Severe acute pancreatitis: Clinical course and management

Figure 1 Pattern of inflammation and systemic complications in acute pancreatitis. MAP: Mild acute pancreatitis; SAP: Severe acute pancreatitis; IAP: Intestinal oedematous pancreatitis; NP: Necrotizing pancreatitis; IN: Infected necrosis; SPN: sterile pancreatic necrosis; SIRS: severe inflammatory response syndrome; OF: Organ failure; MOD: Multiorgan failure; SEPSIS: Leukocytes > 10 000/mm³ + fever > 38.5 rectal/> 48 h + metabolic acidosis base excess > -4 mmol/L; MOFS: Multiorgan failure syndrome; ESAP: Early severe acute pancreatitis.

Figure 2 Relation between bacterial infection and extent of necrosis in 225 patients with severe acute pancreatitis. ¹On the basis of contrast-enhanced CT. ^bP = 0.008 between the groups, Cochran-Armitage trend test.

Figure 3 Algorithm for clinical decision making in acute pancreatitis. AIP: Acute interstitial pancreatitis; NP: Necrotizing pancreatitis; CRP: C reactive protein; CECT: Contrast-enhanced computer tomography; LDH: Lactate dehydrogenase; ERC: Endoscopic retrograde cholangiography; ES: Endoscopic sphincterotomy; CE: Laparoscopic cholecystectomy; FNP: Fine needle procedure; MOF: Multiorgan failure syndrome.