Treatment in acute pancreatitis

Abstract

The prevalence of acute pancreatitis in population is estimated as 100.000/520 and alcohol and bile stone migration are considered as causes in 80% of cases. Disease has a mild course in most cases and patients recover with a short term hospitalization. In minority of patients, disease has a severe course that may cause death eventually. Patients in last form should be treated in ICU and be monitored very closely. Therefore estimating the severity of the disease early in the course, using several severity indexes which is developed for this purpose is very important. The treatment includes medical and interventional (surgical / endoscopic) modalities. Fluid replacement, pain control, antibiotic prophylaxis , enteral feeding, thrombosis prophlaxis and O2 support are considered as essentials of medical treatment. Invasive methods are consist of biliary stone extraction , stenting in pancreas divisium, sphincterotomy in Sphyncter of Oddi Dysfunction via endoscopic retrograde cholangiopancreatography and endoscopic or surgical debridman in pancreatic necrosis and pseudocyst drainage.

Keywords

• Acute, pancreatitis, treatment

Akut pankreatitde tedavi

Öz

Toplumdaki insidansı 100.000'de 5-20 olan akut pankreatitin en sık nedeni %80 olguda alkol ve safra taşı migrasyonudur. Olguların büyük çoğunluğu hafif formda olup, sadece kısa süreli hospitalizasyonla düzelebilirken, az bir kısmı ciddi mortalitiye de neden olabilen şiddetli formda görülür. Şiddetli formlarda tedavi mutlak yoğun bakım koşullarında yapılmalı ve hasta çok yakından izlenmelidir. Bu nedenle bu amaçla geliştirilmiş indeksler kullanılarak şiddetli formun önceden tanınması çok önemlidir. Tedavi medikal ve girişimsel (endoskopik/cerrahi) olmak üzere ikiye ayrılabilir. Sıvı replasmanı, ağrı kontrolü, tromboz proflaksisi, antibiyotik proflaksisi, enteral beslenme, O2 tedavisi medikal tedavide önemliyken, endoskopik retrograd kolanjiyopankreatografi ile biliyer pankreatitde taş ekstraksiyonu, pankreas divisumda stent yerleştirilmesi, sfinkter oddi disfonksiyonunda sfinkterotomi ve ayrıca endoskopik/cerrahi nekroz debridmanı, pseudokist drenajı uygulanabilecek girişimsel yöntemlerdir.

Anahtar Kelimeler

• Akut, pankreatit, tedavi

Kaynakça

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