11 patients aged 24-70, with pancreatitis admitted at Viet Duc Hospital from Jan 1998 to Dec 2002. Ultrasonic examination was carried out and terminated diagnosis was performed surgically, blood level of amylase increased by 3 times versus normal level. The highest incidence level is in the middle age (13/14 patients – 31,7%). Ultrasonic signs characteristic for acute pancreatitis of edematous form is enlarged pancrea with appeared edge, low echo or equal echo of pancrea parenchyma. In necrojy form of acute pancreatitis the pancrea edge is dim, pancrea parenchyma is unregulated with the mixed structure. In 9/41 patients, by ultrasound the pancrea is not appeared. Thus in accessing the pancrea, pancreatitis can be diagnosed with a sensibility of 81,23%
Pancreatitis ; Ultrasonics ; Pancreatitis, Acute Necrotizing

Acute necrotizing pancreatitis accounts for 10% of acute pancreatitis (AP) cases and is associated with a higher mortality and morbidity. Necrosis within the first 4 weeks of disease onset is defined as an acute necrotic collection (ANC), while walled off pancreatic necrosis (WOPN) develops after 4 weeks of disease onset. An infected or symptomatic WOPN requires drainage. The management of pancreatic necrosis has shifted away from open necrosectomy, as it is associated with a high morbidity, to less invasive techniques. In this review, we summarize the current management and therapies for acute necrotizing pancreatitis.
Drainage ; Mortality ; Necrosis ; Pancreatitis* ; Pancreatitis, Acute Necrotizing

Acute Disease ; Humans ; Pancreas ; Pancreatitis ; surgery ; Pancreatitis, Acute Necrotizing

No abstract available.
Acute Kidney Injury* ; Humans ; Pancreatitis*

Acute Disease ; Humans ; Pancreatitis ; therapy

Acute pancreatitis is a common acute abdomen of the digestive system. In recent years,great progress has been made in the diagnosis and treatment concepts,methods and strategies of acute pancreatitis,which plays an important role in promoting the standardization of acute pancreatitis management and improving the level of patient treatment. Based on the previous guidelines and expert consensus,this guideline adopts an evidence-based and problem-oriented presentation in a way. Comprehensive analysis of the data of important domestic and foreign clinical research in the past 5 years,29 recommendations are formed after multi-disciplinary expert discussion which including diagnosis,treatments and follow-up,with the expectation of providing evidence support for clinical practice of acute pancreatitis in China.
Acute Disease ; China ; Consensus ; Humans ; Pancreatitis/therapy*

Gallstones and alcohol consumption are well-known causes of acute pancreatitis, which usually follows a mild and self-limited course. Although extremely rare, hypercalcemia is a possible cause of acute pancreatitis. There are only few reported cases, all of which were mild and self-limited. Here we report a patient with iatrogenic hypercalcemia-induced necrotizing pancreatitis that progressed to serious adverse events such as biliary obstruction, peripancreatic fluid collection with walled-off necrosis, and acute cholecystitis. The patient was successfully treated with appropriate endoscopic and radiologic interventions, and recovered well.
Alcohol Drinking ; Calcium Compounds ; Cholecystitis, Acute ; Gallstones ; Humans ; Hypercalcemia* ; Necrosis ; Pancreatitis ; Pancreatitis, Acute Necrotizing*

Acute Disease ; Combined Modality Therapy ; Humans ; Pancreatitis ; therapy ; Pancreatitis, Acute Necrotizing ; therapy

The management of pancreatitis remained controversial over the past decades, varying from conservative medical treatment to surgical treatment. However, in recent years, treatment of severe acute pancreatitis is shifting from an early surgical debridement and necrosectomy to an aggressive intensive medical care. While the treatment is conservative in the earlier phase of the disease, surgery might be considered in the later phase. In chronic pancreatitis and in pancreatic pseudocyst, various surgical approaches are available these days. Apart from the conventional open surgery, laparoscopic procedure became popular since it is minimally invasive and effective. In addition, with the great improvements in interventional radiology and endoscopic techniques, multidisciplinary approaches including medical, interventional, and surgical management become much more important in the proper treatment of pancreatitis. In this review, pancreatitis is classified into three categories (acute pancreatitis, chronic pancreatitis, and pancreatic pseudocyst) for convenience, and the surgical treatment is described in each category.
Acute Disease ; English Abstract ; Humans ; Pancreatic Pseudocyst/surgery ; Pancreatitis/*surgery ; Pancreatitis, Chronic/surgery

Pancreatic inflammatory disease can be classified as acute pancreatitis (AP) and chronic pancreatitis (CP) primarily by clinical criteria, with an obvious difference by restoration of normal function in the former or by permanent residual damage in the latter. Gallstones and alcohol are the most common causes of AP. Recent investigations have established that AP from all cause may disrupt normal stimulus-secretion coupling function within the acinar cell. This disruption within the acinar cell leads to an event termed 'co-localization' in which the digestive and lysosomal enzymes merge resulting in a premature activation of proteases. The mechanisms of inflammatory cells which adhere to endothelial cell are determined by a variety of mediators of cytokines released at the site of tissue damage. Cytokines hold the key for both local and systemic inflammatory response in AP. Besides, CP is a debilitating disease characterized by progressive and irreversible destruction of pancreatic tissue leading to exocrine and endocrine insufficiencies. Alcohol intake is the most common cause of CP. Mutations in the cationic trypsinogen gene were identified as causative gene for hereditary pancreatitis. The recognition of frequent cystic fibrosis transmembrane conductance regulator (CFTR) mutations and serine protease inhibitor, Kazal type 1 (SPINK1) mutations in idiopathic CP has hightened the awareness of importance of genetic mutations in CP. Pancreatic stellate cells represent the main cellular source of extracellular matrix in CP and play a key role in pancreatic fibrosis.
Acute Disease ; English Abstract ; Humans ; Pancreatitis/*etiology/physiopathology ; Pancreatitis, Chronic/etiology/physiopathology