Acute pancreatitis (AP) is a severe disease that usually involves hospitalization and a customized therapy. To date, remarkable progress has been made in establishing the etiology, diagnosis and therapy of this condition. For example, it is well documented that the AP course consists of two distinct pathophysiological phases. The first phase lasts about 1-2 weeks, involving only local inflammatory changes and possibly a transient SIRS syndrome, which require conservative therapy. The second phase is represented either by disease remission in patients with mild forms of AP, or by the persistence of SIRS syndrome and the occurrence of local complications in patients with moderate forms. Local complications therefore often occur in the second phase, when therapy must be customized according to the complications of the pancreatic area, as well as to provide adequate systemic support. Methods/ Results: Severe forms are less common and generally associate MSOF, which can develop at any time in the evolution of AP. MSOF worsens preexisting SIRS syndrome and local complications, making treatment more difficult and significantly increasing morbidity and mortality. This study presents the evolution of a group of patients with acalculous AP, who did not present in the first phase any systemic determinant of SIRS syndrome. Consequently, our initial prognosis was favorable, but the evolution of some patients was unexpectedly severe. Conclusions: Such surprising cases in terms of the evolution may suggest that increased caution is required in all AP patients, even if preliminary data suggest a mild form of the disease. Additional studies are necessary in the near future on this topic, both to improve therapy and to establish a better prognostic score by using new diagnostic tools.
Keywords: acalculousforms; acutepancreatitis; severeevolutions; youngfemalepatients.
Celsius.