Risk and markers of severe acute pancreatitis.
Acute pancreatitis begins with pancreatic injury, elicits an acute inflammatory response, and encompasses a variety of potential complications in a subset of patients. Early determination of severity and risk of complications is crucial for instituting immediate interventions to improve outcome. The severity of acute pancreatitis is a function of the amount of pancreas that is injured and the intensity of the inflammatory response. Early death is mainly linked to an overwhelming inflammatory response leading to cardiovascular collapse or acute respiratory distress syndrome, whereas late death is associated with infected pancreatic necrosis and sepsis. This article reviews recent advancements in understanding the pathogenesis, immunology, and genetics of severe acute pancreatitis, and the literature on laboratory-based markers, which predict a severe clinical course and pancreatic necrosis.
Papachristou
Georgios I
GI
Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. papachristoug@dom.pitt.edu
Clermont
Gilles
G
Sharma
Arun
A
Yadav
Dhiraj
D
Whitcomb
David C
DC
D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D016207:Cytokines / Q000097:blood*; D003937:Diagnosis, Differential; D014943:Global Health; D006801:Humans; D015994:Incidence; D019283:Pancreatitis, Acute Necrotizing / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index
D015415:Biomarkers; D016207:Cytokines; D002097:C-Reactive Protein