Multiple organ failure in patients with severe acute pancreatitis / 第三军医大学学报

ABSTRACT

In order to clarify the limitative factors in the management of severe acute pancreatitis (SAP) especially the problems of the complicated multiple organ failure (MOF),70 cases of SAP,of which 17 were complicated with MOF,admitted to our hospital in the past 16 years were reviewed.The overall mortality rate of the series was 20.0% (14/70),and the death of 12 cases out of the 14 was associated with MOF (85.7%) and that of the other 2 with single organ failure (14.3%).MOF occurred in 17 cases with a mortality rate of 70.0%.Two patterns of MOF manifestations identifiedA rapid single-phase of MOF was found in 7 cases.It developed rather early after the onset of SAP and was associated with severe pancreatic necrosis and early shock.And a delayed two-phaseof MOF was seen in 10 cases.It developed progressively with a lagging interval and from the pancre-atic necrosis and subsequent infection.The clinical manifestations of MOF were characterized by a severe and systemic inflammatory response.It is believed that the systemic inflammatory response trigged by the septic material released from the pancreatic necrotic focus seems to be the pathological channel to link SAP with MOF.