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Phases of acute pancreatitis

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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phases of acute pancreatitis

Two overlapping phases with two peaks of mortality can be identified in acute pancreatitis:

  • early phase
    • present during the first week (but may extend to the second week as well)

    • host response to local pancreatic injury will result in systemic disturbances which will clinically manifest as the systemic inflammatory response syndrome (SIRS)
      • SIRS - defined by presence of two or more criteria:
        • heart rate >90 beats/min
        • core temperature <36°C or >38°C
        • white blood count <4000 or >12000/mm3
        • respirations >20/min or PCO2 <32mmHg

    • the severity of acute pancreatitis during early phase is determined by the presence and duration of organ failure
      • persistent SIRS (>48 hours) has been shown to be strongly associated with subsequent risk of developing organ failure

    • local complications may be present but does not influence the severity of the condition

  • late phase
    • characterised by the continuation of systemic signs of inflammation or by the presence of local complications
    • seen only in patients with moderately severe or severe acute pancreatitis (1,2)

Reference:


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