الفهرس | Only 14 pages are availabe for public view |
Abstract Acute pancreatitis is a nonbacterial inflammation of the pancreas caused by the activation, interstitial liberation, and the digestion of the gland by its own enzymes. It is characterized clinically by acute abdominal pain, elevated concentration of pancreatic enzymes in blood, and an increase in the amount of pancreatic enzymes excreted in urine (Reber, 1999 ). . ·,•.. Early prediction of severity is important in determining appropriate management of a patient admitted with acute pancreatitis ( Toh et al 1997). Since Ranson and colleagues first introduced their criteria in 1974, considerable research has been undertaken to find the ideal predictor that allows for rapid and correct assessment of severity (johnson, 1996 ). For many years the main value of predictive scores, such as Ranson’s and the Glasgow Scores, has been to categorize patients and to stratify study groups as predicted mild or severe to allow adequate comparison of reported series ( Blamey et al, 1984) However the value of early stratification is becoming increasingly important, as Recent evidence suggests that aggressive early intervention including emergency endoscopic sphineterotomy in predicted severe gallstone pancreatitis ( de Beaux et al, 1996 ),prophylactic antibodies (johnson, 1996 ) and novel therapies, in particular, antioxidants and anticytokine drugs ( Kingnorth et al, 1995; Toh et al, 1997 ) may improve the outcome of severe cases if given early in the course of the attack. .The use of predicted probability in the assessment of severity is proposed as a way of determining individual risk of complications for each patient. In this work our aim will be to highlight the deficiencies and recent developments in severity prediction (Reber, 1999). |