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septiembre 30, 2017

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Management of acute pancreatitis

INTRODUCTION — Acute pancreatitis is an acute inflammatory process of the pancreas. Mortality ranges from 3 percent in patients with interstitial edematous pancreatitis to 17 percent in patients who develop pancreatic necrosis [1,2]. This topic reviews the management of acute pancreatitis. Our recommendations are largely consistent with the American Gastroenterological Association, the American College of Gastroenterology, and the International Association of Pancreatology/American Pancreatic Association guidelines for the treatment of acute pancreatitis [3-5]. The etiology, clinical manifestations, diagnosis, and assessment of severity of acute pancreatitis are discussed separately. (See "Etiology of acute pancreatitis" and "Clinical manifestations and diagnosis of acute pancreatitis" and "Predicting the severity of acute pancreatitis".) CLASSIFICATION — According to the Atlanta classification, acute pancreatitis can be divided into two broad ...

Celular Dr. Gonzalo Pérez Chávez

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Acute Cholecystitis and biliary cholic

Biliary colic and cholecystitis are in the spectrum of biliary tract disease. This spectrum ranges from asymptomatic gallstones to biliary colic, cholecystitis, choledocholithiasis, and cholangitis. [ 1 ] Gallstones can be divided into 2 categories: Cholesterol stones (80%) and pigment stones (20%). Most patients with gallstones are asymptomatic. Stones may temporarily obstruct the cystic duct or pass through into the common bile duct, leading to symptomatic biliary colic, which develops in 1-4% of patients with gallstones annually. Cholecystitis occurs when obstruction at the cystic duct is prolonged (usually several hours) resulting in inflammation of the gallbladder wall. Acute cholecystitis develops in approximately 20% of patients with biliary colic if they are left untreated. [ 2 ] However, the incidence of acute cholecystitis is falling, likely due to increased acceptance by patients of laparoscopic cholecystectomy as a treatment of symptomatic gallstone...

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