| Hemorrhage in acute pancreatitis: should gastrointestinal bleeding be considered an organ failure? | |
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MedLine Citation:
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PMID: 18376304 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To define the magnitude, causes, risk factors, and consequences of hemorrhage in acute pancreatitis (AP). METHODS: Consecutive patients with AP were studied for hemorrhagic complication and its impact on mortality. Patients with gastrointestinal (GI) hemorrhage or hemorrhage within the pancreatic bed were managed with transfusions, endotherapy, angiographic embolization, or surgery as appropriate. RESULTS: Of 449 patients, 28 (6.2%) developed hemorrhage. The mean age of patients with hemorrhage was 39 +/- 14 years and 25 (89%) were men. Of the 28 patients, 16 had GI hemorrhage, and 12 had hemorrhage into the pancreatic bed. Median interval between the onset of AP and hemorrhage was 26.5 days. Pancreatic necrosis, sepsis, fluid collection, and organ failure were found to be risk factors for hemorrhage. Five patients had pseudoaneurysms; angiographic embolization was successful in 4 of them. The mortality rate in bleeders was higher than that in nonbleeders (28.6% vs 13%; P = 0.02). None of the patients died as a direct consequence of hemorrhage except 1 patient who died after surgery for failed embolization of bleeding pseudoaneurysm. Deaths were mainly caused by sepsis and multiorgan failure. CONCLUSIONS: Hemorrhagic complications are usually late manifestations in the course of severe pancreatitis and per se have little bearing on mortality. |
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Authors:
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Praveen Kumar Sharma; Kaushal Madan; Pramod Kumar Garg |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Pancreas Volume: 36 ISSN: 1536-4828 ISO Abbreviation: Pancreas Publication Date: 2008 Mar |
Date Detail:
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Created Date: 2008-03-31 Completed Date: 2008-06-19 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8608542 Medline TA: Pancreas Country: United States |
Other Details:
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Languages: eng Pagination: 141-5 Citation Subset: IM |
Affiliation:
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Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Adult Disease Progression Female Gastrointestinal Hemorrhage / etiology*, mortality, pathology, therapy Hemorrhage / etiology*, mortality, pathology, therapy Humans Male Middle Aged Multiple Organ Failure / etiology*, mortality, pathology, therapy Necrosis Pancreatic Diseases / etiology*, mortality, pathology, therapy Pancreatitis / complications*, mortality, pathology, therapy Prospective Studies Risk Factors Sepsis / complications Severity of Illness Index |
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