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Pancreatite aguda: estratificação de risco

Authors: Condado, Daniana Alexandra Sirgado de Alpoim;

Pancreatite aguda: estratificação de risco

Abstract

A pancreatite aguda é definida como uma condição inflamatória aguda do pâncreas, com acometimento variável das estruturas peripancreáticas e órgãos a distância, cuja génese depende da autodigestão do seu parênquima pelas próprias enzimas pancreáticas. Representa uma das principais causas de internamento em unidades de cuidados intensivos de gastroenterologia. A sua incidência varia nos diferentes países e depende da etiologia. A sua patogénese ainda não está completamente esclarecida, mas conhecem-se múltiplas condições predisponentes. A severidade é variável, podendo apresentar-se de forma autolimitada até evolução para falência de múltiplos órgãos e sistemas, sepsis e morte. Na maioria dos casos as apresentações são brandas e tratadas com suporte clínico. Já nos casos mais graves, comporta-se como doença multissistémica e leva a síndrome da resposta inflamatória, com alta letalidade, sendo necessário cuidado especializado e intervenção cirúrgica. Existem critérios de gravidade cientificamente validados e é neles que se deve basear a abordagem clínica, com a adequação da terapêutica a cada caso individual. No presente artigo pretende-se fazer uma revisão da literatura em relação às diferentes vertentes da patologia, recolhendo a informação mais atualizada acerca da sua correta abordagem. Para tal, foi realizada uma pesquisa alargada da literatura científica acerca da Pancreatite Aguda, utilizando como motor de busca PubMed, Medscape, google, literatura cinzenta e livros publicados no âmbito da temática.

Acute pancreatitis is defined as an acute inflammatory condition of the pancreas, with involvement of the variable peripancreatic structures and organs at distance, genesis of which depends from autodigestion of its own parenchyma by pancreatic enzymes. Represents a major cause of hospitalization in intensive care units of gastroenterology. Its incidence varies in different countries and depends on the etiology. Their pathogenesis is not yet fully understood, but are known multiple predisposing conditions. The severity is variable and can present itself in a self-limited evolution up to failure of multiple organs and systems, sepsis and death. In most cases the presentations are mild and treated with clinical support. Yet in severe cases, it behaves as multisystemic disease and leads to inflammatory response syndrome with high mortality, requiring specialized care and surgical intervention. There are scientifically settled severity criteria and it is them that should be based on the clinical approach, with the adequacy of therapy in each individual case. In this article we intend to do a literature review of the pathology, collecting the most updated recommendations about their management. For that purpose, an extensive search of scientific literature about acute pancreatitis was made, using as a search engine PubMed, Medscape, google, gray literature and books in the subject.

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Portugal
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Keywords

Pâncreas - Anatomia - Fisiologia, Pancreatite aguda - Etiologia, Pancreatite aguda - Diagnóstico, Pancreatite aguda - Avaliação do risco, Pancreatite aguda, Pancreatite aguda - Mortalidade

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selected citations
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This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
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