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Pancreatitis

MedGen UID:
14586
Concept ID:
C0030305
Disease or Syndrome
Synonyms: Pancreatitides
SNOMED CT: Pancreatitis (75694006)
 

Definition

The pancreas is a large gland behind the stomach and close to the first part of the small intestine. It secretes digestive juices into the small intestine through a tube called the pancreatic duct. The pancreas also releases the hormones insulin and glucagon into the bloodstream. Pancreatitis is inflammation of the pancreas. It happens when digestive enzymes start digesting the pancreas itself. Pancreatitis can be acute or chronic. Either form is serious and can lead to complications. Acute pancreatitis occurs suddenly and usually goes away in a few days with treatment. It is often caused by gallstones. Common symptoms are severe pain in the upper abdomen, nausea, and vomiting. Treatment is usually a few days in the hospital for intravenous (IV) fluids, antibiotics, and medicines to relieve pain. Chronic pancreatitis does not heal or improve. It gets worse over time and leads to permanent damage. The most common cause is heavy alcohol use. Other causes include cystic fibrosis and other inherited disorders, high levels of calcium or fats in the blood, some medicines, and autoimmune conditions. Symptoms include nausea, vomiting, weight loss, and oily stools. Treatment may also be a few days in the hospital for intravenous (IV) fluids, medicines to relieve pain, and nutritional support. After that, you may need to start taking enzymes and eat a special diet. It is also important to not smoke or drink alcohol. NIH: National Institute of Diabetes, Digestive and Kidney Diseases.  [from MedlinePlus]

Recent clinical studies

Etiology

Bakker OJ, van Brunschot S, van Santvoort HC, Besselink MG, Bollen TL, Boermeester MA, Dejong CH, van Goor H, Bosscha K, Ahmed Ali U, Bouwense S, van Grevenstein WM, Heisterkamp J, Houdijk AP, Jansen JM, Karsten TM, Manusama ER, Nieuwenhuijs VB, Schaapherder AF, van der Schelling GP, Schwartz MP, Spanier BW, Tan A, Vecht J, Weusten BL, Witteman BJ, Akkermans LM, Bruno MJ, Dijkgraaf MG, van Ramshorst B, Gooszen HG; Dutch Pancreatitis Study Group
N Engl J Med 2014 Nov 20;371(21):1983-93. doi: 10.1056/NEJMoa1404393. PMID: 25409371
Sarathi Patra P, Das K, Bhattacharyya A, Ray S, Hembram J, Sanyal S, Dhali GK
Br J Surg 2014 Dec;101(13):1721-8. Epub 2014 Oct 20 doi: 10.1002/bjs.9666. [Epub ahead of print] PMID: 25329330
Maksimow M, Kyhälä L, Nieminen A, Kylänpää L, Aalto K, Elima K, Mentula P, Lehti M, Puolakkainen P, Yegutkin GG, Jalkanen S, Repo H, Salmi M
Crit Care Med 2014 Dec;42(12):2556-64. doi: 10.1097/CCM.0000000000000550. PMID: 25126879
Park JS, Kim TN, Kim KH
Dig Dis Sci 2014 Dec;59(12):3092-8. Epub 2014 Jul 5 doi: 10.1007/s10620-014-3259-3. [Epub ahead of print] PMID: 24996378
Stobaugh DJ, Deepak P
Ann Pharmacother 2014 Oct;48(10):1282-7. Epub 2014 Jun 30 doi: 10.1177/1060028014540869. [Epub ahead of print] PMID: 24982311

Diagnosis

Moubax K, Mana F, Urbain D
Acta Gastroenterol Belg 2014 Sep;77(3):357-8. PMID: 25509209
Maksimow M, Kyhälä L, Nieminen A, Kylänpää L, Aalto K, Elima K, Mentula P, Lehti M, Puolakkainen P, Yegutkin GG, Jalkanen S, Repo H, Salmi M
Crit Care Med 2014 Dec;42(12):2556-64. doi: 10.1097/CCM.0000000000000550. PMID: 25126879
Morse B, Centeno B, Vignesh S
Am J Med 2014 Oct;127(10):1010.e1-9. Epub 2014 May 14 doi: 10.1016/j.amjmed.2014.04.033. [Epub ahead of print] PMID: 24835039
Sung HY, Kim JI, Lee HJ, Cho HJ, Cheung DY, Kim SS, Cho SH, Kim JK
Gut Liver 2014 May;8(3):265-70. doi: 10.5009/gnl.2014.8.3.265. PMID: 24827622Free PMC Article
Schepers NJ, Besselink MG, van Santvoort HC, Bakker OJ, Bruno MJ; Dutch Pancreatitis Study Group
Best Pract Res Clin Gastroenterol 2013 Oct;27(5):727-43. Epub 2013 Sep 6 doi: 10.1016/j.bpg.2013.08.007. [Epub ahead of print] PMID: 24160930

Therapy

Bakker OJ, van Brunschot S, van Santvoort HC, Besselink MG, Bollen TL, Boermeester MA, Dejong CH, van Goor H, Bosscha K, Ahmed Ali U, Bouwense S, van Grevenstein WM, Heisterkamp J, Houdijk AP, Jansen JM, Karsten TM, Manusama ER, Nieuwenhuijs VB, Schaapherder AF, van der Schelling GP, Schwartz MP, Spanier BW, Tan A, Vecht J, Weusten BL, Witteman BJ, Akkermans LM, Bruno MJ, Dijkgraaf MG, van Ramshorst B, Gooszen HG; Dutch Pancreatitis Study Group
N Engl J Med 2014 Nov 20;371(21):1983-93. doi: 10.1056/NEJMoa1404393. PMID: 25409371
Park JS, Kim TN, Kim KH
Dig Dis Sci 2014 Dec;59(12):3092-8. Epub 2014 Jul 5 doi: 10.1007/s10620-014-3259-3. [Epub ahead of print] PMID: 24996378
Stobaugh DJ, Deepak P
Ann Pharmacother 2014 Oct;48(10):1282-7. Epub 2014 Jun 30 doi: 10.1177/1060028014540869. [Epub ahead of print] PMID: 24982311
Morse B, Centeno B, Vignesh S
Am J Med 2014 Oct;127(10):1010.e1-9. Epub 2014 May 14 doi: 10.1016/j.amjmed.2014.04.033. [Epub ahead of print] PMID: 24835039
Jacob TG, Raghav R, Kumar A, Garg PK, Roy TS
Int J Exp Pathol 2014 Jun;95(3):199-208. Epub 2014 Apr 25 doi: 10.1111/iep.12081. [Epub ahead of print] PMID: 24761825

Prognosis

Sarathi Patra P, Das K, Bhattacharyya A, Ray S, Hembram J, Sanyal S, Dhali GK
Br J Surg 2014 Dec;101(13):1721-8. Epub 2014 Oct 20 doi: 10.1002/bjs.9666. [Epub ahead of print] PMID: 25329330
Roch AM, Parikh JA, Al-Haddad MA, DeWitt JM, Ceppa EP, House MG, Nakeeb A, Schmidt CM
Surgery 2014 Oct;156(4):923-9. doi: 10.1016/j.surg.2014.07.010. PMID: 25239347
Maksimow M, Kyhälä L, Nieminen A, Kylänpää L, Aalto K, Elima K, Mentula P, Lehti M, Puolakkainen P, Yegutkin GG, Jalkanen S, Repo H, Salmi M
Crit Care Med 2014 Dec;42(12):2556-64. doi: 10.1097/CCM.0000000000000550. PMID: 25126879
Hietanen D, Räty S, Sand J, Mäkelä T, Laukkarinen J, Collin P
Pancreatology 2014 Mar-Apr;14(2):91-4. Epub 2014 Feb 4 doi: 10.1016/j.pan.2014.01.003. [Epub ahead of print] PMID: 24650960
Wang S, Feng X, Li S, Liu C, Xu B, Bai B, Yu P, Feng Q, Zhao Q
J Crit Care 2014 Aug;29(4):693.e7-11. Epub 2014 Jan 29 doi: 10.1016/j.jcrc.2014.01.011. [Epub ahead of print] PMID: 24581950

Clinical prediction guides

Bakker OJ, van Brunschot S, van Santvoort HC, Besselink MG, Bollen TL, Boermeester MA, Dejong CH, van Goor H, Bosscha K, Ahmed Ali U, Bouwense S, van Grevenstein WM, Heisterkamp J, Houdijk AP, Jansen JM, Karsten TM, Manusama ER, Nieuwenhuijs VB, Schaapherder AF, van der Schelling GP, Schwartz MP, Spanier BW, Tan A, Vecht J, Weusten BL, Witteman BJ, Akkermans LM, Bruno MJ, Dijkgraaf MG, van Ramshorst B, Gooszen HG; Dutch Pancreatitis Study Group
N Engl J Med 2014 Nov 20;371(21):1983-93. doi: 10.1056/NEJMoa1404393. PMID: 25409371
Sarathi Patra P, Das K, Bhattacharyya A, Ray S, Hembram J, Sanyal S, Dhali GK
Br J Surg 2014 Dec;101(13):1721-8. Epub 2014 Oct 20 doi: 10.1002/bjs.9666. [Epub ahead of print] PMID: 25329330
Maksimow M, Kyhälä L, Nieminen A, Kylänpää L, Aalto K, Elima K, Mentula P, Lehti M, Puolakkainen P, Yegutkin GG, Jalkanen S, Repo H, Salmi M
Crit Care Med 2014 Dec;42(12):2556-64. doi: 10.1097/CCM.0000000000000550. PMID: 25126879
Park JS, Kim TN, Kim KH
Dig Dis Sci 2014 Dec;59(12):3092-8. Epub 2014 Jul 5 doi: 10.1007/s10620-014-3259-3. [Epub ahead of print] PMID: 24996378
Wang S, Feng X, Li S, Liu C, Xu B, Bai B, Yu P, Feng Q, Zhao Q
J Crit Care 2014 Aug;29(4):693.e7-11. Epub 2014 Jan 29 doi: 10.1016/j.jcrc.2014.01.011. [Epub ahead of print] PMID: 24581950

Recent systematic reviews

Wu LM, Sankaran SJ, Plank LD, Windsor JA, Petrov MS
Br J Surg 2014 Dec;101(13):1644-56. Epub 2014 Oct 21 doi: 10.1002/bjs.9665. [Epub ahead of print] PMID: 25334028
Seta T, Noguchi Y, Shikata S, Nakayama T
BMC Gastroenterol 2014 May 30;14:102. doi: 10.1186/1471-230X-14-102. [Epub ahead of print] PMID: 24886242Free PMC Article
Li L, Shen J, Bala MM, Busse JW, Ebrahim S, Vandvik PO, Rios LP, Malaga G, Wong E, Sohani Z, Guyatt GH, Sun X
BMJ 2014 Apr 15;348:g2366. PMID: 24736555Free PMC Article
Monami M, Dicembrini I, Nardini C, Fiordelli I, Mannucci E
Diabetes Res Clin Pract 2014 Feb;103(2):269-75. Epub 2014 Jan 14 doi: 10.1016/j.diabres.2014.01.010. [Epub ahead of print] PMID: 24485345
Yuhara H, Ogawa M, Kawaguchi Y, Igarashi M, Shimosegawa T, Mine T
J Gastroenterol 2014 Mar;49(3):388-99. Epub 2013 May 30 doi: 10.1007/s00535-013-0834-x. [Epub ahead of print] PMID: 23720090

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