tailieunhanh - Emergencies and Complications in Gastroenterology - part 4

Viêm tụy cấp trừu tượng là một bệnh cấp tính vùng bụng đau khởi phát đột ngột khoảng từ một bệnh nhẹ và tự giới hạn đến một tình trạng đe dọa tính mạng nghiêm trọng và nghiêm trọng. Mặc dù nhiều thập kỷ nghiên cứu chuyên sâu, không có lựa chọn điều trị nguyên nhân. | Review Article Digestive Diseases Dig Dis 2003 21 30-37 DOI 000071337 Acute Pancreatitis Treatment Strategies Stefan Kahl Sandra Zimmermann Peter Malfertheiner Department of Gastroenterology Hepatology and Infectious Diseases Otto von Guericke University Magdeburg Germany Key Words Pancreatitis Endoscopy Pain Drug therapy Enteral nutrition Abstract Acute pancreatitis is an acute painful abdominal disease of sudden onset that ranges from a mild and self-limited illness to a severe and severe life-threatening condition. In spite of decades of intensive research there are no causal therapeutic options. Treatment relies on supportive treatment principles based on adequate volume replacement to compensate for fluid loss in the intraperitoneal space and analgesics for pain relief. In cases with acute pancreatitis predicted to have a severe course of the disease antibiotic therapy is recommended to avoid infection of pancreatic necrosis. Despite a substantial set of clinical trials in favor of antibiotic treatment to reduce morbidity there is no general consensus on the prophylactic antibiotic treatment. Adequate nutritional support is required for patients with severe acute pancreatitis and a protracted course of the disease. Enteral nutrition appears to be superior to enteral nutrition. Copyright 2003 S. Karger AG Basel Introduction Acute pancreatitis is characterized by severe pain with sudden onset fig. 1 . The course of the disease ranges from a mild and self-limited illness to a severe and rapidly or delayed progressive severe or life-threatening condition. The ratio of mild to severe acute pancreatitis is approximately 5 1. Patients with severe acute pancreatitis may develop systemic complications due to either the systemic inflammatory response syndrome SIRS or to sepsis which may lead to multiorgan failure MOF . The death rate of severe acute pancreatitis despite important progress in clinical management is still within the range of 10-20 1-7 . Etiology .