Pancreatitis: Difference between revisions
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imported>Robert Badgett (→Acute pancreatitis: Adapted from content I helped write at WP) |
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==Diagnosis== | ==Diagnosis== | ||
===Acute pancreatitis=== | ===Acute pancreatitis=== | ||
The diagnostic criteria for pancreatitis are "two of the following three features: 1) abdominal pain characteristic of acute pancreatitis, 2) serum [[amylase]] and/or [[lipase]] ≥3 times the upper limit of normal, and 3) characteristic findings of acute pancreatitis on [[X-ray computed tomography|CT scan]]."<ref name="pmid17032204">{{cite journal |author=Banks P, Freeman M |title=Practice guidelines in acute pancreatitis |journal=Am J Gastroenterol |volume=101 |issue=10 |pages=2379-400 |year=2006 |id=PMID 17032204 | doi=10.1111/j.1572-0241.2006.00856.x}}</ref> | |||
Two [[clinical practice guideline]]s state: | |||
: "It is usually not necessary to measure both serum amylase and lipase. Serum lipase may be preferable because it remains normal in some nonpancreatic conditions that increase serum amylase including macroamylasemia, parotitis, and some carcinomas. In general, serum lipase is thought to be more sensitive and specific than serum amylase in the diagnosis of acute pancreatitis"<ref name="pmid17032204">.</ref> | |||
: "Although amylase is widely available and provides acceptable accuracy of diagnosis, where lipase is available it is preferred for the diagnosis of acute pancreatitis (recommendation grade A)"<ref name="pmid15831893">{{cite journal |author=UK Working Party on Acute Pancreatitis |title=UK guidelines for the management of acute pancreatitis |journal=Gut |volume=54 Suppl 3 |issue= |pages=iii1-9 |year=2005 |id=PMID 15831893 | doi=10.1136/gut.2004.057026 | url=http://gut.bmj.com/cgi/content/full/54/suppl_3/iii1}}</ref> | |||
===Chronic pancreatitis=== | ===Chronic pancreatitis=== | ||
Revision as of 02:38, 19 February 2008
Pancreatitis is "inflammation of the pancreas. Pancreatitis is classified as acute unless there are computed tomographic or endoscopic retrograde cholangiopancreatographic findings of chronic pancreatitis (International Symposium on Acute Pancreatitis, Atlanta, 1992). The two most common forms of acute pancreatitis are alcoholic pancreatitis and gallstone pancreatitis."[1]
Classification
Acute pancreatitis
Acute necrotizing pancreatitis
Acute necrotizing pancreatitis is a "severe form of acute inflammation of the pancreas characterized by one or more areas of necrosis in the pancreas with varying degree of involvement of the surrounding tissues or organ systems. Massive pancreatic necrosis may lead to diabetes mellitus, and malabsorption.[2]
Chronic pancreatitis
Chronic pancreatitis is "inflammation of the pancreas that is characterized by recurring or persistent abdominal pain with or without steatorrhea or diabetes mellitus. It is characterized by the irregular destruction of the pancreatic parenchyma which may be focal, segmental, or diffuse.[3]
Etiology/cause
The most common causes are gallstones and alcohol.[4]
Diagnosis
Acute pancreatitis
The diagnostic criteria for pancreatitis are "two of the following three features: 1) abdominal pain characteristic of acute pancreatitis, 2) serum amylase and/or lipase ≥3 times the upper limit of normal, and 3) characteristic findings of acute pancreatitis on CT scan."[5]
Two clinical practice guidelines state:
- "It is usually not necessary to measure both serum amylase and lipase. Serum lipase may be preferable because it remains normal in some nonpancreatic conditions that increase serum amylase including macroamylasemia, parotitis, and some carcinomas. In general, serum lipase is thought to be more sensitive and specific than serum amylase in the diagnosis of acute pancreatitis"[5]
- "Although amylase is widely available and provides acceptable accuracy of diagnosis, where lipase is available it is preferred for the diagnosis of acute pancreatitis (recommendation grade A)"[6]
Chronic pancreatitis
Treatment
Acute pancreatitis
Chronic pancreatitis
References
- ↑ Anonymous (2024), Pancreatitis (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ Anonymous (2024), Acute necrotizing pancreatitis (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ Anonymous (2024), Chronic pancreatitis (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ Anonymous (2024), Pancreatitis (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ 5.0 5.1 Banks P, Freeman M (2006). "Practice guidelines in acute pancreatitis". Am J Gastroenterol 101 (10): 2379-400. DOI:10.1111/j.1572-0241.2006.00856.x. PMID 17032204. Research Blogging.
Cite error: Invalid
<ref>tag; name "pmid17032204" defined multiple times with different content - ↑ UK Working Party on Acute Pancreatitis (2005). "UK guidelines for the management of acute pancreatitis". Gut 54 Suppl 3: iii1-9. DOI:10.1136/gut.2004.057026. PMID 15831893. Research Blogging.