Complicaciones de la pancreatitis aguda en el área de Cuidados Intensivos y sus factores de riesgo
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2016
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
La pancreatitis aguda es una enfermedad inflamatoria que además del páncreas compromete tejidos vecinos y a distancia. Su presentación clínica es muy variable y en algunos casos tiene una morbimortalidad importante. Requiere un manejo precoz y oportuno para evitar complicaciones y muerte, ya que produce secuelas con impacto negativo y altos costos económicos y sociales. La mortalidad global por pancreatitis aguda, se da aproximadamente con el 5 % de los casos, se han identificado varias causas metabólicas como principal de etiología biliar y alcohólica, además existiendo otras causas como traumatismo, infecciones, virus, parásitos, micoplasma y algunas metabólicas. Entre su sintomatología es caracterizado por intenso dolor abdominal continua y terebrante, localizado en epigastrio y región peri umbilical, nauseas, vomito, anorexia y distensión abdominal, sus complicaciones pueden ser sistémicas y locales. Entre las sistémicas, insuficiencia orgánica múltiple, insuficiencia renal aguda, insuficiencia respiratoria, trastorno de la coagulación, hiperglucemia e hipocalcemia. Entre las complicaciones locales frecuentes tenemos; necrosis pancreática, colecciones liquidas peri pancreáticas, pseudoquistes. El pronóstico dependerá dela terapéutica, se valora con varias escalas clínicas, la más usada en la actualidad son los criterios de Ranson, el tratamiento dependerá del cuadro clínico según las escalas. El 80% de los pacientes con pancreatitis aguda se tratan con medidas de sostén y el 20 % restante se tratara en unidad de cuidados intensivos.
Acute pancreatitis is an inflammatory disease that, in addition to the pancreas, involves nearby and distant tissues. Its clinical presentation is very variable and in some cases has an important morbimortality. It requires early and timely management to avoid complications and death, as it produces sequels with negative impact and high economic and social costs. The global mortality due to acute pancreatitis occurs in approximately 5% of cases. Several metabolic causes have been identified as the main cause of biliary and alcoholic etiology, besides other causes such as trauma, infections, viruses, parasites, mycoplasma, and some metabolic causes. Among its symptomatology is characterized by intense abdominal pain and terebrante, located in epigastrium and peri umbilical region, nausea, vomiting, anorexia and abdominal distension, its complications can be systemic and local. Among the systemic, multiple organ failure, acute renal failure, respiratory failure, coagulation disorder, hyperglycemia and hypocalcemia. Among the frequent local complications we have; Pancreatic necrosis, peri-pancreatic liquid collections, pseudocysts. The prognosis depends on the therapeutic, is valued with several clinical scales, the most used at the present time are the Ranson criteria, the treatment will depend on the clinical picture according to the scales. 80% of patients with acute pancreatitis are treated with supportive measures and the remaining 20% are treated in an intensive care unit.
Acute pancreatitis is an inflammatory disease that, in addition to the pancreas, involves nearby and distant tissues. Its clinical presentation is very variable and in some cases has an important morbimortality. It requires early and timely management to avoid complications and death, as it produces sequels with negative impact and high economic and social costs. The global mortality due to acute pancreatitis occurs in approximately 5% of cases. Several metabolic causes have been identified as the main cause of biliary and alcoholic etiology, besides other causes such as trauma, infections, viruses, parasites, mycoplasma, and some metabolic causes. Among its symptomatology is characterized by intense abdominal pain and terebrante, located in epigastrium and peri umbilical region, nausea, vomiting, anorexia and abdominal distension, its complications can be systemic and local. Among the systemic, multiple organ failure, acute renal failure, respiratory failure, coagulation disorder, hyperglycemia and hypocalcemia. Among the frequent local complications we have; Pancreatic necrosis, peri-pancreatic liquid collections, pseudocysts. The prognosis depends on the therapeutic, is valued with several clinical scales, the most used at the present time are the Ranson criteria, the treatment will depend on the clinical picture according to the scales. 80% of patients with acute pancreatitis are treated with supportive measures and the remaining 20% are treated in an intensive care unit.
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PANCREATITIS, COMPLICACIONES, UNIDADES DE CUIDADOS INTENSIVOS, HOSPITAL DE ESPECIALIDADES GUAYAQUIL DR. ABEL GILBERT PONTON, CANTON GUAYAQUIL, ECUADOR