[Fulminant pancreatitis--internal point of view].
In acute pancreatitis pancreatic necrosis and involvement of different organ systems determine clinical course and severity. There is no method to predict the outcome of acute pancreatitis at the beginning of the disease. If there is evidence for severe pancreatitis, an immediate intensive care of all organ systems is needed, to avoid complications. Besides clinical signs, serum CRP is the most valuable parameter to define severity. According to present knowledge, a CT scan is only needed in sepsis or multiorgan failure. Non-invasive ventilation should be started early in case of hypoxia. Up to now, no general benefit was detected for antibiotic prophylaxis or enteral nutrition.
Adler
G
G
Abteilung Innere Medizin, Universitätsklinikum Ulm. guido.adler@uniklinik-ulm.de
D018806:APACHE; D058186:Acute Kidney Injury / Q000150:complications / Q000628:therapy; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001803:Blood Transfusion; D002097:C-Reactive Protein / Q000032:analysis; D003422:Critical Care; D003937:Diagnosis, Differential; D004177:Dipyrone / Q000627:therapeutic use; D004232:Diuretics / Q000008:administration & dosage / Q000627:therapeutic use; D004750:Enteral Nutrition; D005440:Fluid Therapy; D015600:Glasgow Coma Scale; D006801:Humans; D000860:Hypoxia / Q000628:therapy; D008614:Meperidine / Q000627:therapeutic use; D008991:Monitoring, Physiologic; D009102:Multiple Organ Failure / Q000000981:diagnostic imaging; D019283:Pancreatitis, Acute Necrotizing / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000628:therapy; D011379:Prognosis; D012121:Respiration, Artificial; D018805:Sepsis / Q000000981:diagnostic imaging; D013997:Time Factors; D014057:Tomography, X-Ray Computed
D000701:Analgesics, Opioid; D000900:Anti-Bacterial Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D004232:Diuretics; D004177:Dipyrone; D002097:C-Reactive Protein; D008614:Meperidine