Acute pancreatitis, a feared diagnosis among the elderly


Authors: M. Berková;  Z. Berka;  E. Topinková
Authors‘ workplace: Geriatrická klinika 1. LF UK a VFN Praha 1;  2. interní klinika LF UP a FN Olomouc 2
Published in: Geriatrie a Gerontologie 2015, 4, č. 1: 19-25
Category: Review Article

Overview

Acute pancreatitis is a non-infectious inflammation primarily arising in the exocrine part of pancreas. Its incidence is slightly increasing (in the Central Europe this means approximately 20 cases/100 000 inhabitants per year). Biliary and alcoholic aetiology is the most common cause of acute pancreatitis. From the point of view of pathological anatomy, acute pancreatitis proceeds as interstitial edematous pancreatitis or acute necrotic pancreatitis. The revised Atlanta classification from 2012 defines three forms of acute pancreatitis according its clinical severity: mild, moderately severe and severe. Multiple organ system failure and infection of pancreatic and extrapancreatic necrosis represent the most severe complications. The most reliable examination procedures are abdominal ultrasonography, contrast enhanced computed tomography and magnetic resonance imaging with cholangiopancreatopgraphy, or alternatively endoscopic ultrasonography. Endoscopic retrograde cholangiopancreatography is used for therapeutic purpose in biliary pancreatitis. Despite of significant therapeutic progress provided at intensive care units and at departments of anesthesiology and resuscitation, mortality of severe pancreatitis with circulatory failure, especially in older polymorbid patients is still high (≥ 50 %).

Keywords:
acute pancreatitis – systemic inflammatory response – organ failure – pancreatic necrosis – mortality


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Geriatrics General practitioner for adults Orthopaedic prosthetics
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