Management of severe acute pancreatitis
DOI link for Management of severe acute pancreatitis
Management of severe acute pancreatitis book
Acute pancreatitis is an inflammatory disorder of the pancreas where pancreatic enzymes leak out from the acinar cells to surrounding pancreatic tissues and cause an acute inflammatory response. Severe acute pancreatitis (SAP) accounts for 20% of cases and is associated with organ dysfunction. Hospital mortality in patients with infected pancreatic necrosis is threefold higher than without infected necrosis. Severity criteria are divided into gallstone and non-gallstone pancreatitis. Inflammation of the pancreas can cause diaphragmatic splinting, pleural effusions and acute lung injury. Patients will become hypoxic, often develop respiratory failure and require invasive respiratory support with intubation and ventilation. Careful fluid management guided using intensive haemodynamic monitoring is a reason to admit to intensive care unit. Patients may also require cardiovascular support with vasopressors such as noradrenaline, especially if peripherally dilated and septic. Renal failure is common and hourly monitoring of urine output is essential.