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. 2024 Mar;119(2):156-164.
doi: 10.1007/s00063-023-01104-w. Epub 2024 Jan 29.

[Management of acute pancreatitis in the emergency department and the intensive care unit]

[Article in German]
Armin Finkenstedt  1 , Michael Joannidis  2   3
Affiliations

[Management of acute pancreatitis in the emergency department and the intensive care unit]

[Article in German]
Armin Finkenstedt et al. Med Klin Intensivmed Notfmed. 2024 Mar.

Abstract
in English, German

Acute pancreatitis is a gastrointestinal emergency where diagnosis is based on typical symptoms, increased serum lipase concentration, and abdominal imaging. Local complications and organ failure in severe acute pancreatitis regularly necessitate treatment in the intensive care unit and are associated with increased mortality rates. Only optimal interdisciplinary treatment can improve the prognosis of patients with severe acute pancreatitis. This article gives guidance on the initial diagnostic and etiological examinations as well as on the evaluation of organ failure and the severity assessment according to common classification systems. Furthermore, the endoscopic management of biliary pancreatitis and infected necrosis is discussed and the basics of targeted volume therapy, nutrition, and indications for antibiotic treatment are reviewed.

Bei der akuten Pankreatitis handelt es sich um eine gastrointestinale Akuterkrankung, die anhand von typischer Symptomatik, erhöhter Serumlipase und abdomineller Bildgebung diagnostiziert werden kann. Durch Organversagen und lokale Komplikationen weisen schwere Verläufe eine hohe Sterblichkeit auf und erfordern häufig eine Behandlung auf der Intensivstation. Letztlich kann die Prognose von Patienten mit schwerer akuter Pankreatitis nur durch eine optimale interdisziplinäre Behandlung verbessert werden. Dieser Artikel gibt einen Überblick über die die initiale diagnostische und ätiologische Abklärung sowie über die Beurteilung von Organversagen und Abschätzung des Schweregrads gemäß gebräuchlicher Klassifikationssysteme. Ebenso werden das endoskopische Management bei biliärer Genese und von infizierten Nekrosen besprochen und die Grundzüge der zielgerichteten Volumentherapie, der Ernährungsstrategie und der Indikation zur antibiotischen Therapie erläutert.

Keywords: Antibiotic prophylaxis; Cholangitis; Endoscopic retrograde cholangiopancreatography; Enteral nutrition; Necrosis.

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References

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