[Diagnosis and stage-adapted treatment of acute pancreatitis]

Med Klin Intensivmed Notfmed. 2018 Oct;113(7):593-605. doi: 10.1007/s00063-018-0466-2. Epub 2018 Aug 9.
[Article in German]

Abstract

Acute pancreatitis is a potentially life-threatening disease, which is morphologically classified into interstitial edematous or necrotizing pancreatitis. According to the revised Atlanta classification, mild, moderate and severe clinical courses are differentiated regarding local and systemic complications as well as concomitant organ failure. In the initial disease phase, the therapeutic measures are focused on (aggressive) volume replacement, early enteral nutrition and adequate analgesia. Characteristic in the course of severe acute pancreatitis are abdominal necroses, which require individualized and interdisciplinary treatment with antibiotic therapy, drainage and definitive necrosectomy. Necrosectomy should be planned as a "step-up approach" using interventional-radiological, endoscopic and minimally invasive surgical procedures.

Keywords: Analgesia; Endoscopy; Fluid therapy; Intensive care; Pancreatic diseases.

MeSH terms

  • Drainage
  • Endoscopy
  • Enteral Nutrition
  • Humans
  • Pancreatitis, Acute Necrotizing* / diagnosis
  • Pancreatitis, Acute Necrotizing* / therapy