Article
Gastroenterology & Hepatology
Selena Zhou, Carlos Buitrago, Andrew Foong, Vivian Lee, Lillian Dawit, Brent Hiramoto, Patrick Chang, Hannah Schilperoort, Alice Lee, Enrique de-Madaria, James Buxbaum
Summary: Fluid resuscitation with LR reduces the incidence of moderately-severe pancreatitis compared to NS. There was no difference in the development of SIRS or organ failure between LR and NS groups. LR resuscitated patients were less likely to require ICU admission and had fewer local complications. More studies are needed to further investigate these findings and determine underlying mechanisms.
Review
Gastroenterology & Hepatology
Edson Guzman-Calderon, Carlos Diaz-Arocutipa, Eduardo Monge
Summary: This study assessed the use of LR compared to NS in patients with acute pancreatitis and found no significant differences in mortality and SIRS. However, patients who received LR had a lower risk of ICU admission and shorter hospital stay compared to those who received NS.
DIGESTIVE DISEASES AND SCIENCES
(2022)
Review
Gastroenterology & Hepatology
Muhammad Aziz, Zohaib Ahmed, Simcha Weissman, Sami Ghazaleh, Azizullah Beran, Faisal Kamal, Wade Lee -Smith, Ragheb Assaly, Ali Nawras, Stephen J. Pandol, Stephanie McDonough, Douglas G. Adler
Summary: The study found that in patients with acute pancreatitis, lactated Ringer's solution improved outcomes such as ICU admission and length of stay compared to normal saline. However, there was no significant difference between the two treatments in terms of SIRS development rate and mortality.
Article
Gastroenterology & Hepatology
Han Li, Jinyan Xie, Xiuliu Guo, Guilian Yang, Bin Cai, Jingtianyi Liu, Mengjia Yue, Yixin Tang, Gan Wang, Shuxian Chen, Jialin Guo, Xuchen Qi, Donghai Wang, Huijun Zheng, Wei Liu, Hong Yu, Chunfeng Wang, Shu Jeffrey Zhu, Feng Guo
Summary: This study shows that Bifidobacteria, particularly B. animalis, can protect against acute pancreatitis by regulating pancreatic and systemic inflammation. The metabolite lactate produced by B. animalis relieves inflammation through the TLR4/MyD88 and NLRP3/Caspase1 pathways. Clinical research also found a decreased abundance of Bifidobacteria in the intestines of acute pancreatitis patients, which was inversely correlated with the severity of systemic inflammatory responses.
Article
Gastroenterology & Hepatology
Shyam Vedantam, Nadeem Tehami, Enrique De-Madaria, Jodie A. Barkin, Sunil Amin
Summary: This study compared outcomes between LR and NS fluid rehydration strategies in acute pancreatitis and found no significant difference in the odds of developing SIRS within 24 hours. There were also no differences between LR and NS in terms of SIRS at 48 and 72 hours, mortality, and other secondary outcomes, but LR was associated with a decreased need for ICU admission.
DIGESTIVE DISEASES AND SCIENCES
(2022)
Review
Biochemistry & Molecular Biology
Klementina Ocskay, Peter Matrai, Peter Hegyi, Andrea Parniczky
Summary: This study analyzed randomized controlled trials and found that lactated Ringer's solution (LR) significantly reduces the risk of moderate-to-severe pancreatitis, mortality, and the need for intensive care compared to normal saline (NS). LR also reduces the risk of systemic and local complications in acute pancreatitis.
Review
Gastroenterology & Hepatology
Chia Siang Kow, Ismail Abdul Sattar Burud, Syed Shahzad Hasan
Summary: This study conducted a systematic review and meta-analysis to explore the association between the choice of fluid (lactated Ringer's or normal saline) and clinical outcomes in patients with acute pancreatitis. The findings suggest that the administration of lactated Ringer's fluid may reduce the odds of intensive care unit admission and local complications in hospitalized patients with acute pancreatitis compared to normal saline.
Article
Emergency Medicine
Kelly R. Bergmann, M. Jennifer Abuzzahab, Jeffrey Nowak, Joe Arms, Gretchen Cutler, Eric Christensen, Mike Finch, Anupam Kharbanda
Summary: This study examined the use of Ringer's lactate (LR) or normal saline (NS) for resuscitation in children with diabetic ketoacidosis (DKA), finding that resuscitation with LR was associated with lower total cost and rates of cerebral edema (CE) compared to NS. Further investigation using patient-level clinical and laboratory data is needed to evaluate factors that drive cost and risk of CE development with each fluid.
PEDIATRIC EMERGENCY CARE
(2021)
Review
Medicine, General & Internal
Francisco Valverde-Lopez, Juan Gabriel Martinez-Cara, Eduardo Redondo-Cerezo
Summary: Acute pancreatitis is a common disease in gastroenterology, with gallstones and alcohol as the main causes. Diagnostic criteria and imaging techniques have been well defined, with ultrasound being useful for diagnosing the cause and computed tomography being better for assessing risk and complications. Fluid therapy, early oral feeding, and pain management are the mainstay of early treatment for acute pancreatitis. Antibiotics are useful when infected necrosis or extra pancreatic infections are present or suspected, but not for prophylaxis in sterile necrotizing pancreatitis. Minimally invasive approaches have emerged for managing walled off necrosis, improving complications rates, quality of life, and hospital stay compared to open surgery.
Article
Multidisciplinary Sciences
Binod Karki, Suresh Thapa, Dibas Khadka, Sanjit Karki, Roshan Shrestha, Ajit Khanal, Ramila Shrestha, Bidhan Nidhi Paudel
Summary: This study compared the efficacy of Ringers lactate and Normal Saline in the treatment of acute pancreatitis. The results showed that Ringers lactate was associated with a reduction in systemic inflammation in patients with acute pancreatitis. However, the incidence of SIRS at 72 hours and occurrence of local complications were similar in both groups.
Review
Rheumatology
Alina Dima, Daniel Vasile Balaban, Ciprian Jurcut, Mariana Jinga
Summary: SLE-related acute pancreatitis is a rare but severe complication, predominantly affecting females with an average age of around 30 years. It is more frequent in patients with short disease duration, high activity scores, and multiorgan involvement. There is no standardized therapeutic approach, and caution should be exercised when using corticosteroids, while plasma exchange may be beneficial in selected cases.
Article
Gastroenterology & Hepatology
Enrique de-Madaria, James L. Buxbaum
Summary: Recent randomized controlled trials have challenged current approaches to management in acute pancreatitis, including fluid resuscitation, antibiotic administration, management of infected necrosis, and early endoscopic retrograde cholangiopancreatography. This evidence calls for a reassessment of the current management guidelines.
NATURE REVIEWS GASTROENTEROLOGY & HEPATOLOGY
(2023)
Article
Medicine, General & Internal
Wei Liu, Zenghui Li, Xinyu Zhang, Juanjuan Du, Rui Liang, Yifan Ji, Wei Tang, Xiaoming Zhang
Summary: This study investigated the relationship between acute pancreatitis (AP) and preexisting fatty liver (FL), and found that patients with preexisting FL were more likely to develop necrosis, local complications, and persistent systemic inflammatory response syndrome (SIRS). Preexisting FL was considered an independent risk factor for predicting the presence of persistent SIRS in patients with AP.
INTERNATIONAL JOURNAL OF GENERAL MEDICINE
(2022)
Article
Immunology
Menglian Zou, Zihan Yang, Yue Fan, Liang Gong, Ziying Han, Li Ji, Xiaomin Hu, Dong Wu
Summary: This study found that patients with acute necrotizing pancreatitis (NP) have distinct characteristics of intestinal microbiota compared to non-necrotizing pancreatitis (non-NP) patients. Dysbiosis of intestinal microbiota may influence the progression of NP through ketone body or benzoate metabolism. Enterococcus faecium and Finegoldia magna are potential predictors for NP and infected NP.
FRONTIERS IN IMMUNOLOGY
(2022)
Article
Radiology, Nuclear Medicine & Medical Imaging
Maria Gabriella Brizi, Federica Perillo, Federico Cannone, Laura Tuzza, Riccardo Manfredi
Summary: Acute pancreatitis, ranging from mild to severe forms with significant complications, is commonly diagnosed and evaluated using ultrasound, CT, and MRI. CT is the most frequently performed imaging test, while MRI is advantageous in specific situations for better soft tissue contrast resolution and evaluation of ductal disconnection. The revised Atlanta classification system aids radiologists in writing accurate reports and highlights their crucial role in the multidisciplinary team for treating patients with acute pancreatitis.