title: [Latest advances in acute pancreatitis].
abstract: The present article analyses the main presentations on acute pancreatitis at Digestive Disease Week 2015. Arterial pseudoaneurysm is an uncommon complication of acute pancreatitis (incidence 0.7%) and mortality from this cause is currently anecdotal. Diabetes mellitus has little impact on the clinical course of acute pancreatitis, unlike cirrhosis, which doubles the risk of mortality. Intake of unsaturated fat could be associated with an increased severity of acute pancreatitis and is a confounding factor in studies evaluating the relationship between obesity and morbidity and mortality. PET-CT (positron emission tomography-computed tomography) could be a non-invasive tool to detect infection of collections in acute pancreatitis. Peripancreatic fat necrosis is less frequent than pancreatic fat necrosis and is associated with a better clinical course. If the clinical course is poor, increasing the calibre of the percutaneous drains used in the treatment of infected necrosis can avoid surgery in 20% of patients. The use of low molecular-weight heparin in moderate or severe pancreatitis could be associated with a better clinical course, specifically with a lower incidence of necrosis. In acute recurrent pancreatitis, simvastatin is a promising drug for prophylaxis of new episodes of acute pancreatitis. Nutritional support through a nasogastric tube does not improve clinical course compared with oral nutrition.
authors.affiliation: Unidad de Patología Pancreática, Servicio de Aparato Digestivo, Hospital General Universitario de Alicante, Alicante, España; Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Alicante, España. Electronic address: madaria@hotmail.com.
authors.forename: Enrique
authors.initials: E
authors.lastname: de-Madaria
mesh_terms: D017541:Aneurysm, False / Q000209:etiology; D016360:Clostridioides difficile; D003015:Clostridium Infections / Q000209:etiology; D003131:Combined Modality Therapy; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D004322:Drainage; D005218:Fat Necrosis / Q000209:etiology / Q000517:prevention & control; D006495:Heparin, Low-Molecular-Weight; D006801:Humans; D008103:Liver Cirrhosis / Q000453:epidemiology; D009102:Multiple Organ Failure / Q000209:etiology / Q000517:prevention & control; D018529:Nutritional Support / Q000379:methods; D009765:Obesity / Q000453:epidemiology; D019283:Pancreatitis, Acute Necrotizing / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000628:therapy; D000072078:Positron Emission Tomography Computed Tomography; D012720:Severity of Illness Index; D019821:Simvastatin / Q000627:therapeutic use
chemical_list: D006495:Heparin, Low-Molecular-Weight; D019821:Simvastatin
keywords: Acute pancreatitis; Clasificación; Classification; Diagnosis; Diagnóstico; Historia natural; Natural history; Necrosis pancreática; Pancreatic necrosis; Pancreatitis aguda; Prognosis; Pronóstico; Tratamiento; Treatment