title: Severe necrotic and septic pancreatitis. Indications to endoscopic, surgical, and nutritional therapy.
abstract: Severe acute pancreatitis (SAP) management has changed over the last fifteen years, and from too aggressive behaviour, we moved to a cautious one. In every case, we can appreciate defect of extremist conceptual position. We reviewed our strategy on disease treatment, and we analyzed treatment of single cases. We collected 4 SAP cases from January 2009 to January 2010. All patients were septic, and we adopted the same approach for all of them, avoiding surgery without peritoneal infection. In all patients we placed jejumostomy and, after cleaning of septic site, we started immediate enteral nutrition (EN). Antibiotic therapy against Gram+, Gram- and antifugal drug had been started. No one died and all patients were back to an active life even if social costs are considerably high especially due to very long hospital stay.
authors.forename: G
authors.initials: G
authors.lastname: Mangiante
authors.forename: L
authors.initials: L
authors.lastname: Rodella
authors.forename: A
authors.initials: A
authors.lastname: Cerofolini
authors.forename: S
authors.initials: S
authors.lastname: Giacopuzzi
authors.forename: V
authors.initials: V
authors.lastname: Passeri
authors.forename: E
authors.initials: E
authors.lastname: Sterzi
authors.forename: F
authors.initials: F
authors.lastname: Catalano
authors.forename: G
authors.initials: G
authors.lastname: Schenal
authors.forename: G
authors.initials: G
authors.lastname: De Manzoni
mesh_terms: D000328:Adult; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D017281:Cost of Illness; D004322:Drainage; D016099:Endoscopy, Gastrointestinal; D004750:Enteral Nutrition; D005500:Follow-Up Studies; D006801:Humans; D007558:Italy; D007582:Jejunostomy; D007902:Length of Stay / Q000191:economics; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D019283:Pancreatitis, Acute Necrotizing / Q000175:diagnosis / Q000191:economics / Q000601:surgery / Q000628:therapy*; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents