title: Severe acute pancreatitis: advances and insights in assessment of severity and management.
abstract: The patients with acute pancreatitis are at risk to develop different complications from ongoing pancreatic inflammation. Often, there is no correlation between the degree of structural damage to pancreas and clinical manifestation of the disease. The effectiveness of any treatment is related to the ability to predict severity accurately, but there is no ideal predictive system or biochemical marker. Severity assessment is indispensable to the selection of proper initial treatment in the management of acute pancreatitis. The use of multiparametric criteria and the evaluation of severity index permit us to select high-risk patients. Furthermore, contrast-enhanced computed tomographic scanning and contrast-enhanced MRI play an important role in severity assessment. The adoption of multiparametric criteria proposed together with morphological evaluation consents the formulation of a discreetly reliable prognosis on the evolution of the disease a few days from onset.
authors.affiliation: Department of Surgery, Catholic School of Medicine, University Hospital Agostino Gemelli, Largo Agostino Gemelli 8, Rome, Italy. gbrisin@tin.it
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Brisinda
authors.forename: Serafino
authors.initials: S
authors.lastname: Vanella
authors.forename: Anna
authors.initials: A
authors.lastname: Crocco
authors.forename: Andrea
authors.initials: A
authors.lastname: Mazzari
authors.forename: Pasquina
authors.initials: P
authors.lastname: Tomaiuolo
authors.forename: Francesco
authors.initials: F
authors.lastname: Santullo
authors.forename: Ugo
authors.initials: U
authors.lastname: Grossi
authors.forename: Antonio
authors.initials: A
authors.lastname: Crucitti
mesh_terms: D006801:Humans; D008279:Magnetic Resonance Imaging; D010195:Pancreatitis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D011379:Prognosis; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed