Modern diagnostic capabilities of destructive forms of acute pancreatitis

Written by Rapovka V.G., Zavodov K.A., Sobolevskaya O.A.

  UDK: 616.37-002.4-036.11-07-039.11 | Pages: 52–55 | Full text PDF | Open PDF 

Background. Early diagnosis of destructive forms of acute pancreatitis (AP) enables to prevent the development of serious complications and reduce mortality rates.
Methods. 194 patients took part aged 19–78 with AP took part in the study, including 164 patients with acute destructive pancreatitis and 30 patients with edematous form AP.
Results. Leukocytal intoxication index was significantly higher in destructive pancreatitis. Diagnostic sensitivity of C-reactive protein with edematous pancreatitis was 86.4 %, and with destructive pancreatitis it was 87.5 %. In patients with destructive pancreatitis procalcitonin level was significantly higher than in patients with edematous form of AP: 1.24 and 0.34 ng/ml, respectively. The rest of the clinical and laboratory diagnostic tests showed wide variability.
Conclusions. Most of the traditional clinical and laboratory diagnostic techniques of AP does not allow reliably differentiate not only different forms of destructive lesions of the organ, but in some cases also of destructive and swelling forms AP. The most valuable diagnostic markers can serve as acute phase reactants, pro-inflammatory cytokines, and procalcitonin.

Links to authors:

V.G. Rapovka, K.A. Zavodov, O.A. Sobolevskaya
Pacific State Medical University (2 Ostryakova Ave. Vladivostok 690950 Russian Federation)

1. Pugaev A.V. Acute pancreatitis. М.: Profil, 2007. 335 p.
2. Rapovka V.G., Gavrina S.E., Rogatkina E.S. [et al.]. Effect of early enteral nutrition on immune status in the post-surgery period in patients with colon cancer // Pacific Medical Journal. 2013. No. 3. P. 52–55.
3. Savelyev V.S., Filimonov M.I., Gelfand B.R., Burnevich S.Z. The destructive pancreatitis: an algorithm for diagnosis and treatment // Gastroenterology. 2001. Vol. 3, No. 6. P. 373–379.
4. Styazhkina S.N., Sitnikov V.A., Ledneva A.V., Korobeinikov V.I. Acute destructive pancreatitis: Diagnosis and Treatment // International Journal of Experimental and Basic Research. 2011. No. 5. P. 110–112.
5. Ursov S.V., Lysenko M.V. Optimization of diagnostics and treatment of pancreatic necrosis // Emergency and specialized surgical care: abstracts of the Congress of Moscow Surgeons. М., 2005. P. 117–118.
6. Shelest P.V., Mironov V.I. Diagnosis and prognosis of clinical and morphological forms of acute destructive pancreatitis // Siberian Medical Journal. 2007. No. 6. P. 5–9.
7. Al Mofleh I.A. Severe acute pancreatitis: pathogenetic aspects and prognostic factors // World J. Gastroenterol. 2008. Vol. 14, No. 5. P. 675–684.
8. Banks P.A., Freeman M.L. Practice guidelines in acute pancreatitis // Am. J. Gastroenterol. 2006. Vol. 101, No. 10. P. 2379–2400.
9. Beger H.G., Rau B., Isenmann R. Natural history of necrotizing pancreatitis // Pancreatology. 2003. Vol. 3, No. 2. P. 93–101.
10. Buchler M.W., Gloor B., Muller C.A. [et al.]. Acute necrotizing pancreatitis: treatment strategy according to the status of infection // Ann. Surg. 2000. Vol. 232, No. 5. P. 619–626.
11. Forsmark C.E., Baillie J. AGA Institute technical review on acute pancreatitis // Gastroenterol. 2007. Vol. 132, No. 5. P. 2022–2044.
12. Manes G., Spada O.A., Rabitti P.G. [et al.]. Serum interleukin-6 in acute pancreatitis due to common bile duct stones. A reliable marker of necrosis // Recenti Prog. Med. 1997. Vol. 88, No. 2. P. 69–72.
13. Rau B., Steinbach G., Baumgart K. [et al.]. Serum amyloid A versus C-reactive protein in acute pancreatitis: clinical value of an alternative acute-phase reactant // Crit. Care Med. 2000. Vol. 28, No. 3. P. 736–742
14. Uhl W., Warshaw A., Imrie C. [et al.]. IAP Guidelines for the Surgical Management of Acute Pancreatitis // Pancreatology. 2002. Vol. 2, No. 6. P.. 565–573.


Founded in 1997  |  Editions in a year: 4, Articles in one issue: 30 |  ISSN of print version: 1609-1175  |  Ind.: 18410 (Agency "Rospechat’")  |  Edition: 1000 c.