| 41. |
- Andersson, Ellen, et al.
(författare)
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Major haemorrhagic complications of acute pancreatitis.
- 2010
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Ingår i: British Journal of Surgery. - : Oxford University Press (OUP). - 1365-2168 .- 0007-1323. ; Jul 1, s. 1379-1384
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:: Haemorrhage is a rare, potentially fatal complication in acute pancreatitis (AP). The aim was to investigate the incidence, management and outcome related to this complication. METHODS:: The medical records of all patients with AP who presented to a single hospital between January 1994 and July 2009 were reviewed retrospectively. Patients who developed at least one in-hospital episode of major haemorrhage were selected. The aetiology, patient characteristics, occurrence of sentinel bleeding, clinical management and outcome were recorded. RESULTS:: Fourteen (1.0 per cent) of 1356 patients diagnosed with AP developed major haemorrhage. Angiography established the diagnosis in four of six patients. Embolization was successful in one patient. Surgery was performed in two patients. Sentinel bleeding occurred in three of four patients with major postoperative bleeding. The overall mortality rate was 36 per cent (5 of 14 patients). Haemorrhage presenting after more than 7 days was associated with a higher mortality rate of 80 per cent (4 of 5 patients). A fatal outcome was at least three times more likely in patients with severe AP and haemorrhagic complications than in those with severe AP but no bleeding. CONCLUSION:: Major haemorrhagic complications of AP are rare, but clinically important. Major postoperative bleeding is often preceded by sentinel bleeding. Intra-abdominal haemorrhage presenting more than 1 week after disease onset is a highly fatal complication. Copyright (c) 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
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| 42. |
- Andersson, Ellen, et al.
(författare)
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Pancreatic dysfunction in acute pancreatitis
- 2006
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Ingår i: Journal of Organ Dysfuntion. - : Informa UK Limited. - 1747-1060 .- 1747-1079. ; 2:3, s. 135-141
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Tidskriftsartikel (refereegranskat)abstract
- In the normal setting, the release of digestive substances and hormones from the pancreas is closely regulated. However, a variety of diseases, such as acute pancreatitis (AP), may disturb this balance. A limited number of studies on exocrine function in the acute phase of pancreatitis have been performed, most of them in animals. In the convalescent phase of AP, a substantial number of patients will have abnormal results of pancreatic function tests. Many patients with AP develop temporary hyperglycemia requiring insulin treatment and some will end up requiring long-term insulin therapy. The aim of this review is to summarize current knowledge of exocrine and endocrine dysfunction of the pancreas during both the acute and recovery phases of AP. Pancreatic function in the normal setting, dysfunction associated with AP and follow-up studies are presented.
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| 43. |
- Andersson, Ellen, et al.
(författare)
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Tissue factor in predicted severe acute pancreatitis.
- 2010
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Ingår i: World Journal of Gastroenterology. - : Baishideng Publishing Group Inc.. - 1007-9327. ; 16:48, s. 6128-6134
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Tidskriftsartikel (refereegranskat)abstract
- To study tissue factor (TF) in acute pancreatitis and evaluate the role of TF as a predictive marker of severity.
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| 44. |
- Andersson, Ellen, et al.
(författare)
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Treatment with anti-factor VIIa in acute pancreatitis in rats: Blocking both coagulation and inflammation?
- 2007
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Ingår i: Scandinavian Journal of Gastroenterology. - : Informa UK Limited. - 1502-7708 .- 0036-5521. ; 42:6, s. 765-770
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Tidskriftsartikel (refereegranskat)abstract
- Objective. Acute pancreatitis starts as an autodigestive process restricted to the pancreas and progresses to a systemic inflammation via cytokine release into the blood stream. Several inhibitors of the coagulation cascade, including active- siteinactivated factor VIIa, have shown anti- inflammatory properties in other inflammatory models than acute pancreatitis. Free radical scavengers have proven useful in reducing the oxidative damage during hyperinflammatory conditions. The aim of this study was to investigate whether pretreatment with FVIIai would have any effect on the multiple organ dysfunction syndrome ( MODS) in severe acute pancreatitis. Material and methods. Experimental acute pancreatitis was induced by intraductal infusion of taurodeoxycholate in the pancreatic duct. The animals were pretreated with N- acetyl- cysteine and active- site- inactivated factor VIIa. Neutrophil infiltration in the lungs, ileum and colon was quantified by myeloperoxidase activity. Inflammatory markers, IL- 6 and MIP- 2, were measured using ELISA. Results. Tissue infiltration of neutrophils in the lungs, ileum and colon significantly increased during acute pancreatitis as compared to sham operation. These levels were reduced by pretreatment with N- acetylcysteine and active- site- inactivated factor VIIa. Levels of interleukin- 6 and macrophage inflammatory protein- 2 increased significantly during acute pancreatitis. Pretreatment with NAC and FVIIai reduced these levels. Conclusions. Both N- acetylcysteine and active- site- inactivated factor VIIa showed powerful antiinflammatory properties in experimental acute pancreatitis. As they exert their effects through different physiological mechanisms, they represent potential candidates for future multimodal treatment of acute pancreatitis.
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| 45. |
- Andersson, Roland, et al.
(författare)
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Acute pancreatitis - from cellular signalling to complicated clinical course.
- 2007
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Ingår i: HPB. - : Elsevier BV. - 1477-2574 .- 1365-182X. ; 9:6, s. 414-420
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Tidskriftsartikel (refereegranskat)abstract
- Acute pancreatitis (AP) is a common disease that has a mild to moderate course in most cases. During the last decade, a change in diagnostic facilities as well as improved intensive care have influenced both morbidity and mortality in AP. Still, however, a number of controversies and unresolved questions remain regarding AP. These include prognostic factors and how these may be used to improve outcome, diagnostic possibilities, their indications and optimal timing, and the systemic inflammatory reaction (systemic inflammatory response syndrome - SIRS) and its effect on the concomitant course of the disease and potential development of organ failure. The role of the gut has been suggested to be important in severe AP, but has recently been somewhat questioned. Despite extensive research, pharmacological and medical intervention of proven clinical value is scarce. Various aspects on surgical interventions, including endoscopic sphincterotomy, cholecystectomy and necrosectomy, as regards indications and timing, will be reviewed. Last, but not least, are the management of late complications and long-term outcome for patients with especially severe AP.
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| 46. |
- Andersson, Roland, et al.
(författare)
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Acute pancreatitis–can evidence-based guidelines be transferred to an optimized comprehensive treatment program?
- 2021
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Ingår i: Scandinavian Journal of Gastroenterology. - : Informa UK Limited. - 0036-5521 .- 1502-7708. ; 56:10, s. 1220-1221
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Tidskriftsartikel (refereegranskat)abstract
- Acute pancreatitis is a common cause of hospitalization and has an incidence of about 300 per 1,000,000 inhabitants. A majority of patients with acute pancreatitis have mild disease, with an absence of local and systemic complications [1]. The clinical, translational, and experimental research in the field of acute pancreatitis is enormous and various guidelines exist. The guidelines have improved, and now increasingly use evidence-based grading, although expert opinion is still part of numerous recommendations.A persistent problem, however, is the uptake of and compliance with these guidelines. For every guideline recommendation, we should need an implementation plan and an audit. This was pointed out in an editorial in the Scandinavian Journal of Gastroenterology in 2008 [2]. It is reasonable to assume that adherence to existing management recommendations improves clinical outcomes for patients with acute pancreatitis.
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| 47. |
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| 48. |
- Andersson, Roland, et al.
(författare)
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Akut gastroenterologi i fokus
- 2002
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Ingår i: Svensk kirurgi. - 0346-847X. ; 60, s. 336-336
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 49. |
- Andersson, Roland, et al.
(författare)
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Akut pankreatit
- 2005
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Ingår i: Intensivvård. - 9147051353 ; , s. 330-330
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 50. |
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