title: Acute pancreatitis.
abstract: OBJECTIVE
  To summarize recent data on classification systems, cause, risk factors, severity prediction, nutrition, and drug treatment of acute pancreatitis.
  
  
  RESULTS
  Comparison of the Revised Atlanta Classification and Determinant Based Classification has shown heterogeneous results. Simvastatin has a protective effect against acute pancreatitis. Young black male, alcohol, smoldering symptoms, and subsequent diagnosis of chronic pancreatitis are risk factors associated with readmissions after acute pancreatitis. A reliable clinical or laboratory marker or a scoring system to predict severity is lacking. The PYTHON trial has shown that oral feeding with on demand nasoenteric tube feeding after 72 h is as good as nasoenteric tube feeding within 24 h in preventing infections in predicted severe acute pancreatitis. Male sex, multiple organ failure, extent of pancreatic necrosis, and heterogeneous collection are factors associated with failure of percutaneous drainage of pancreatic collections.
  
  
  CONCLUSIONS
  The newly proposed classification systems of acute pancreatitis need to be evaluated more critically. New biomarkers are needed for severity prediction. Further well designed studies are required to assess the type of enteral nutritional formulations for acute pancreatitis. The optimal minimally invasive method or combination to debride the necrotic collections is evolving. There is a great need for a drug to treat the disease early on to prevent morbidity and mortality.
authors.affiliation: aAsian Institute of Gastroenterology/Asian Healthcare Foundation, Hyderabad, Telangana, India bDivision of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Rupjyoti
authors.initials: R
authors.lastname: Talukdar
authors.forename: Santhi S
authors.initials: SS
authors.lastname: Vege
mesh_terms: D000208:Acute Disease; D002763:Cholecystectomy; D003131:Combined Modality Therapy; D004322:Drainage / Q000379:methods; D002149:Energy Intake; D004750:Enteral Nutrition / Q000379:methods; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007441:Intubation, Gastrointestinal; D010195:Pancreatitis / Q000453:epidemiology / Q000628:therapy*; D010359:Patient Readmission; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D019821:Simvastatin / Q000627:therapeutic use*; D013997:Time Factors; D014481:United States / Q000453:epidemiology
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D019821:Simvastatin