Methemalbumin in the diagnosis of acute hemorrhagic pancreatitis. Ann Intern Med 81:483–486PubMedGoogle Scholar
- 8.Groß V, Schölmerich J, Leser HG, Salm R, Lausen M, Rückauer K, Schöffel U, Lay L, Heinisch A, Farthmann EH, Gerok W (1990) Granulocyte elastase in assessment of severity of acute pancreatitis. Comparison with acute phase proteins C-reactive protein, alpha1-antitrypsin, and protease inhibitor alpha2- macroglobulin. Dig Dis Sci 35:97–105PubMedCrossRefGoogle Scholar
- 9.Gudgeon AM, Hurley P, Patel G, Shenkin A, Imrie CW, Heath DI, Jehanli A, Wilson C, Austen BM, Hermon-Taylor J (1990) Trypsinogen activating peptides assay in the early prediction of severity of acute pancreatitis. Lancet 335:4–8PubMedCrossRefGoogle Scholar
- 10.Hjelmqvist B, Wattsgard C, Borgström A, Lasson A, Nyman U, Aspelin P, Ohlsson K (1989) Early diagnosis and classification in acute pancreatitis. Digestion 44:177–183PubMedCrossRefGoogle Scholar
- 11.Imrie CW (1974) Observation in acute pancreatitis. Br J Surg 61:539–544PubMedCrossRefGoogle Scholar
- 12.Kanus WA, Zimmermann JE, Wagner DP, Draper EA, Lawrence DE (1981) Apache - acute physiology and chronic health evaluation: a physiologically based classification system. Crit Care Med 9:591–597CrossRefGoogle Scholar
- 13.Knaus WA, Draper EA, Wagner DP, Zimmermann JE (1985) Apache II: a severity of disease classification system. Crit Care Med 13:818–829PubMedCrossRefGoogle Scholar
- 14.Lankisch PG, Schirren CA (1990) Increased body weight as a prognostic parameter for complications in the course of acute pancreatitis. Pancreas 5: 626–629PubMedCrossRefGoogle Scholar
- 15.Larvin M, McMahaon MJ (1989) Apache-II score for assessment and monitoring of acute pancreatitis. Lancet ii:201–204Google Scholar
- 16.Le Gall JR, Loirat P, Alperovitch A (1984) A simplified acute physiology score for ICU patients. Crit Care Med 12:975–977PubMedCrossRefGoogle Scholar
- 17.McMahon MJ, Playforth MJ, Pickford IR (1980) A comparative study of methods for the prediction of severity of attacks of acute pancreatitis. Br J Surg 67:22–25PubMedCrossRefGoogle Scholar
- 18.Mayer AD, McMahon MJ, Bowen M, Cooper EH (1984) C-reactive protein: an aid to assessment and monitoring of acute pancreatitis. J Clin Pathol 27:207–211CrossRefGoogle Scholar
- 19.Osborne DH, Imrie CW, Carter DC (1981) Biliary surgery in the same admission for gallstone-associated acute pancreatitis. Br J Surg 68:758–761PubMedCrossRefGoogle Scholar
- 20.Poulakkainen P, Valtonen V, Paananen A, Schröder T (1987) C-reactive protein (CRP) and serum phospholipase A2 in the assessment of the severity of acute pancreatitis. Gut 28:764–771CrossRefGoogle Scholar
- 21.Ranson JHC, Spencer FC (1978) The role of peritoneal lavage in severe acute pancreatitis. Ann Surg 187:565–575PubMedCrossRefGoogle Scholar
- 22.Ranson JHC, Rifkind KM, Roses DF (1974) Prognostic signs and the role of operative management in acute pancreatitis. Surg Gynecol Obstet 139:69–81PubMedGoogle Scholar
- 23.Ranson JHC (1979) The timing of biliary surgery in acute pancreatitis. Ann Surg 189:654–663PubMedCrossRefGoogle Scholar
- 24.Renner IG, Savage WT, Pantoja JL, Renner VJ (1985) Death due to acute pancreatitis: a retrospective analysis of 405 autopsy cases. Dig Dis Sci 10: 1005–1018CrossRefGoogle Scholar
- 25.Schölmerich J, Johannesson T, Brobmann G, Wimmer B, Thiedemann B, Groß V, Gerok W, Farthmann EH (1989) Die Sonographie bei akuten Pankreatitis- Diagnose, Ätiologieklärung und Prognoseabschätzung. Ultraschall 10:290–294CrossRefGoogle Scholar
- 26.Wilson C, Heath DI, Imrie CW (1990) Prediction of outcome in acute pancreatitis: a comparative study of Apache-II, clinical assessment and multiple factor scoring systems. Br J Surg 77:1260–1264PubMedCrossRefGoogle Scholar
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