Epidemiology, pathophysiology and management of acute pancreatitis: A literature review
DOI:
https://doi.org/10.33448/rsd-v13i4.45494Keywords:
Acute pancreatitis; Acute necrotizing pancreatitis; Gallstones; Alcohol abuse.Abstract
Introduction: Acute pancreatitis has an increasing incidence among all age groups. It’s typical presentation is marked by abdominal pain, vomiting and nausea and, among its causes, alcohol abuse and cholelithiasis are the most prominent. Although 80% of cases are mild manifestations, acute pancreatitis still has significant mortality and morbidity, therefore, this research aims to elucidate its aspects and understand the best management of the condition. Methodology: This is an integrative review on acute pancreatitis. Data from the Virtual Health Library (VHL), Scientific Electronic Library of Medicine (SciELO) and National Library of Medicine (PubMed) databases were used, by crossing the descriptors “acute pancreatitis”, “acute necrotizing pancreatitis”, “calculi biliary” and “alcohol abuse” to answer the question formulated through the PICO strategy. Results and Discussion: Acute pancreatitis affects approximately 34 out of every 100,000 people per year and risk factors include alcohol abuse, cholelithiasis, female gender, smoking, hypertriglyceridemia, among others. The diagnosis depends on 3 criteria, 2 of which are sufficient for this and clinical management depends on the severity of the presentation, with fluid therapy, cholecystectomy and ERCP being the highlights. The use of antibiotics as prophylaxis and drainage are still the subject of debate for the treatment of the disease. Conclusion: There is still a certain lack of knowledge about acute pancreatitis and some conflicts about its treatment and, therefore, more studies are needed to elucidate appropriate clinical management, the pathophysiology of the disease and how to eliminate risk factors.
References
Beyer, G., Hoffmeister, A., Lorenz, P., Lynen, P., Lerch, M. M., & Mayerle, J. (2022). Clinical Practice Guideline—Acute and Chronic Pancreatitis. Deutsches Arzteblatt international, 119(29-30), 495–501. https://doi.org/10.3238/arztebl.m2022.0223
Beyer, G., Hoffmeister, A., Michl, P., Gress, T. M., Huber, W., Algül, H., Neesse, A., Meining, A., Seufferlein, T. W., Rosendahl, J., Kahl, S., Keller, J., Werner, J., Friess, H., Bufler, P., Löhr, M. J., Schneider, A., Lynen Jansen, P., Esposito, I., Grenacher, L., … Collaborators: (2022). S3-Leitlinie Pankreatitis – Leitlinie der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) – September 2021 – AWMF Registernummer 021-003. Zeitschrift fur Gastroenterologie, 60(3), 419–521. https://doi.org/10.1055/a-1735-3864
Bougard, M., Barbier, L., Godart, B., Le Bayon-Bréard, A. G., Marques, F., & Salamé, E. (2019). Management of biliary acute pancreatitis. Journal of visceral surgery, 156(2), 113–125. https://doi.org/10.1016/j.jviscsurg.2018.08.002
Boxhoorn, L., van Dijk, S. M., van Grinsven, J., Verdonk, R. C., Boermeester, M. A., Bollen, T. L., Bouwense, S. A. W., Bruno, M. J., Cappendijk, V. C., Dejong, C. H. C., van Duijvendijk, P., van Eijck, C. H. J., Fockens, P., Francken, M. F. G., van Goor, H., Hadithi, M., Hallensleben, N. D. L., Haveman, J. W., Jacobs, M. A. J. M., Jansen, J. M., … Dutch Pancreatitis Study Group (2021). Immediate versus Postponed Intervention for Infected Necrotizing Pancreatitis. The New England journal of medicine, 385(15), 1372–1381. https://doi.org/10.1056/NEJMoa2100826
Chatila, A. T., Bilal, M., & Guturu, P. (2019). Evaluation and management of acute pancreatitis. World journal of clinical cases, 7(9), 1006–1020. https://doi.org/10.12998/wjcc.v7.i9.1006
Del Vecchio Blanco, G., Gesuale, C., Varanese, M., Monteleone, G., & Paoluzi, O. A. (2019). Idiopathic acute pancreatitis: a review on etiology and diagnostic work-up. Clinical Journal of Gastroenterology, 12(6), 511–524. https://doi.org/10.1007/s12328-019-00987-7
Ding, N., Sun, Y.-H., Wen, L.-M., Wang, J.-H., Yang, J.-H., Cheng, K., Lin, H., & Chen, Q.-L. (2019). Assessment of prophylactic antibiotics administration for acute pancreatitis: a meta-analysis of randomized controlled trials. Chinese Medical Journal, 133(2), 212–220. https://doi.org/10.1097/cm9.0000000000000603
Greenberg, J. A., Hsu, J., Bawazeer, M., Marshall, J., Friedrich, J. O., Nathens, A., Coburn, N., May, G. R., Pearsall, E., & McLeod, R. S. (2016). Clinical practice guideline: management of acute pancreatitis. Canadian journal of surgery. Journal canadien de chirurgie, 59(2), 128–140. https://doi.org/10.1503/cjs.015015
Habtezion, A., Gukovskaya, A. S., & Pandol, S. J. (2019). Acute Pancreatitis: A Multifaceted Set of Organelle and Cellular Interactions. Gastroenterology, 156(7), 1941–1950. https://doi.org/10.1053/j.gastro.2018.11.082
James, T. W., & Crockett, S. D. (2018). Management of acute pancreatitis in the first 72 hours. Current opinion in gastroenterology, 34(5), 330–335. https://doi.org/10.1097/MOG.0000000000000456
Kiss, L., Fűr, G., Sailaja Pisipati, Prasad Rajalingamgari, Ewald, N., Singh, V. P., & Zoltán Rakonczay. (2023). Mechanisms linking hypertriglyceridemia to acute pancreatitis. Acta Physiologica, 237(3). https://doi.org/10.1111/apha.13916
Lee, P. J., & Papachristou, G. I. (2019). New insights into acute pancreatitis. Nature reviews. Gastroenterology & hepatology, 16(8), 479–496. https://doi.org/10.1038/s41575-019-0158-2
Pandol, S. J., & Gottlieb, R. A. (2022). Calcium, mitochondria and the initiation of acute pancreatitis. Pancreatology, 22(7), 838–845. https://doi.org/10.1016/j.pan.2022.07.011
Patel, M. L., Shyam, R., Atam, V., Bharti, H., Sachan, R., & Parihar, A. (2022). Clinical profile, etiology, and outcome of acute pancreatitis: Experience at a tertiary care center. Annals of African Medicine, 21(2), 118–123. https://doi.org/10.4103/aam.aam_83_20
Petrov, M. S., & Yadav, D. (2019). Global epidemiology and holistic prevention of pancreatitis. Nature reviews. Gastroenterology & hepatology, 16(3), 175–184. https://doi.org/10.1038/s41575-018-0087-5
Saeed S. A. (2020). Acute pancreatitis in children: Updates in epidemiology, diagnosis and management. Current problems in pediatric and adolescent health care, 50(8), 100839. https://doi.org/10.1016/j.cppeds.2020.100839
Schepers, N. J., Hallensleben, N. D. L., Besselink, M. G., Anten, M.-P. G. F., Bollen, T. L., da Costa, D. W., van Delft, F., van Dijk, S. M., van Dullemen, H. M., Dijkgraaf, M. G. W., van Eijck, C. H. J., Erkelens, G. W., Erler, N. S., Fockens, P., van Geenen, E. J. M., van Grinsven, J., Hollemans, R. A., van Hooft, J. E., van der Hulst, R. W. M., & Jansen, J. M. (2020). Urgent endoscopic retrograde cholangiopancreatography with sphincterotomy versus conservative treatment in predicted severe acute gallstone pancreatitis (APEC): a multicentre randomised controlled trial. Lancet (London, England), 396(10245), 167–176. https://doi.org/10.1016/S0140-6736(20)30539-0
Souza M. T. de, Silva M. D. da, Carvalho R. (2010). Revisão integrativa: o que é e como fazer. Einstein (São Paulo), 8(1), 102–106. https://doi.org/10.1590/s1679-45082010rw1134
Strum, W. B., & Boland, C. R. (2023). Advances in acute and chronic pancreatitis. World journal of gastroenterology, 29(7), 1194–1201. https://doi.org/10.3748/wjg.v29.i7.1194
Szatmary, P., Grammatikopoulos, T., Cai, W., Huang, W., Mukherjee, R., Halloran, C., Beyer, G., & Sutton, R. (2022). Acute Pancreatitis: Diagnosis and Treatment. Drugs, 82(12), 1251–1276. https://doi.org/10.1007/s40265-022-01766-4
Walkowska, J., Zielinska, N., Karauda, P., Tubbs, R. S., Kurtys, K., & Olewnik, Ł. (2022). The Pancreas and Known Factors of Acute Pancreatitis. Journal of clinical medicine, 11(19), 5565. https://doi.org/10.3390/jcm11195565
Yang, A. L., & McNabb-Baltar, J. (2020). Hypertriglyceridemia and acute pancreatitis. Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.], 20(5), 795–800. https://doi.org/10.1016/j.pan.2020.06.005
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Júlia Paiva Lounine; Maria Júlia Cardoso de Melo; Thiago Barroso Ferreira Lima Brito Campos; Larissa Ferreira Carvalho Silva; Pedro Luccas Leal Contini Sanches; Laura Rodrigues Haddad; Hugo Nacif da Costa Valle; Laura Rodrigues Fonseca Nascimento; José Pedro Gomes de Faria Tavares; Júlia Alvim Aguiar
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
