Posted on 03/26/2024 4:33:59 PM PDT by ConservativeMind
In a clinical guideline issued by the American College of Gastroenterology, evidence-based recommendations are presented for the management of patients with acute pancreatitis (AP).
Scott Tenner, M.D., M.P.H., from the and colleagues discussed management of AP, defined as acute inflammation of the pancreas.
The authors note that AP is heterogeneous and progresses differently among patients. Most patients experience symptoms lasting a few days, but about 20 percent will experience complications including pancreatic necrosis and/or organ failure.
To assess for biliary pancreatitis, transabdominal ultrasound is suggested for patients with AP; additional diagnostic evaluation is suggested for patients with idiopathic AP. Moderately aggressive fluid resuscitation is suggested for patients. Lactated Ringer solution is recommended over normal saline for intravenous resuscitation.
In acute biliary pancreatitis without cholangitis, medical therapy is suggested over early endoscopic retrograde cholangiopancreatography. It is recommended that patients with severe AP should not receive prophylactic antibiotics.
Patients with suspected infected pancreatic necrosis are not suggested to undergo fine needle aspiration. Early oral feeding (within 24 to 48 hours) is suggested for patients with mild AP as tolerated by the patient compared with the traditional nothing-by-mouth approach. Initial oral feeding with a low-fat solid diet is recommended for mild AP rather than a stepwise liquid-to-solid approach.
"Although further study is needed, the concept that urgent surgery is required in patients found to have infected necrosis is no longer valid," the authors write.
(Excerpt) Read more at medicalxpress.com ...
Good news that your doctor hopefully will get before you go in.
I’ve had a couple biopsy’s on my pancreas over the years and a doctor friend of mine said that no doctor ever wants to mess with it. My understanding of the biopsies was that they were done with a needle to minimize disruption.
There’s something especially charming about your pancreas exploding...
Before I realized what I had, there was a chance it could have burst within 24 hours. No time for anything but surgery.
Most of this is old news. The use of LR instead of NS is controversial. The studies are inconsistent.
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