Pezzilli Raffaele, Fantini Lorenzo
Dipartimento di Medicina Interna, Azienda Ospedaliero-Universitaria Policlinico Sant'Orsola-Malpighi, Bologna.
Recenti Prog Med. 2006 Sep;97(9):477-80.
Acute pancreatitis represents the 0.15-1.5% of all diagnoses in the Emergency Room. Biliary diseases and alcohol abuse are the two mainly etiological factors of this illness in Italy. From a clinical point of view, the course of alcoholic and biliary acute pancreatitis is the same; however, because the endoscopic retrograde cholangiopancreatography associated with endoscopic sphincterotomy can prevent further complications in patients with severe biliary pancreatitis, it is important to early recognize the biliary origin of the disease. On the other hand, the identification of alcoholic origin of pancreatitis can prevent interventional procedures not useful in this kind of patients. In this paper we will assess the markers able to early identify the etiology of this acute illness such as the liver function tests and the lipase/amylase ratio.
急性胰腺炎占急诊室所有诊断病例的0.15%至1.5%。在意大利,胆道疾病和酒精滥用是该疾病的两个主要病因。从临床角度来看,酒精性和胆源性急性胰腺炎的病程相同;然而,由于内镜逆行胰胆管造影术联合内镜括约肌切开术可预防重症胆源性胰腺炎患者出现进一步并发症,因此早期识别疾病的胆源性很重要。另一方面,识别胰腺炎的酒精性病因可避免对这类患者进行无用的介入操作。在本文中,我们将评估能够早期识别这种急性疾病病因的标志物,如肝功能检查和脂肪酶/淀粉酶比值。