Help
Subscribe


Submit Videos to GastroHep Read For FREE - Our full range of review articles
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Guido Tytgat Profile of Pete Peterson Profile of Peter Cotton 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 12–24 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; 108:1400–1415
26 September 2013

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

 03 July 2015

Advanced search
 03 July 2015 
Tumors with mismatch-repair deficiency
 03 July 2015 
Aptitude of trainees in endoscopic ultrasonography
 03 July 2015 
Extracolonic pathologies in colorectal cancer
 02 July 2015 
Ulcerative colitis prognosis after thiopurines withdrawal
 02 July 2015 
Health care use by IBD children
 02 July 2015 
Anastomotic leak and cancer cancer
 01 July 2015 
Oral mechanical bowel preparation
 01 July 2015 
Missed gastric cancers
 01 July 2015 
Probiotics in IBD
 30 June 2015 
Split-dose preparations vs day-before bowel cleansing regimens
 30 June 2015 
Glucocorticoids and peptic ulcer bleeding
 30 June 2015 
NSAIDs and hearburn symptoms
 29 June 2015 
Prevention of pancreatitis after ERCP
 29 June 2015 
Advances in autoimmune pancreatitis
 29 June 2015 
Rescue therapy in ulcerative colitis
 26 June 2015 

Gene polymorphism in alcoholic liver disease

 26 June 2015 
Dietary fibre–microbiota interactions
 26 June 2015 
Gastritis in celiac disease
 25 June 2015 
Persistent organ failure in acute cholangitis patients
 25 June 2015 
Vitamin D level and primary biliary cirrhosis
 25 June 2015 
Fecal microbiota in pediatric IBD
 24 June 2015 
Fatigue scales for IBD
 24 June 2015 
Mucosal healing tests in ulcerative colitis
 24 June 2015 
Environmental risk in IBD
 23 June 2015 
Marker associated with endoscopic lesion in Crohn's
 23 June 2015 
Body composition in children with IBD
 23 June 2015 
Medical vs nurse endoscopists
 22 June 2015 
Gene polymorphism associated with increased liver enzymes
 22 June 2015 
Treatment of uncomplicated acute appendicitis
 22 June 2015 
Solid organ cancers after liver transplant
 19 June 2015 
Causes of death in HBV
 19 June 2015 
Lifetime benefits of increased adenoma detection rates
 19 June 2015 
Acid-suppressive therapy before anti-reflux surgery
 18 June 2015 
Risk for dyspepsia
 18 June 2015 
Endoscopic activity in symptomatic IBD patients
 18 June 2015 
Regimens for H. pylori eradication
 17 June 2015 
NAFLD risk in celiac disease
 17 June 2015 
Non-invasive markers of advanced liver fibrosis
 17 June 2015 
Patients’ and clinicians’ perception of pouch dysfunction
 16 June 2015 
Risk score for hepatocellular carcinoma screening
 16 June 2015 
Esophageal food bolus impaction
 16 June 2015 
Evaluating lymph node metastasis for rectal cancer
 15 June 2015 
Low-cost colonoscopy training
 15 June 2015 
Determining dysbiosis in IBS or IBD
 15 June 2015 
Light alcohol consumption and NAFLD
 12 June 2015 
Smoking and disease course in IBD
 12 June 2015 
Hep D in a Hep B endemic area
 12 June 2015 
Patient-orientated internet information in ulcerative colitis
 11 June 2015 
Physical inactivity and NAFLD
 11 June 2015 
Esophageal stricture after endoscopic resection
 11 June 2015 
Guideline based screening strategies for hepatitis
 10 June 2015 
Cost-effectiveness of HCV treatment in liver disease
 10 June 2015 
Abdominoperineal excision for low rectal cancer
 10 June 2015 
Pediatric chronic Hep C
 09 June 2015 
Bile acid malabsorption in IBS
 09 June 2015 
Racial differences in celiac disease
 09 June 2015 
Conversion from laparoscopic to open colorectal cancer resection
 08 June 2015 
Short sleep duration and NAFLD
 08 June 2015 
Heritability in inflammatory bowel disease
 08 June 2015 
Eosinophilic esophagitis

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2015 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us