Akute Pankreatitis: eine „klinische“ Herangehensweise

Bei der akuten Pankreatitis handelt es sich um einen entzündlichen Prozess der Bauchspeicheldrüse, der zu lokalen und systemischen Komplikationen bis hin zum Organversagen führen kann. Die akute Pankreatitis ist eine der häufigsten nicht malignen Aufnahmediagnosen in der Gastroenterologie, wobei die schwere Form mit einer relevanten Letalität vergesellschaftet ist.

Kernaussagen

• Gallensteine und Alkoholkrankheit stellen die häufigsten Ursachen der akuten Pankreatitis dar.

• Anamnese, klinische Untersuchung sowie die transabdominelle Sonografie sind die Grundlagen der Diagnostik.

• In der Labordiagnostik spielen Lipase, Triglyzeride, Kalzium sowie Cholestase-Parameter eine wichtige Rolle.

• Das persistierende Organversagen (> 48 h) gilt als einer der stärksten Prädiktoren einer hohen Letalität.

• Eine kausale Therapie existiert nur für die biliäre Pankreatitis.

• Infizierte (peri-)pankreatische Nekrosen gehen mit einer erhöhten Mortalität einher.

• Die antibiotische und interventionelle Therapie sollte nicht verzögert werden.

• Eine schwere Pankreatitis hat eine relevante Letalität und erfordert eine enge Kooperation zwischen Intensivmedizinern, (interventionellen) Gastroenterologen und Chirurgen.

Schlüsselwörter

Cholezystolithiasis - Choledocholithiasis - Bauchspeicheldrüse - Gastroenterologie - Alkoholabusus

Publikationsverlauf

Artikel online veröffentlicht:
11. März 2022

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