ABSTRACT
Background: Acute pancreatitis is a pestilent disease with severity ranging from mild and self-limiting to a rapidly progressive illness leading to multi organ failure. Mild acute pancreatitis is inflammation of the pancreas with minimal remote organ involvement. Since the disturbance in the homeostasis is minimal, the treatment aims at supporting the native reparative processes of the body. One of the main supportive mechanisms is adequate nutritional supplementation. Gut barrier damage in the early phase of acute pancreatitis accounts for the bacterial translocation, initiation of sepsis, infected pancreatic necrosis and SIRS. Aim of the study was to determine the feasibility, advantages and disadvantages of early enteral nutrition in mild acute pancreatitis.Methods: 40 patients taken consecutively from units which start enteral feeds before 48 hours (study group) were compared against 40 patients taken consecutively from units where patients will be kept fasting for 48 hours (control group) to determine whether early enteral feeding is better in determining the recovery in terms of duration of hospital stay, reduction in abdominal symptoms and use of analgesics.Results: There was significant reduction in the duration of hospital stay (p=0.011), intensity and duration of abdominal pain, need for analgesics, and risk of oral food intolerance in the study group.Conclusions: Patients with mild acute pancreatitis can safely be started on early enteral feeds. It reduces gastro intestinal adverse effects, abdominal pain and need for analgesics and improves oral food tolerance causing shorter hospital stay.
ABSTRACT
La malformación arterio-venosa (MAV) en el páncreas es una anomalía anatómica poco frecuente que puede ser causa de pancreatitis aguda. Presentamos el caso de un paciente de 46 años cuyo diagnóstico se sospechó por los hallazgos de la tomografía computarizada con contraste endovenoso y por resonancia magnética y se confirmó mediante una arteriografía del tronco celíaco y de la arteria mesentérica superior. El tratamiento recibido fue por vía endovascular, aunque la otra opción válida para el tratamiento de esta enfermedad es la resección quirúrgica. El objetivo de esta comunicación es presentar un caso de pancreatitis aguda por MAV tratada por vía endovascular.
Arteriovenous malformation in the pancreas is a rare anatomic abnormality that may produce acute pancreatitis. The diagnosis was suspected by computed tomography with intravenous contrast and by magnetic resonance imaging and it was confirmed by arteriography of the celiac trunk and superior mesenteric artery. The treatment received was endovascular, although the other valid option for the treatment of this disease is the surgical resection. The objective of this communication is to present a case of acute pancreatitis due to arteriovenous malformation treated by endovascular approach.
Subject(s)
Humans , Male , Middle Aged , Pancreas/blood supply , Pancreatitis/etiology , Arteriovenous Malformations/complications , Pancreatitis/surgery , Pancreatitis/diagnostic imaging , Arteriovenous Malformations/diagnostic imaging , Magnetic Resonance Imaging , Tomography, X-Ray Computed , Acute Disease , Treatment Outcome , Endovascular ProceduresABSTRACT
Objective To evaluate the effect of early non-liquid diet for patients with mild acute pancreatitis by using Meta-analysis. Methods The randomized controlled trials(RCT) on early non-liquid diet intake for patients with mild acute pancreatitis were collected by computer searching the database of China National Knowledge Infrastructure(CNKI),Wanfang Periodical Database,CBM,Elsevier Scien Direct, cochrane library and PubMed from inception to February 2017, and analyzed by RevMan 5.2 software. Results Five RCTs were included in the study.The Results of Meta-analysis revealed that both the length of hospitalization after eating [MD=-1.48,95%CI-2.50~-0.47, P=0.004] and the total length of hospitalization[MD=-1.99,95%CI-(0.99-2.99),P=0.0001]in liquid diet group were less than that of non-liquid diet group,and the differences were statistically significant.There was no significant difference in the rate of the pain recurrence[RR=1.21,95%CI 0.77-1.91,P=0.40]and the rate of the elimination of oral feeding[RR=1.02,95%CI 0.45-2.30,P=0.96]because of pain,nausea or vomiting after refeeding,although all that rate in non-liquid diet was not lower than that of liquid diet group. Conclusions compared with liquid diet,early non-liquid diet intake for mild acute pancreatitis can shorten their hospitalization time, and it cannot be concluded that the non-liquid diet will increase the pain recurrence rate, and most patients have a better tolerance to non-liquid diet,and non-liquid diet can promote rehabilitation.
ABSTRACT
Objective To explore the relationship between serum C level of C-reactive protein and the classification of acute pancreatitis, and to provide reference for clinical diagnosis and treatment.Methods From January 2012 to January 2015, 100 cases of acute pancreatitis in our hospital were divided into light acute pancreatitis (MAP) group and severe acute pancreatitis (SAP) group.The levels of serum CRP were detected by 1, 3, 5, 7, and levels were compared with the patients of two groups.The sensitivity and specificity of ROC were compared with CRP curve.Results The serum levels of CRP in patients with MAP group and SAP group were increased and then decreased, and serum CRP in MAP group was lower than that in SAP group.The levels of serum CRP in pancreatic necrosis group were lower than those in pancreatic necrosis group.The sensitivity and specificity of CRP were improved with the increase of CRP levels.Conclusion Serum CRP levels can be used for early typing of acute pancreatitis, and it has a certain clinical reference value.