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1.
Bol. méd. Hosp. Infant. Méx ; 80(5): 296-301, Sep.-Oct. 2023. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1527954

ABSTRACT

Abstract Background: The use of pancreatic prostheses in children with acute recurrent pancreatitis (ARP) and chronic pancreatitis (CP) has evolved. The main established indication is the treatment of persistent abdominal pain. This study aimed to evaluate the efficacy of pancreatic stenting for refractory abdominal pain in pediatric patients with ARP and CP. Methods: We conducted a retrospective case series study. We included patients under 16 years of age diagnosed with ARP and CP in the study. Endoscopic retrograde cholangiopancreatography (ERCP) was performed with the insertion of one and later two pancreatic stents. We evaluated abdominal symptoms before and after treatment, number of changes, duration of treatment, and complications with follow-up at 24 months and after withdrawal. Results: Nine patients with ARP and CP were included in the study: six with undetermined etiology and three with pancreas divisum. The mean age was 12.4 years. Prosthesis placement relieved abdominal pain in 100% of cases, with 3.2 replacement sessions every 6.2 months for 27.4 months, and mild complications (15.7%). One patient experienced pain on removal of the prosthesis and required bypass surgery. Conclusion: Pancreatic stent placement in patients with refractory abdominal pain with ARP and CP proved to be effective and safe, providing medium-term symptom relief and minimal complications.


Resumen Introducción: El uso de prótesis pancreáticas en niños con pancreatitis aguda recurrente (PAR) y crónica (PC) ha evolucionado. La principal indicación establecida es el tratamiento del dolor abdominal persistente. El objetivo de este estudio fue evaluar la eficacia del uso prótesis pancreática para el dolor abdominal refractario en pacientes pediátricos con PAR y PC, sin respuesta a manejo conservador. Métodos: Se llevó a cabo un estudio retrospectivo de serie de casos. Se incluyeron pacientes menores de 16 años con diagnóstico de PAR y PC. Se realizó una colangio pancreatografía retrograda endoscópica (CPRE) para introducir inicialmente una y posteriormente dos prótesis pancreáticas. Se evaluaron síntomas abdominales antes y después del tratamiento, número de recambios, duración del tratamiento y complicaciones con seguimiento a 24 meses y posterior a su retiro. Resultados: Se incluyeron 9 pacientes con PAR y PC: seis de etiología no determinada y tres con páncreas divisum. La edad promedio fue de 12.4 años. La colocación de prótesis alivió el dolor abdominal en el 100%, con 3.2 sesiones de recambio cada 6.2 meses en 27.4 meses, y complicaciones leves (15.7%). Un paciente presentó dolor al retirar las prótesis y requirió cirugía derivativa. Conclusiones: El uso de prótesis pancreática en pacientes con dolor abdominal refractario con PAR y PC demostró ser eficaz y seguro al aliviar los síntomas a mediano plazo con mínimas complicaciones.

2.
Actual. osteol ; 19(2): 160-166, sept. 2023. ilus, tab
Article in Spanish | LILACS, UNISALUD, BINACIS | ID: biblio-1525671

ABSTRACT

Introducción: describir el caso de un paciente con pancreatitis aguda secundaria a hipercalcemia por hiperparatiroidismo prImario. Esta es una causa poco frecuente de pancreatitis, asociada a morbimortalidad significativa en caso de no ser diagnosticada oportunamente Caso clínico: un hombre de 44 años, con antecedente de pancreatitis de presunto origen biliar que había requerido previamente colecistectomía, consultó por dolor abdominal y náuseas. Los estudios complementarios fueron compatibles con un nuevo episodio de pancreatitis aguda. Presentaba hipercalcemia y hormona paratiroidea (PTH) elevada, configurando hiperparatiroidismo primario. La gammagrafía informó hallazgos compatibles con adenoma paratiroideo. Se inició tratamiento con reanimación hídrica y analgesia con adecuada disminución de calcio sérico y resolución de dolor abdominal. Después de la paratiroidectomía se logró normalizar los niveles de calcio y PTH. Discusión: la pancreatitis aguda es una condición potencialmente fatal, por lo que la sospecha de causas poco frecuentes como la hipercalcemia debe tenerse en cuenta. El tratamiento de la hipercalcemia por adenoma paratiroideo se basa en reanimación hídrica adecuada y manejo quirúrgico del adenoma, con el fin de evitar recurrencia de pancreatitis y mortalidad. (AU)


Introduction: we describe the case of a patient with acute pancreatitis secondary to hypercalcemia due to primary hyperparathyroidism. This is a rare cause of pancreatitis associated with significant morbidity and mortality if not diagnosed in time. Clinical case: a 44-year-old man with a history of pancreatitis of presumed biliary origin, which had previously required cholecystectomy, consulted for abdominal pain and nausea. The laboratory findings were compatible with a new episode of acute pancreatitis. He presented hypercalcemia and an elevated parathyroid hormone (PTH), configuring primary hyperparathyroidism. Scintigraphy was performed, yielding findings compatible with parathyroid adenoma. Treatment with fluid resuscitation and analgesia was started, resulting in an adequate decrease in serum calcium and resolution of abdominal pain. After parathyroidectomy, calcium and PTH levels were normalized. Discussion: acute pancreatitis is a potentially fatal condition; therefore the suspicion of rare causes, such as hypercalcemia, should be considered. The treatment of hypercalcemia due to parathyroid adenoma is based on adequate fluid resuscitation and surgical management of the adenoma, to avoid recurrence of pancreatitis and death. (AU)


Subject(s)
Humans , Male , Adult , Pancreatitis/etiology , Parathyroid Neoplasms/diagnostic imaging , Hyperparathyroidism, Primary/diagnostic imaging , Hypercalcemia/etiology , Pancreatitis/prevention & control , Parathyroid Neoplasms/surgery , Parathyroid Neoplasms/complications , Radionuclide Imaging , Technetium Tc 99m Sestamibi , Hyperparathyroidism, Primary/complications , Hypercalcemia/blood , Hypercalcemia/therapy
3.
Gac. méd. Méx ; 159(4): 345-351, jul.-ago. 2023. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1514135

ABSTRACT

Resumen Antecedentes: El ácido ursólico se encuentra en numerosas plantas y se ha informado que tiene efectos antiproteasas, antioxidantes, antiinflamatorios, antimicrobianos, nefroprotectores, hepatoprotectores y cardioprotectores. Objetivo: Este estudio tuvo como objetivo investigar los efectos del ácido ursólico en la pancreatitis aguda inducida por ceruleína. Material y métodos: Treinta y dos ratas albinas Wistar fueron asignadas aleatoriamente a cuatro grupos iguales: grupo simulado, grupo de pancreatitis aguda, grupo de tratamiento y grupo de ácido ursólico. Resultados: Los niveles de amilasa sérica en los grupos de pancreatitis aguda y de tratamiento fueron significativamente más altos que en los otros grupos (p < 0.05). Además, los niveles séricos de IL-1β, IL-6 y TNF-α fueron significativamente más altos en el grupo de pancreatitis aguda en comparación con el grupo de tratamiento. Aunque la actividad oxidante total del tejido pancreático en ambos grupos fue similar, la capacidad antioxidante total del tejido pancreático en el grupo de tratamiento fue significativamente mayor. Conclusión: Se observó que el ácido ursólico reduce el daño al páncreas y órganos remotos en la pancreatitis aguda, al igual que el estrés oxidativo.


Abstract Background: Ursolic acid (UA) is found in many plants, and has been reported to have anti-protease, antioxidant, anti-inflammatory, antimicrobial, nephroprotective, hepatoprotective, and cardioprotective effects. Objective: The purpose of this study was to investigate the effects of ursolic acid in cerulein-induced acute pancreatitis (AP). Materials and methods: Thirty-two Wistar albino rats were randomly assigned to 4 equal groups: Sham, acute pancreatitis, treatment, and ursolic acid group. Results: Serum amylase levels in the AP and treatment groups were significantly higher than in the others (p < 0.05). In addition, serum IL-1β, IL-6, and TNF-α levels were significantly higher in the AP group in comparison with the treatment group. Although pancreatic tissue total oxidant activity in the AP and treatment groups was similar, pancreatic tissue total antioxidant capacity was significantly higher in the treatment group than in the AP group. Conclusions: Damage to the pancreas and remote organs in AP was observed to be reduced by UA. In addition, oxidative stress was observed to be decreased by the effect of UA.

4.
Medwave ; 23(7): e2684, 01-08-2023.
Article in English | LILACS-Express | LILACS | ID: biblio-1511212

ABSTRACT

A 32-year-old woman with systemic lupus erythematosus came to the rheumatology outpatient clinic reporting abdominal pain for a week, along with fever, arthralgias, myalgias, alopecia, asthenia and dyspnea on exertion over the last two months. She was hypotensive and tachycardic, requiring admission to the intensive care unit. She was diagnosed with lupus-related acute pancreatitis, an unusual complication occurring in less than 1% of cases. Most cases are mild and self-limited; however, severe and life-threatening events with multiple organ failure are possible. This article is a case report of lupus-related critical acute pancreatitis, and a literature review.


Mujer de 32 años con lupus eritematoso sistémico acude a consulta externa de reumatología por dolor abdominal de una semana de evolución, además de fiebre, artralgias, mialgias, alopecia, astenia y disnea de esfuerzo de 2 meses de evolución. También presentó hipotensión y taquicardia, por lo que requirió ingreso en la unidad de cuidados intensivos. Le diagnosticaron pancreatitis aguda relacionada con el lupus, que es una complicación inusual que ocurre en menos del 1% de los pacientes. La mayoría de los casos son leves y autolimitados, sin embargo, es posible que se presenten eventos graves y potencialmente mortales, con disfunción multiorgánica. Este artículo es un reporte de caso de una pancreatitis aguda crítica relacionada con lupus y una revisión de la literatura.

5.
Medicina (B.Aires) ; 83(3): 394-401, ago. 2023. graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1506693

ABSTRACT

Resumen Introducción: En 1994, Claudio Bassi relató un caso de tratamiento médico de la necrosis pancreática infec tada (NPI); luego desde 1996 se publicaron numerosos artículos de serie de casos con tratamiento solo con antibióticos con buenos resultados. Objetivos: Presentar nuestra experiencia en el manejo de la necrosis pancreática infectada con antibióticos (sin drenaje). Métodos: Revisamos retrospectivamente los pacientes con diagnóstico de NPI desde enero de 2018 a octubre del 2020, enfocándonos en aquellos casos que se trata ron de forma conservadora (soporte hidroelectrolítico, nutricional y antibióticos). El diagnóstico se realizó ob servando gas en el retroperitoneo por TC asociado o no a deterioro clínico del paciente con necrosis pancreática sin otro foco. No se realizó punción aspiración con aguja fina (PAAF). Resultados: Identificamos 25 pacientes con diag nóstico de NPI. Once fueron tratados de forma conser vadora. Según la clasificación de Atlanta, modificada en 2012, 3 casos fueron clasificados de forma grave y el resto moderadamente grave. Todos recibieron antibióticos al menos durante 3 semanas. Ninguno requirió nutrición parenteral. El promedio de estan cia hospitalaria fue de 38 días. Tres pacientes fueron readmitidos. A 8 se les realizó colecistectomía luego de haber resuelto el cuadro; los restantes ya estaban colecistectomizados. No hubo muertes en esta serie. Conclusiones: La NPI puede ser tratada de forma con servadora sin drenaje con buenos resultados en casos seleccionados.


Abstract Introduction: In 1994, Claudio Bassi reported a case of medical treatment for infected pancreatic necrosis (IPN); then since 1996 numerous articles of case series were published with treatment only with antibiotics with good outcomes. Objectives: To present our experience in the mana gement of patients with IPN with antibiotics (without drainage). Methods: We retrospectively reviewed cases with a diagnosis of IPN from January 2018 to October 2020, focusing on those cases that were treated conservatively (hydro-electrolyte, nutritional support and antibiotics). The diagnosis was made by observing gas in the re troperitoneum by CT or by clinical deterioration of the patient with pancreatic necrosis without another focus. Fine needle aspiration was not performed. Results: We identified 25 patients with a diagnosis of IPN; eleven were treated conservatively. According to Atlanta, modified in 2012, 3 were classified severely and the rest moderately severe. All received antibiotics for at least 3 weeks. None required parenteral nutrition. The mean hospital stay was 38 days. Three patients were readmitted. 8 underwent cholecystectomy after having resolved the condition; the rest were already cholecys tectomized. There were no deaths in this series. Conclusions: IPN can be treated conservatively without drainage with good results in selected cases.

6.
Acta méd. peru ; 40(2)abr. 2023.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1519935

ABSTRACT

La obesidad es una patología de importancia a nivel mundial porque conlleva a una alta carga de mortalidad y morbilidad. El balón intragástrico representa una técnica no quirúrgica empleada cada vez con más frecuencia para lograr pérdida de peso. Si bien, este se considera un método seguro, se han reportado algunas complicaciones desde náuseas y vómitos, hasta eventos adversos graves, tales como perforación. La pancreatitis aguda constituye una complicación muy rara del balón intragástrico y se atribuye su efecto a la compresión directa que ejerce sobre el páncreas. Presentamos el caso de una paciente mujer de 21 años, quien después de 7 meses de colocación de balón intragástrico, cursó con dolor abdominal, náuseas y vómitos, asociados a elevación de enzimas pancreáticas. Se hizo diagnóstico de pancreatitis aguda y se corroboró compresión de la cola del páncreas mediante estudio tomográfico. Se decidió retiro del balón mediante endoscopía, cursando luego con evolución favorable.


Obesity is a pathology of importance worldwide because it leads to a high burden of mortality and morbidity. The intragastric balloon represents a non-surgical technique used more and more frequently to achieve weight loss. Although this is considered a safe method, some complications have been reported, from nausea and vomiting to serious adverse events, such as perforation. Acute pancreatitis is a very rare complication of the intragastric balloon, and its effect is attributed to the direct compression it exerts on the pancreas. We present the case of a 21-year-old female patient who, after 7 months of intragastric balloon placement, developed abdominal pain, nausea, and vomiting, associated with elevated pancreatic enzymes. A diagnosis of acute pancreatitis was made and compression of the tail of the pancreas was confirmed by tomographic study. It was decided to remove the balloon by endoscopy, which then progressed favorably.

7.
Bol. méd. Hosp. Infant. Méx ; 80(2): 122-128, Mar.-Apr. 2023. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1447529

ABSTRACT

Abstract Background: Acute recurrent pancreatitis (ARP) and chronic pancreatitis (CP) are infrequent clinical entities in pediatric patients, as less than 8% of the literature mentions this population. This study aimed to describe the clinical and paraclinical profile, and the etiology related to patients with ARP and CP attended at a tertiary-level healthcare institute in Mexico. Methods: We conducted a retrospective study from medical records of patients with ARP and CP attended between 2010 and 2020, analyzing the clinical characteristics, imaging studies, and the etiology associated with each patient. Results: We analyzed 25 patients: 17 were diagnosed with ARP, and eight with CP. The main etiology identified was an anatomical alteration of the pancreatic duct (32%); pancreas divisum was the most prevalent condition. In 48% of the population, the etiology was not identified. The group with CP was higher in frequency for calcifications and dilation of the pancreatic duct (p < 0.005) compared to the ARP group. Conclusions: The main etiology for ARP and CP was an anatomical alteration of the pancreatic duct; however, in almost half of the cases, no established cause was identified. Although comparing our results with those offered by large cohorts such as the INSPPIRE group can be complex, we found relevant similarities. Currently, the data obtained from this first descriptive study are the foundation for future research in the field of Mexican pediatric pancreatology.


Resumen Introducción: La pancreatitis aguda recurrente (PAR) y crónica (PC) son entidades poco frecuentes en la edad pediátrica; sin embargo, menos del 8% de la literatura hace referencia a esta población. El objetivo de este estudio fue describir el perfil clínico, paraclínico y etiologías vinculadas en los pacientes con PAR y PC atendidos en una institución de tercer nivel de atención en México. Métodos: Se realizó un estudio retrospectivo de los expedientes de los pacientes con PAR y PC atendidos entre 2010 a 2020, analizando las características clínicas, estudios de imagen y etiologías asociadas en cada uno de los pacientes. Resultados: Se analizaron 25 pacientes, 17 con diagnóstico de PAR y ocho con PC. La principal etiología identificada correspondió a las alteraciones anatómicas del conducto pancreático (32%); el páncreas divisum fue la entidad más prevalente. En el 48% de la población no se pudo identificar una etiología. El grupo con PC presentó mayor frecuencia de calcificaciones y dilatación ductal pancreática (p < 0.005) en comparación al grupo de PAR. Conclusiones: La principal etiología de PAR y PC identificada en nuestro estudio corresponde a las alteraciones anatómicas del conducto pancreático; sin embargo, en casi la mitad de los casos, no se tiene una causa establecida. Aunque es complicado comparar nuestros resultados con los ofrecidos por las grandes cohortes del grupo INSPPIRE, sí encontramos similitudes relevantes. Los datos obtenidos en este primer estudio descriptivo son la base para futuras investigaciones en el ámbito de la pancreatología pediátrica mexicana.

8.
Rev. gastroenterol. Perú ; 43(2)abr. 2023.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1450015

ABSTRACT

La Sociedad Europea de Endoscopia Gastrointestinal (ESGE) define "canulación difícil" como aquella en la que se realizan más de 5 intentos, se exceden 5 minutos, o se produce canulación inadvertida del conducto pancreático 2 o más veces (criterios 5-5-2), recomendando estos puntos de corte para realizar técnicas avanzadas de canulación y disminuir la tasa de eventos adversos post CPRE. Nuestro objetivo fue evaluar el rendimiento de los criterios 5-5-2 y su asociación con complicaciones post CPRE en un hospital de referencia de Perú. Realizamos un estudio analítico prospectivo de casos y controles en el que se incluyó 120 pacientes a los que se realizó CPRE. El grupo casos estuvo formado por 30 pacientes que cumplieron al menos uno de los criterios 5-5-2 y el grupo controles por 90 pacientes sin ninguno de estos criterios. Se comparó el desarrollo de complicaciones en cada grupo y su asociación con cada uno de los criterios 5-5-2. Las complicaciones presentadas fueron: pancreatitis post CPRE (6,6% en el grupo casos vs 3,3% en el grupo controles), sangrado (3,3% controles vs 0% casos) y perforación (1,1% controles vs 0 % casos); sin observar diferencia estadísticamente significativa. El criterio de 2 o más ingresos inadvertidos al conducto pancreático presentó asociación significativa (OR= 10,29, IC: 1,47-71,98; p= 0,005) con el desarrollo de pancreatitis post CPRE. Los criterios 5 minutos y 5 intentos no se asociaron a complicaciones post CPRE. En conclusión, el más relevante de los criterios 5-5-2 fue el ingreso inadvertido al conducto pancreático en 2 o más ocasiones, mostrando asociación por sí solo con pancreatitis post CPRE. Los criterios tiempo y número de intentos podrían ampliarse con cautela sin aumentar la tasa de complicaciones post CPRE.


The European Society for Gastrointestinal Endoscopy (ESGE) defines "difficult biliary cannulation" by the presence of one or more of the following: more than 5 contacts with the papilla, more than 5 minutes attempting to cannulate, or inadvertent cannulation of the pancreatic duct in 2 or more times (5-5-2 criteria), recommending these cut-off points to perform advanced cannulation techniques in order to reduce the rate of post-ERCP adverse events. Our objective was to evaluate the performance of the 5-5-2 criteria and their association with post-ERCP complications in a reference hospital in Peru. We performed a prospective analytical case-control study and 120 patients who underwent ERCP were enrolled. The case group included 30 patients who met at least one of the 5-5-2 criteria and the control group included 90 patients without any of these criteria. The ERCP- related complications in both groups and their association with each of the 5-5-2 criteria were compared. The ERCP-related complications that occurred were post-ERCP pancreatitis (6.6% in the case group vs. 3.3% in the control group), bleeding (3.3% controls vs. 0% cases) and perforation (1.1% controls vs. 0% cases); no statistically significant differences were observed. The criterion of 2 or more unintended cannulations to the pancreatic duct showed a significant association (OR= 10.29, CI: 1.47-71.98; p= 0.005) with the incidence of post-ERCP pancreatitis. The criteria 5 minutes and 5 attempts were not associated with post-ERCP complications. In conclusion, among 5-5-2 criteria only the unintended cannulation of 2 or more times into the pancreatic duct was associated with an increased risk of post-ERC pancreatitis. The time and number of attempts criteria could be cautiously expanded without increasing the rate of post-ERCP complications.

9.
Rev. gastroenterol. Perú ; 43(2)abr. 2023.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1450022

ABSTRACT

La disfunción del esfínter de Oddi (DEO) es una patología poco frecuente que debe ser considerada en el diagnóstico diferencial de pacientes con episodios de dolor biliar o pancreatitis aguda recurrente y antecedente de colecistectomía. Generalmente son pacientes con múltiples consultas, en los cuales la patología ha afectado considerablemente su calidad de vida. El diagnóstico se sustenta en la clínica, los marcadores serológicos y los medios diagnósticos de soporte, que se solicitan según el componente esfinteriano sospechado. El tratamiento con mayor eficacia es la esfinterotomía endoscópica. El uso de prótesis es aceptado, pero discutido. Se presenta el caso de un paciente masculino en la cuarta década de la vida que consultó por múltiples episodios de pancreatitis aguda recurrente con estudios de etiología que sospecharon disfunción del esfínter de Oddi pancreático y quien fue llevado a manejo endoscópico, con mejoría de su cuadro clínico.


Sphincter of Oddi Dysfunction (SOD) is a rare pathology that should be considered in the differential diagnosis of patients with biliary pain episodes or recurrent acute pancreatitis and a background of cholecystectomy. Generally, these are patients with multiple consultations where this pathology has considerably affected their quality of life. Diagnosis is based on clinical findings, serological markers and supporting diagnostic tests requested according to the suspected sphincteric component. The most effective treatment is endoscopic sphincterotomy. The use of prosthesis is accepted but debated. We present the case of a male patient in his forties who consulted for multiple episodes of recurrent acute pancreatitis with etiology studies suspecting dysfunction of the pancreatic sphincter of Oddi and who was taken to endoscopic management with improvement of his clinical picture.

10.
Rev. gastroenterol. Perú ; 43(2)abr. 2023.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1450026

ABSTRACT

El presente artículo resume la guía de práctica clínica (GPC) para el manejo de la pancreatitis aguda en el Seguro Social del Perú (EsSalud). Su objetivo es proveer recomendaciones clínicas basadas en evidencia para el manejo de la pancreatitis aguda en EsSalud. Se conformó un grupo elaborador de la guía (GEG) que incluyó médicos especialistas y metodólogos. El GEG formuló 7 preguntas clínicas a ser respondidas por la presente GPC. Se realizó búsquedas sistemáticas de revisiones sistemáticas y -cuando fue considerado pertinente- estudios primarios en PubMed durante el 2022. Se seleccionó la evidencia para responder cada una de las preguntas clínicas planteadas. La certeza de la evidencia fue evaluada usando la metodología Grading of Recommendations Assessment, Development, and Evaluation (GRADE). En reuniones de trabajo periódicas, el GEG usó la metodología GRADE para revisar la evidencia y formular las recomendaciones, los puntos de buenas prácticas clínicas y flujogramas correspondientes. Finalmente, la GPC fue aprobada con Resolución N° 105-IETSI-ESSALUD-2022. La presente GPC abordó 7 preguntas clínicas sobre fluidoterapia, momento de inicio de nutrición enteral, analgesia, tipo de nutrición, tratamiento antibiótico y quirúrgico. En base a dichas preguntas se formularon 8 recomendaciones (1 fuerte y 7 condicionales), 13 BPC, y 1 flujograma. El presente artículo resume la metodología y las conclusiones basadas en evidencia de la GPC para el manejo de la pancreatitis aguda en EsSalud.


This article summarizes the clinical practice guideline (CPG) for the management of acute pancreatitis in the Social Security of Peru (EsSalud), to provide evidence-based clinical recommendations for the management of acute pancreatitis in EsSalud. A guideline development group (GEG) was formed that included medical specialists and methodologists. The GEG formulated 7 clinical questions to be answered by this CPG. Systematic searches of systematic reviews and -when considered relevant-primary studies were carried out in PubMed during 2022. The evidence was selected to answer each of the clinical questions posed. The certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. In periodic work meetings, the GEG used the GRADE methodology to review the evidence and formulate the recommendations, the points of good clinical practice, and the corresponding ow charts. Finally, the CPG was approved with Resolution No. 105-IETSI-ESSALUD-2022. This CPG addressed 7 clinical questions on buid therapy, start of enteral nutrition, analgesia, type of nutrition, antibiotic, and surgical treatment. Based on these questions, 8 recommendations (1 strong and 7 conditional), 13 BPCs, and 1 flowchart were formulated. This article summarizes the methodology and evidence-based conclusions of the CPG for the management of acute pancreatitis in EsSalud.

11.
Rev. colomb. cir ; 38(2): 339-351, 20230303. fig, tab
Article in Spanish | LILACS | ID: biblio-1425210

ABSTRACT

Introducción. La pancreatitis aguda es una condición gastrointestinal común que se asocia a una importante morbimortalidad. Se estima que su incidencia es de 34 por cada 100.000 habitantes, afecta principalmente a adultos a partir de la sexta década de la vida y en nuestra región es debida en la mayoría de los casos a cálculos biliares. Métodos. Se hizo una revisión de los aspectos fundamentales de esta patología, común y potencialmente mortal. Resultados. El diagnóstico requiere del hallazgo de manifestaciones clínicas, aumento de las enzimas pancreáticas en suero y, en ocasiones, el uso de imágenes diagnósticas. Se puede clasificar en leve, moderada y severa, lo cual es fundamental para determinar la necesidad de tratamiento y vigilancia en una unidad de cuidados intensivos. Conclusión. En la actualidad los pilares de manejo de la pancreatitis aguda son la terapia temprana con líquidos, tratamiento del dolor, inicio precoz de la vía oral y resolución del factor etiológico desencadenante. En presencia de complicaciones o un curso severo de enfermedad, pueden requerirse manejo antibiótico e intervenciones invasivas


Introduction. Acute pancreatitis is a common gastrointestinal condition that is associated with significant morbidity and mortality. It is estimated that its incidence is 34 per 100,000 inhabitants, it mainly affects adults from the sixth decade of life, and in our region, most of the cases are secondary to gallbladder stones. Methods. We present a review of the fundamental aspects of this disease, common and potentially fatal. Results. Diagnosis requires finding clinical manifestations, increased serum pancreatic enzymes, and sometimes the use of diagnostic imaging. It can be classified as mild, moderate and severe, which is essential to determine the need for treatment and monitoring in an intensive care unit. Conclusion. Currently, the pillars of management of acute pancreatitis are early fluid therapy, pain management, early oral food intake, and resolution of the etiology. In the presence of complications or a severe course of the disease, antibiotic management and invasive interventions may be required


Subject(s)
Humans , Pancreatitis , Abdomen, Acute , Pancreas , Abdominal Pain , Pancreatitis, Acute Necrotizing
12.
Rev. cir. (Impr.) ; 75(1)feb. 2023.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1441447

ABSTRACT

El síndrome del ducto pancreático desconectado (SDPD) consiste en la disrupción del ducto pancreático principal con pérdida de continuidad entre el remanente pancreático distal viable y el tracto gastrointestinal, generalmente causado por necrosis ductal secundaria a pancreatitis aguda grave. Esto resulta en fuga de fluido pancreático, provocando un curso de enfermedad prolongado y complicaciones. La literatura sobre este tema es limitada, con algoritmos de tratamiento poco claros. Hemos realizado una revisión de la literatura sobre el tema. Revisión en Pubmed y Scielo (2011-2021) de artículos en inglés y español utilizando términos «síndrome del conducto pancreático desconectado», «DPDS» y «páncreas desconectado» encontrando 16 artículos relevantes. Dadas las pocas citas, se revisaron las referencias de estos artículos. Finalmente, revisamos un total de 21 artículos. Entre las referencias encontradas existe 1 metaanálisis, 4 estudios prospectivos y no existen ensayos aleatorizados.


Disconnected pancreatic duct syndrome (DPDS) is characterized by disruption of the main pancreatic duct with a loss of continuity between the viable upstream pancreatic parenchyma and the gastrointestinal tract, generally caused by ductal necrosis after severe acute necrotizing pancreatitis. This compromised ductal integrity leads to extraductal leakage of pancreatic secretions, causing a prolonged disease course and complications. The existing literature is limited, with unclear therapeutic algorithms. We have performed a review of the literature on DPDS. Review in Pubmed and Scielo (2011-2021) of articles in English and Spanish using the terms "disconnected pancreatic duct syndrome", "DPDS" and "disconnected pancreas" finding 16 relevant articles. Given the few citations, the references of these articles was reviewed. Finally, we found 21 articles. Among them, there is one meta-analysis, 4 prospective studies and no randomized trials.

13.
Med. U.P.B ; 42(1): 96-99, ene.-jun. 2023.
Article in Spanish | LILACS, COLNAL | ID: biblio-1416211

ABSTRACT

La pancreatitis en pediatría se consideraba anteriormente una enfermedad poco fre­cuente; en la actualidad se reportan 13.2 casos por 100 000 niños/año. La causa más importante de pancreatitis en la población pediátrica, después de la etiología biliar, son los medicamentos (13% de los casos). Uno de los principales medicamentos como causa de pancreatitis en pediatría es el ácido valproico (AV); el cual puede inducir una pancreatitis aguda. Aquí se presentará el primer caso de pancreatitis por AV en población pediátrica reportado en Colombia. Se trata de un paciente de cuatro años, con trastorno en el neurodesarrollo por un síndrome de TORCH, quien tomaba AV a largo plazo por un trastorno de la conducta. Ingresó a una institución de alta complejidad donde se diagnostica pancreatitis aguda con signos de necrosis en tejido pancreático secundario a uso de AV. Se suspendió el medicamento con resolución de su cuadro clínico y alta médica hacia el día 15


Pediatric pancreatitis was previously considered a rare disease. Currently, 13.2 cases are reported per 100,000 children/year. The most important cause of pancreatitis in the pediatric population, after biliary etiology, are medications (13% of cases). One of the main medications as a cause of pediatric pancreatitis is valproic acid (VA), which can lead to acute pancreatitis. Here we will present the first case of VA pancreatitis in the pediatric population reported in Colombia. This is a four-year-old patient, with a neurodevelopmental disorder due to TORCH syndrome, who was taking VA long-term for a conduct disorder. He was admitted to a highly complex institution where acute pancreatitis was diagnosed with signs of necrosis in pancreatic tissue secondary to the use of VA. The medication was discontinued with resolution of his set of symptoms and medical discharge around day 15.


A pancreatite pediátrica era anteriormente considerada uma doença rara; atualmente, 13,2 casos por 100 000 crianças/ano são relatados. A causa mais importante de pancreatite na população pediátrica, depois da etiologia biliar, são os medicamentos (13% dos casos). Uma das principais medicações como causa de pancrea-tite em pediatria é o ácido valpróico (VA); que podem induzir pancreatite aguda. Aqui apresentaremos o primeiro caso de pancreatite AV na população pediátrica relatado na Colômbia. Trata-se de uma paciente de quatro anos de idade, com transtorno do neuro-desenvolvimento devido à síndrome TORCH, que fazia uso de AV de longa duração para um transtorno de conduta. Ele foi internado em uma instituição de alta complexidade onde foi diagnosticado pancreatite aguda com sinais de necrose no tecido pancreático secundário ao uso de AV. A medicação foi suspensa com resolução do quadro clínico e alta médica por volta do 15º dia


Subject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Pancreatitis , Pediatrics , Pharmaceutical Preparations , Valproic Acid
14.
Med. U.P.B ; 42(1)ene.-jun. 2023. ilus
Article in Spanish | LILACS, COLNAL | ID: biblio-1416213

ABSTRACT

La cocaína es una de las sustancias ilegales más consumidas y Colombia no es la ex­cepción. Dentro de las sustancias ilegales es la segunda más consumida después del cannabis. Por su mecanismo mismo de acción, que produce aumento de aminas bióge­nas, se han asociado con la cocaína diferentes riesgos, tanto agudos como crónicos, y dentro de sus complicaciones se han descrito cambios comportamentales, compromiso cardiovascular y neurológico. La coingesta de cocaína y alcohol da lugar a un metabolito conocido como cocaetileno, que lleva a complicaciones cardiovasculares. Poco se ha descrito sobre el riesgo de la cocaína o la coingesta cocaína y alcohol, como un factor sumatorio, para la pancreatitis. Reportamos tres pacientes jóvenes consumidores del alcaloide que desarrollaron pancreatitis aguda, dos de ellos murieron. El objetivo de este reporte es sensibilizar a los trabajadores de la salud sobre otro riesgo para considerar en los pacientes consumidores de cocaína.


Cocaine is one of the most consumed illegal substances and Colombia is no exception. It is the second most consumed among the illegal substances after cannabis. Due to its very mechanism of action, which produces an increase in biogenic amines, different risks, both acute and chronic, have been associated with cocaine, and among its complications, behavioral changes, cardiovascular and neurological compromise have been described. The co-ingestion of cocaine and alcohol gives rise to a metabolite known as cocaethylene, which leads to cardiovascular complications. Little has been described about the risk of cocaine or cocaine and alcohol co-ingestion, as a summative factor, for pancreatitis. We report three young patients consuming the alkaloid who developed acute pancreatitis, two of whom died. The objective of this report is to sensitize health workers about another risk to consider in cocaine-consuming patients.


A cocaína é uma das substâncias ilícitas mais consumidas e a Colômbia não é exceção. Dentro das substâncias ilícitas é a segunda mais consumida depois da maconha. Devido ao seu próprio mecanismo de ação, que produz aumento de aminas biogênicas, diversos riscos, tanto agudos quanto crônicos, têm sido associados à cocaína e, entre suas complicações, têm sido descritas alterações comportamentais, comprometimento cardiovascular e neurológico. A co-ingestão de cocaína e álcool dá origem a um metabólito conhecido como cocaetileno, que leva a complicações cardiovasculares. Pouco tem sido descrito sobre o risco da co-ingestão de cocaína ou cocaína e álcool, como fator somativo, para pancreatite. Relatamos 3 pacientes jovens consumindo o alcalóide que desenvolveram pancreatite aguda, dois dos quais morreram. O objetivo deste relatório é sensibilizar os profissionais de saúde sobre outro risco a ser considerado em pacientes consumidores de cocaína.


Subject(s)
Humans , Cocaine , Pancreatitis , Alkaloids
15.
Article | IMSEAR | ID: sea-220690

ABSTRACT

Background: Of all abdominal emergencies, pancreatitis is one of the most complicated and clinically dif?cult. The preferred imaging technique for determining the severity of acute pancreatitis and its consequences is computed tomography (CT). To evaluate the clinical outcome of acute pancreatitis and prognostic Aim: correlation based on the CT severity index. We included 30 patients with suspected acute pancreatitis Settings and Design: attending department of Radio Diagnosis, KVG medical college and hospital during the study period (January 2022 to May 2022). All the patients were evaluated by contrast enhanced CT. The severity of pancreatitis was scored using CT severity index (Balthazar), modi?ed severity index (Mortele) and revised Atlanta classi?cation and the cases were classi?ed into mild, moderate and severe. The outcome parameters studied were Length of hospital stay, Need for surgery or percutaneous intervention, incidence of infection or organ failure and death. The age group of patients was 16 to 69 years with Results: maximum patients (36%) between 25 and 35 years. Majority were males (81%). According to Modi?ed CT Severity Index, 15% patients had mild, 42% patients had moderate and 43% had severe pancreatitis. Majority of the cases (44%) were categorized as severe pancreatitis according modi?ed Mortele CT score. Majority of the cases were categorized as mild pancreatitis according Balthazar CTSI score and revised Atlanta classi?cation. 38% patients are considered to have end organ failure. Hepatic failure is the most common system failure seen in 22% patients. 36% patients had evidence of systemic infection. 10% patients required surgical interventions. The score is simpler to calculate and the inter-observer variability is Conclusions: decreased using the modi?ed CT severity index.

16.
Rev. gastroenterol. Perú ; 43(1)ene. 2023.
Article in English | LILACS-Express | LILACS | ID: biblio-1441878

ABSTRACT

Data on recurrent episodes of acute pancreatitis (RAP) are scarce. The aim of the study was to evaluate our rate of RAP and risks factors. This is a retrospective, single-center, study of consecutive patients admitted for AP and followed-up. Patients with more than one AP attack (RAP) were compared with patients with only a single AP episode (SAP) Clinical, demographic, outcome measures and severity were studied. 561 patients were included and follow-up over a mean 67.63 months' time. Our rate of RAP was 18,9%. Most patients suffered form only one episode of RAP (93%). Etiology of RAP episodes was mainly biliary (67%). On univariate analysis younger age (p 0.004), absence of high blood pressure (p 0.013) and absent of SIRS (p 0.022) were associated with recurrence of AP. On multivariate analysis only younger age was related to RAP (OR 1.015 95%IC 1.00-1.029). There were no statistical differences in outcome measures between both cohorts. RAP had a milder course in terms of severity (SAP 19% moderately severe/severe versus 9% in SAP). Almost 70% of the biliary RAP patients did not have a cholecystectomy performed. In this subset of patients, age OR 0.964 (95%IC 0.946-0.983), cholecystectomy OR 0.075 (95%IC 0.189-0.030) and cholecystectomy plus ERCP OR 0.190 (95%IC 0.219-0.055) were associated with absent of RAP. The rate of RAP in our series was 18,9%. Younger age was the only risk factor associated. Biliary etiology accounts for a large proportion of our RAP which could have been prevented with cholecystectomy or cholecystectomy plus ERCP.


La Pancreatitis Aguda Recurrente (PAR) es una entidad frecuente de la que hay pocos datos publicados. El objetivo del estudio es hallar la tasa y factores de riesgo asociados a PAR en nuestro medio. Es un estudio retrospectivo, unicéntrico, de pacientes ingresados por Pancreatitis Aguda (PA) y seguidos posteriormente. Se dividen en 2 grupos de pacientes: 1.- pacientes con un solo episodio de PA (PAS) y 2.- pacientes con más de un ingreso por PA (PAR). Se comparan variables clínicas, demográficas y de resultado. Resultados: 561 pacientes fueron incluidos y seguidos durante una media de 67,63 meses. 18,9% tuvieron al menos otro ingreso por PA. La mayoría sufrieron un solo episodio de PAR (93%). La etiología más frecuente fue biliar (67%). En el análisis univariado, una menor edad (p 0,004), la ausencia de hipertensión arterial (p 0,013) y de SIRS (p 0,022) se asociaron con PAR. En el análisis multivariado solo una menor edad se relacionó con PAR (OR 1,015, 95%, IC 1,00-1,029). No encontramos diferencias en las variables resultados entre ambos grupos. La PAR cursó de forma más leve (9% de pancreatitis moderada/graves o graves versus 19%). Casi un 70% de los pacientes con PAR biliar no tenían realizada una colecistectomía tras el ingreso índice. En este subgrupo de PAR, la edad OR 0,964 (95% IC 0,946-0,983), la colecistectomía OR 0,075 (95% IC 0,189-0,030) y la colecistectomía más colangiografía retrógrada OR 0,190 (95% IC 0,219-0,055) se asociaban a ausencia de PAR. Conclusión: Nuestra tasa de PAR fue 18,9%, con una menor edad como factor de riesgo. La etiología biliar fue la más frecuente que podría haberse evitado de haber realizado colecistectomía o colecistectomía más colangiografía retrógrada tras el primer ingreso.

17.
J. vasc. bras ; 22: e20220161, 2023. graf
Article in English | LILACS-Express | LILACS | ID: biblio-1440482

ABSTRACT

Abstract Superior mesenteric artery syndrome designates compression of the third part of the duodenum between the superior mesenteric artery and the aorta. This condition has a low incidence, being more common in thin young women. Nutcracker syndrome is compression of the left renal vein between the superior mesenteric artery and the aorta. Both entities are rare, and their coexistence has been reported in a few cases. Conservative treatment targeting weight gain is sufficient in most cases. An association between the superior mesenteric artery syndrome and acute pancreatitis has rarely been reported. We intend to describe the case of an 18-year-old girl who was admitted to the emergency room with epigastric pain and emesis. Our investigation revealed acute acalculous pancreatitis. During work-up, we discovered superior mesenteric artery syndrome and a compressed left renal vein. The patient is on conservative treatment, and her symptoms have improved.


Resumo A síndrome da artéria mesentérica superior designa compressão da terceira parte do duodeno pela artéria mesentérica superior e a aorta. Essa condição tem uma baixa incidência, sendo mais comum em mulheres jovens magras. A síndrome de quebra-nozes resulta da compressão da veia renal esquerda pela artéria mesentérica superior e a aorta. Ambas as entidades são raras, e a sua coexistência foi descrita em poucos casos. Tratamento conservador com o objetivo de ganho ponderal é suficiente na maioria dos casos. A associação entre a síndrome da artéria mesentérica superior e a pancreatite aguda foi raramente relatada. Pretendemos descrever o caso de uma jovem de 18 anos que recorreu ao serviço de urgência com epigastralgia e vômitos. A investigação realizada revelou pancreatite aguda alitiásica. Durante o estudo complementar, foi identificada a síndrome da artéria mesentérica superior, bem como uma veia renal esquerda comprimida. A paciente encontra-se em tratamento conservador, apresentando melhora clínica.

18.
Gastroenterol. latinoam ; 34(1): 8-14, 2023. graf, tab
Article in Spanish | LILACS | ID: biblio-1524554

ABSTRACT

Background: Acute pancreatitis (AP) is a common disease. There is no information available on the costs of treatment in Chile. Aim: To obtain information on the cost of hospitalization for AP and identify the factors that influence the account, to analyze health insurance coverage and the economic charge for the patient. Patients and Method: Retrospective and descriptive study. Patients treated at the Hospital Clínico Universidad de Chile with diagnosis of AP between May 1, 2014 and April 30, 2016 were included. The clinical records were reviewed after the patient's discharge. Demographic characteristics, clinical evolution, the account issued, the insurance payment and patient's copayment were registered. Results: In the period studied, 176 patients (90 women) were discharged with diagnosis of AP. The dominant etiology was biliary in 61%. According to the Atlanta 2013 classification, 78.4% of the cases were mild, 10.2% moderate, and 11.4% severe. 3 patients (1.7%) died. The median cost in Chilean pesos was $ 2,537,918 (1,383,151-3,897,673) (p25-75). The total sum of the accounts of 176 patients was $ 885,261,241, with an average of $ 5,029,893. The average coverage of the health system (FONASA or ISAPRE) was $ 4,293,113, leaving a copayment of $ 801,661. The final cost was related to the severity of the disease, the length of hospitalization and the need for a high-complexity bed. Discussion: Hospitalization costs for PA are high. It is advisable to rationalize the critical care bed indication.


Introducción: La pancreatitis aguda (PA) es una patología frecuente. No hay información disponible del costo de su tratamiento en Chile. Objetivo: Obtener información del costo de hospitalización por PA, identificar los factores que influyen en la cuenta, estudiar la cobertura por seguros de salud y el cargo económico para el paciente. Pacientes y Métodos: Estudio retrospectivo, descriptivo. Se incluyeron pacientes tratados en el Hospital Clínico Universidad de Chile con diagnóstico de PA entre 01 de mayo de 2014 y 30 de abril de 2016. Las fichas clínicas fueron revisadas después del alta del paciente, se registraron sus características demográficas, evolución clínica, la cuenta emitida, el pago del seguro y el copago del paciente. Resultados: En el periodo estudiado 176 pacientes (90 mujeres) fueron dados de alta con diagnóstico de PA. La etiología dominante fue biliar en 61% . Según la clasificación de Atlanta 2013, 78,4% de los casos fueron leves, 10,2% moderados y 11,4% severos. Fallecieron 3 pacientes (1,7%). La mediana de costos fue de $2.537.918 (1.383.151-3.897.673) (p25-75). La suma total de las cuentas de 176 pacientes fue de $ 885.261.241, con un promedio de $ 5.029.893. La cobertura promedio del sistema de salud (FONASA o ISAPRE) fue de $ 4.293.113 dejando un copago de $ 801.661. El costo final se correlacionó con la severidad de la enfermedad, la duración de la hospitalización y la necesidad de cama de alta complejidad. Discusión: Los costos de hospitalización por PA son elevados. Es recomendable racionalizar la indicación de cama crítica.


Subject(s)
Pancreatitis/economics , Cost of Illness , Pancreatitis/epidemiology , Chile , Health Care Costs , Hospitals, University
19.
Article in Chinese | WPRIM | ID: wpr-984577

ABSTRACT

ObjectiveTo explore the mechanism of Dahuang Mudantang in alleviating the intestinal injury in the rat model of acute pancreatitis via the high-mobility group box 1 (HMGB1)/receptor for advanced glycation endproduct (RAGE)/nuclear factor-κB (NF-κB) signaling pathway. MethodOne hundred and twenty SPF-grade Wistar rats received retrograde injection of 5% sodium taurocholate into the biliopancreatic duct for the modeling of intestinal injury in acute pancreatitis. The rats were randomized into blank, model, low-, medium-, and high-dose (3.5, 7, 14 g·kg-1, administrated by gavage) Dahuang Mudantang, and octreotide (1×10-5 g·kg-1, subcutaneous injection) groups (n=20). The rats in blank and model groups received equal volume of distilled water by gavage. Drugs were administered 1 h before and every 12 h after modeling, and samples were collected 24 h after modeling. The general status of the rats was observed. The biochemical methods were employed to measure the levels of amylase (AMS) and C-reactive protein (CRP) in the serum. The enzyme-linked immunosorbent assay (ELISA) was employed to measure the levels of tumor necrosis factor (TNF)-α, interleukin (IL)-1β, and IL-6 in the colon tissue. The morphological changes of pancreatic and colon tissues were observed by hematoxylin-eosin (HE) staining. Real-time fluorescence quantitative polymerase chain reaction (Real-time PCR) and Western blot were employed to measure the expression levels of HMGB1, RAGE, inhibitor of NF-κB kinase (IKK), and NF-κB suppressor protein α(IκBα)in the colon tissue. ResultThe rats in the model group showed poor general survival, writhing response, reduced frequency of defecation, and dry stool. The symptoms of rats in the model group were mitigated in each treatment group, and the high-dose Dahuang Mudantang showed the most significant effect. Compared with the normal group, the model group had elevated AMS and CRP levels (P<0.05), which were lowered by Dahuang Mudantang (P<0.05), especially that at the high dose (P<0.05). Compared with the normal group, the modeling elevated that levels of TNF-α, IL-1β, and IL-6 (P<0.05). Such elevations were lowered by Dahuang Mudantang (P<0.05), and the high-dose group and the octreotide group showed better performance (P<0.05). The modeling caused necrotic, congested, and destructed pancreatic and colonic tissues, which were ameliorated by the drugs, especially high-dose Dahuang Mudantang. Compared with the normal group, the modeling up-regulated the mRNA levels of HMGB1, RAGE, IKK, IκBα, and NF-κB (P<0.05). Compared with the model group, Dahuang Mudantang and octreotide down-regulated the mRNA levels of HMGB1, RAGE, IKK, IκBα, and NF-κB (P<0.05), and the high-dose Dahuang Mudantang demonstrated the best performance (P<0.05). Western blot results showed a trend consistent with the results of Real-time PCR. ConclusionDahuang Mudantang can improved the general status, reduce inflammation, and alleviate histopathological changes in the pancreatic and colon tissues in the rat model of acute pancreatitis by inhibiting the HMGB1/RAGE/NF-κB signaling pathway.

20.
Rev. chil. endocrinol. diabetes ; 16(3): 87-90, 2023. graf
Article in Spanish | LILACS | ID: biblio-1451975

ABSTRACT

La hipertrigliceridemia severa es una de las principales causas etiológicas de la pancreatitis aguda, donde la literatura internacional la posiciona como la tercera causa. Sus causas gatillantes, comorbilidades, severidad y evolución son importantes de conocer para evitar futuros episodios. En Chile, a nuestro entender, no tenemos literatura sobre esta asociación, por lo que presentamos datos de un hospital terciario, destacando 15 casos de pancreatitis aguda en 5 años de estudio, casi la mitad de ellos con antecedentes previos de hipertrigliceridemia, un porcentaje importante de los casos con cuadros graves y con complicaciones intrahospitalarias y que la diabetes mellitus tipo 2 fue la principal condición asociada a la hipertrigliceridemia severa.


Severe hypertriglyceridaemia is one of the main aetiological causes of acute pancreatitis, with international literature ranking it as the third leading cause. Its triggering causes, comorbidities, severity and evolution are important to know in order to avoid future episodes. In Chile, to our knowledge, we have no literature on this association, so we present data from a tertiary hospital, highlighting 15 cases of acute pancreatitis in 5 years of study, almost half of them with a previous history of hypertriglyceridaemia, a significant percentage of cases with severe symptoms and in-hospital complications, and that type 2 diabetes mellitus was the main condition associated with severe hypertriglyceridaemia.


Subject(s)
Humans , Male , Female , Adult , Pancreatitis/etiology , Pancreatitis/epidemiology , Hypertriglyceridemia/complications , Tertiary Healthcare , Retrospective Studies , Diabetes Mellitus, Type 2/complications
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