Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 28 July 2016

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

American College of Gastroenterology guidelines for the management of acute pancreatitis

This week's issue of the American Journal of Gastroenterology reports on the American College of Gastroenterology guidelines for the management of acute pancreatitis.

News image

Dr Santhi Swaroop Vege and colleagues from Minnesota, USA present recommendations for the management of patients with acute pancreatitis.

During the past decade, there have been new understandings and developments in the diagnosis, etiology, and early and late management of the disease.

As the diagnosis of acute pancreatitis is most often established by clinical symptoms and laboratory testing, contrast-enhanced computed tomography (CECT) and/or magnetic resonance imaging (MRI) of the pancreas should be reserved for patients in whom the diagnosis is unclear or who fail to improve clinically.

Hemodynamic status should be assessed immediately upon presentation and resuscitative measures begun as needed.

The team report that patients with organ failure and/or the systemic inflammatory response syndrome (SIRS) should be admitted to an intensive care unit or intermediary care setting whenever possible.

Prophylactic antibiotics in severe acute pancreatitis is not recommended
American Journal of Gastroenterology

Aggressive hydration should be provided to all patients, unless cardiovascular and/or renal comorbidites preclude it.

The research team noted that early aggressive intravenous hydration is most beneficial within the first 1224 hours, and may have little benefit beyond.

Patients with acute pancreatitis, and concurrent acute cholangitis should undergo endoscopic retrograde cholangiopancreatography (ERCP) within 24 hours of admission.

The team reported that pancreatic duct stents and/or postprocedure rectal nonsteroidal anti-inflammatory drug (NSAID) suppositories should be utilized to lower the risk of severe post-ERCP pancreatitis in high-risk patients.

Routine use of prophylactic antibiotics in patients with severe acute pancreatitis, and/or sterile necrosis is not recommended.

In patients with infected necrosis, antibiotics known to penetrate pancreatic necrosis may be useful in delaying intervention, thus decreasing morbidity and mortality.

In mild acute pancreatitis, oral feedings can be started immediately if there is no nausea and vomiting.

The team observed that in severe acute pancreatitis, enteral nutrition is recommended to prevent infectious complications, whereas parenteral nutrition should be avoided.

Dr Vege's team concludes, "Asymptomatic pancreatic and/or extrapancreatic necrosis and/or pseudocysts do not warrant intervention regardless of size, location, and/or extension."

"In stable patients with infected necrosis, surgical, radiologic, and/or endoscopic drainage should be delayed, preferably for 4 weeks, to allow the development of a wall around the necrosis."

Am J Gastroenterol 2013; 108:14001415
26 September 2013

Go to top of page Email this page Email this page to a colleague

 28 July 2016 
Hep B screening and immunosuppressive therapy
 28 July 2016 
Pancreatitis after ERCP
 28 July 2016 
HCV eradication in cirrhotic patients
 27 July 2016 
Bleeding GI recurrence with aspirin use
 27 July 2016 
IBD during pregnancy
 27 July 2016 
Gluten exposure in patients with celiac disease
 26 July 2016 
Post-infectious IBS after C. diff
 26 July 2016 
Gut microbiota and IBD
 26 July 2016 
Neighborhood variation in the use of laparoscopy for colon cancer
 25 July 2016 
Antibiotic prophylaxis for open colectomies
 25 July 2016 
Steroids in eosinophilic esophagitis
 25 July 2016 
Prevention of post-ERCP pancreatitis
 22 July 2016 
Upper GI lesions at primary diagnosis in IBD
 22 July 2016 
Duodenal villous atrophy and celiac disease
 22 July 2016 
Fecal calprotectin and IBD
 21 July 2016 
Radiofrequency ablation in Barrett's
 21 July 2016 
HCV eradication and inflammation in cirrhotic patients
 21 July 2016 
Surveillance of Barrett's
 20 July 2016 
Nonselective β-blockers and survival in cirrhosis
 20 July 2016 
Adolescent body mass index and and colorectal cancer risk
 20 July 2016 
Genetic biomarkers and IBD treatment response
 19 July 2016 
Prevention of chemotherapy-induced nausea and vomiting
 19 July 2016 
Screening diabetic patients for NAFLD
 19 July 2016 
Longterm clinical follow-up of living liver donors
 18 July 2016 
Rectal neuroendocrine tumors
 18 July 2016 
Liver cancer prediction scores in Hep B
 18 July 2016 
Liver stiffness measurement in chronic liver disease
 15 July 2016 
Patient reported outcomes in celiac disease
 15 July 2016 
Tonsillectomy and IBD risk
 15 July 2016 
Trainee IBD education in the USA
 14 July 2016 
Screening for familial pancreatic cancer
 14 July 2016 
Fecal calprotection for IBD prognosis
 14 July 2016 
Perianal surgery risk in Crohn's
 13 July 2016 
Psychological comorbidity and postinfectious IBS
 13 July 2016 
Lung transplant outcomes in Hep C
 13 July 2016 
Graft selection strategy in living donor liver transplants
 12 July 2016 
Therapy for iron deficiency anemia in IBD
 12 July 2016 
Surveillance endoscopy in Barrett's esophagus
 12 July 2016 
Treatment of pediatric acute liver failure
 11 July 2016 
Transition to adulthood in celiac disease
 11 July 2016 
Factors that influence access to liver transplant
 11 July 2016 
Disturbed sleep and IBS
 08 July 2016 
Mortality and peptic ulcers
 08 July 2016 
Statins and cirrhosis in Hep B
 08 July 2016 
Genetic risk score and body mass index
 07 July 2016 
Predicting food triggers in eosinophilic esophagitis
 07 July 2016 
Extraperitoneal vs transperitoneal colostomy for hernia
 07 July 2016 
Predictors fecal transplant failure in C. diff infection
 06 July 2016 
Therapies for Hep B cure
 06 July 2016 
Hospital volume and liver cancer survival
 06 July 2016 
Adverse events after outpatient colonoscopy
 05 July 2016 
Non-invasive scoring systems for fibrosis in NAFLD
 05 July 2016 
Exercise and gastroesophageal reflux
 05 July 2016 
Colorectal surgery and dialysis
 04 July 2016 
Guidelines on PPI and NSAID prescription
 04 July 2016 
Rectal cancer surgery checklist
 04 July 2016 
Autoimmunity in eosinophilic esophagitis and families
 01 July 2016 
Outcome measures in celiac disease
 01 July 2016 
Growth factor activity and IBD
 01 July 2016 
Aspirin and colorectal cancer

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2016 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us