Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
5.4
3.9
Journals
JCM
Special Issues
Clinical Diagnosis and Treatment of Pancreatitis
share announcement

Clinical Diagnosis and Treatment of Pancreatitis

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Gastroenterology & Hepatopancreatobiliary Medicine".

Deadline for manuscript submissions: 15 July 2024 | Viewed by 4849

Special Issue Editor

Dr. Alberto Maringhini

E-Mail Website
Guest Editor
ARNAS Civico, Palermo, Italy
Interests: pancreatitis; acute pancreatitis; cirrhosis infections; internal medicine

Special Issue Information

Dear Colleagues,

Acute pancreatitis is associated with significant morbidity and mortality rates, with hospitalization costs of more than USD 30,000 per person in the United States. Its mortality rate is approximately 1% overall; however, among hospitalized patients with pancreatitis and organ failure or pancreatitis necrosis, mortality may be as high as 30-40%.

The most common causes of acute pancreatitis are gallstones and alcohol use; other definite causes include metabolic (hypertriglyceridemia and hypercalcemia), drug-induced, autoimmune, post-endoscopic retrograde cholangiopancreatography, trauma (including biopsy), infectious, congenital or genetic and idiopathic abnormalities.

Acute pancreatitis incidence and hospitalization rates have continuously increased over the last 20 years.

Approximately 80% of acute pancreatitis cases are mild, with a short hospitalization duration and support treatment. The remaining 20% are severe, with discrete mortality and complex clinical presentation, systemic and local complications that require intensive care and specialized consulting.

These increasing incidence rates and hospitalization costs have promoted scientists to develop fast and accurate diagnostic techniques and better therapies to treat this disease’s complications, to look for accurate predictors of severity so resources can be allocated to the most severe patients, and to investigate its etiology and pathogenesis with the aim of prevention.

In the last 20 years, therapeutic approaches have considerably changed and, in several fields, no consensus has been reached. We are still not sure if acute pancreatitis is only one disease or a potpourri of different complications due to a generically poor understanding of pancreatic inflammation and its consequences.

The present Special Issue aims is to collect experimental findings, innovative single reports, population epidemiological studies, case series, clinical studies, critical reviews, and outside-the-box viewpoints that focus on the history, background, advances, and challenges regarding this disease’s diagnosis and treatment, the relationship between acute pancreatitis and cancer or chronic pancreatitis, etiology and natural history, diabetes, and exocrine deficiency. The role of interventional radiology, endoscopic ultrasound, and surgery in the treatment of acute pancreatitis in the present and in the future is also of interest.

Dr. Alberto Maringhini
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • acute pancreatitis
  • morbidity and mortality rates
  • gallstones
  • alcohol use
  • hospitalization
  • intensive care
  • etiology
  • chronic pancreatitis

Published Papers (3 papers)

Download All Papers
Order results
Result details
Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:

Research

Jump to: Review, Other

11 pages, 653 KiB  
Article
Acute Pancreatitis and Type 2 Diabetes Mellitus: The Chicken–Egg Paradox—A Seven-Year Experience of a Large Tertiary Center
by Mihai Radu Pahomeanu, Damiana Ojog, Diana Teodora Nițu, Irina Ștefania Diaconu, Hosein Nayyerani and Lucian Negreanu
J. Clin. Med. 2024, 13(5), 1213; https://doi.org/10.3390/jcm13051213 - 21 Feb 2024
Viewed by 734
Abstract
(1) Background: Preexisting type 2 diabetes mellitus (T2DM) has been shown in some studies as a risk factor and a severity factor for acute pancreatitis (AP). In this study, we aimed to demonstrate the link between T2DM and AP using data from a [...] Read more.
(1) Background: Preexisting type 2 diabetes mellitus (T2DM) has been shown in some studies as a risk factor and a severity factor for acute pancreatitis (AP). In this study, we aimed to demonstrate the link between T2DM and AP using data from a large retrospective epidemiological registry in a tertiary center. (2) Methods: We conducted a retrospective, large-cohort study of 1855 cases of AP and recurrent AP drawn from the seven-year consecutive hospitalization electronic health records of the largest acute-care tertiary teaching center in Romania. (3) Results: We observed a significant association between T2DM and a more severe course of the disease, and between T2DM and admission to the intensive care unit (ICU) due to AP, in our cohort using a chi-square test. However, we did not see a meaningful difference in comparing LoS-ICU between T2DM-AP and OAP (other known cause of AP). AP patients with T2DM had a greater probability of a severe course of the disease and were more likely to be admitted to the ICU than to the OAP. (4) Conclusions: The association between T2DM and AP remains a topic very representative of the “chicken–egg paradox”. We need further research on DM-related AP and their bidirectional association as our study is limited by its retrospective design. Full article
(This article belongs to the Special Issue Clinical Diagnosis and Treatment of Pancreatitis)
►▼ Show Figures

Figure 1

Review

Jump to: Research, Other

21 pages, 481 KiB  
Review
Recent Treatment Strategies for Acute Pancreatitis
by Yongcook Song and Sang-Hoon Lee
J. Clin. Med. 2024, 13(4), 978; https://doi.org/10.3390/jcm13040978 - 8 Feb 2024
Cited by 1 | Viewed by 1950
Abstract
Acute pancreatitis (AP) is a leading gastrointestinal disease that causes hospitalization. Initial management in the first 72 h after the diagnosis of AP is pivotal, which can influence the clinical outcomes of the disease. Initial management, including assessment of disease severity, fluid resuscitation, [...] Read more.
Acute pancreatitis (AP) is a leading gastrointestinal disease that causes hospitalization. Initial management in the first 72 h after the diagnosis of AP is pivotal, which can influence the clinical outcomes of the disease. Initial management, including assessment of disease severity, fluid resuscitation, pain control, nutritional support, antibiotic use, and endoscopic retrograde cholangiopancreatography (ERCP) in gallstone pancreatitis, plays a fundamental role in AP treatment. Recent updates for fluid resuscitation, including treatment goals, the type, rate, volume, and duration, have triggered a paradigm shift from aggressive hydration with normal saline to goal-directed and non-aggressive hydration with lactated Ringer’s solution. Evidence of the clinical benefit of early enteral feeding is becoming definitive. The routine use of prophylactic antibiotics is generally limited, and the procalcitonin-based algorithm of antibiotic use has recently been investigated to distinguish between inflammation and infection in patients with AP. Although urgent ERCP (within 24 h) should be performed for patients with gallstone pancreatitis and cholangitis, urgent ERCP is not indicated in patients without cholangitis. The management approach for patients with local complications of AP, particularly those with infected necrotizing pancreatitis, is discussed in detail, including indications, timing, anatomical considerations, and selection of intervention methods. Furthermore, convalescent treatment, including cholecystectomy in gallstone pancreatitis, lipid-lowering medications in hypertriglyceridemia-induced AP, and alcohol intervention in alcoholic pancreatitis, is also important for improving the prognosis and preventing recurrence in patients with AP. This review focuses on recent updates on the initial and convalescent management strategies for AP. Full article
(This article belongs to the Special Issue Clinical Diagnosis and Treatment of Pancreatitis)
►▼ Show Figures

Figure 1

Other

Jump to: Research, Review

13 pages, 1359 KiB  
Case Report
Significantly Elevated CA 19-9 after COVID-19 Vaccination and Literature Review of Non-Cancerous Cases with CA 19-9 > 1000 U/mL
by Jakub Ciesielka, Krzysztof Jakimów, Natalia Tekiela, Laura Peisert, Anna Kwaśniewska, Dariusz Kata and Jerzy Chudek
J. Clin. Med. 2024, 13(5), 1263; https://doi.org/10.3390/jcm13051263 - 23 Feb 2024
Viewed by 1826
Abstract
Background: CA 19-9 is a commonly assessed tumor marker, considered characteristic of pancreatic ductal adenocarcinoma (PDAC) and biliary tract cancers; however, the positive predictive value of CA 19.9 is too low, and the usage of CA 19.9 as a screening tool in the [...] Read more.
Background: CA 19-9 is a commonly assessed tumor marker, considered characteristic of pancreatic ductal adenocarcinoma (PDAC) and biliary tract cancers; however, the positive predictive value of CA 19.9 is too low, and the usage of CA 19.9 as a screening tool in the healthy population remains controversial. Methods: The presented case illustrates a reversed diagnosis of highly elevated serum CA 19-9 levels in a 54-year-old female complaining of pain in the epigastric region, shortly after COVID-19 vaccination. Laboratory tests showed a significantly elevated level of the CA 19-9 marker (>12,000 U/mL, reference value: <37 U/mL) with normal pancreatic enzyme activity. The patient underwent imaging examination, which showed no abnormalities, except for increased pancreatic dimension and areas of fluid signal in the pancreas in magnetic resonance imaging (MRI), which may correspond to autoimmune pancreatitis (AIP). The patient remains asymptomatic with a recommendation for a follow-up MRI in 12 months. Results: A literature review conducted revealed multi-causal CA 19-9 increases above 1000 U/mL, including non-cancerous diseases of the lung, pancreas, liver, ovary, kidney, and others. The median concentration of CA 19-9 regardless of the cause of disease was 2810 U/mL (IQR ± 6895). The median CA 19-9 values in men and women were 3500 (IQR ± 10,050) and 2455 (IQR ± 3927), respectively, and differ significantly between the compared groups (p < 0.05). There was no difference between CA 19-9 values and the categorized cause of the increase. Conclusions: Conducting differential diagnosis, it should not be forgotten that most international guidelines recommend the use of CA 19-9 only in conjunction with pathology of pancreas in radiological imaging; however, even such a combination can point the diagnostic pathway in the wrong direction. A highly elevated CA 19-9 level, typically associated with PDAC, may be the result of benign disease including AIP related to COVID-19 vaccination. Full article
(This article belongs to the Special Issue Clinical Diagnosis and Treatment of Pancreatitis)
►▼ Show Figures

Figure 1

Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:
 
Displaying articles 1-3
Back to TopTop