Download Acute Pancreatitis: Research and Clinical Management by V. Becker (auth.), Hans G. Beger MD, FACS, Markus Büchler MD PDF

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By V. Becker (auth.), Hans G. Beger MD, FACS, Markus Büchler MD (eds.)

Presents findings on acute pancreatitis within the fields of morphology, epidemiology, pathophysiology, enzymatic and in- strumental analysis, scientific points and pharmacological and surgical procedure. Emphasis on medical implications at the neighborhood unlock and vasoactice and poisonous elements, the excessive price of bacterial an infection within the necroses, and the motives of impairment of cardiocirculatory, pulmonary and re- nal organs.

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This study showed that biliary lithiasis as a risk factor for acute pancreatitis is usually more important than chronic alcoholism but that alcoholism in turn becomes an important risk factor when consumed in quantities of 40 g/day or more. The risk index doubles for quantities of 80 g/day or more, and the combined effects of alcohol excess and biliary lithiasis increase the risk of acute pancreatitis in an additional fashion. Thus, it can be concluded that: (a) the true incidence of acute pancreatitis is known only in a few limited geographical areas from which, however, it can be deduced that it is increasing; (b) the mortality from acute pancreatitis does not seem to have substantially changed in the past 20 years; and (c) the alcoholic etiology is increasing at least in those countries where alcohol consumption has increased in the past 30 years, but biliary lithiasis still appears to be the most important risk factor.

In any individual case it is difficult to estimate how far hyperlipoproteinemia type I or IV can be regarded as the cause of pancreatitis. The most frequent cause of acute pancreatitis in West Germany is alcohol. But alcohol leads in many patients to hyperlipoproteinemia [18-21]. Therefore some authors postulate the alcohol is causing pancreatitis via hyperlipoproteinemia. Contrary to this theory are the many clinical observations in which alcohol-induced pancreatitis was not associated with hyperlipoproteinemia; and, again, pancreatitis occurs in patients with hyperlipoproteinemia and no alcohol intake.

Ditschuneit 34 Results Out of the total of 86 patients with acute pancreatitis 80 cases were evaluated. In 60% of the cases the genesis of the disease could be traced to an alcohol consumption increased to more than 100 g per day; in 30% a biliary genesis was likely; and in 10% (8 patients) the cause was not clear. Three of the last group had hyperlipoproteinemia type V with triglycerides of up to 107 mmolll. The remaining five did not show any reasonable sign of a cause for their illness. The triglycerides, measured in 35 patients within 48 h after onset of the first subjective symptoms, are shown in Fig.

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