The Effects Of SIRS And Dysfunction Of Liver And Kidney On The Prognosis Of Patients With Severe Acute Pancreatitis

Acute pancreatitis may vary in severity, approximately 10 - 30% of patients develop severe illness with pancreatic inflammation progressing to pancreatic and peripancreatic necrosis with life-threatening sequelae. The severity of the local response can lead to development of the systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome(MODS), with considerable morbidity and mortality. Despite advances in the understanding of the pathophysiology of pancreatitis and improvements in imaging technology, diagnostic modalities for acute pancreatitis have not changed drastically in recent years. Clinical signs and symptoms, such as upper abdominal pain, back pain, vomiting, fever, tachycardia, and leukocytosis, are relatively nonspecific. Diagnosis therefore typically depends on a high level of clinical suspicion and the demonstration of elevated plasma concentrations of pancreatic enzymes and tomography. Clinical scoring systems specific for pancreatitis, such as the Ranson and Glasgow systems, have been shown to predict prognosiss in groups of patients with acute pancreatitis but require 48 hours from admission for full assessment. The Acute Physiology And Chronic Health Evaluation (APACHE) II scoring system, albeit superior and more flexible. The need therefore exists for an early objective predictor of severity to facilitate the selection of appropriate patients for these intensive or premium therapies thus minimizing the numbers of patients treated unnecessarily. An early goal in...