Anu Aronen, Lucía Guilabert, Amer Hadi, Vytautas Kiudelis, Afrodita Panaitescu, Barbara Wlodarczyk, Johanna Laukkarinen, Sara Regner, Enrique de-Madaria
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By finding the aetiology with the highest possible yield it may be possible to reduce recurrent AP (RAP) episodes and related morbidity and thereby decrease health care costs and possibly improve patients' quality of life.</p><p><strong>Methods: </strong>This narrative review includes articles retrieved from PubMed search with publications from 2013-2023. Cross references were used when found relevant.</p><p><strong>Key content and findings: </strong>The rates of aetiologies of AP and the diagnostics performed behind these numbers vary widely between different studies, time periods and different geographical regions, as there is no unified algorithm in diagnostic work-up of IAP. In this study, we describe an up-to-date summary of epidemiology, diagnostic course and treatment of IAP, and propose an algorithm of IAP diagnostics in light of recent scientific studies and their outcomes and address possible treatments of IAP.</p><p><strong>Conclusions: </strong>Although aetiology is key for AP management, there is still no validated protocol for aetiological diagnosis. IAP is relevant due to its recurrence rate and possible evolution to chronic pancreatitis. 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引用次数: 0
摘要
背景和目的:这篇叙述性综述探讨了特发性急性胰腺炎(IAP)及其近十年来的流行病学、诊断、临床过程和治疗。由于以前没有经过验证的急性胰腺炎(AP)病因诊断方案,本研究的主要目的是寻找、描述和统一有关 AP 诊断工作的证据,以诊断真正的 IAP。通过尽可能高的诊断率找到病因,就有可能减少急性胰腺炎(RAP)的反复发作和相关发病率,从而降低医疗成本,并有可能改善患者的生活质量:本叙事性综述包括从 PubMed 检索到的 2013-2023 年间发表的文章。主要内容和研究结果:由于 IAP 的诊断工作没有统一的算法,因此不同研究、不同时期和不同地理区域之间 AP 的病因比率和这些数字背后的诊断方法存在很大差异。在本研究中,我们对 IAP 的流行病学、诊断过程和治疗进行了最新总结,并根据最新的科学研究及其结果提出了 IAP 诊断算法,同时探讨了 IAP 的可能治疗方法:结论:尽管病因学是 AP 治疗的关键,但目前仍没有有效的病因学诊断方案。IAP 的相关性在于其复发率和演变为慢性胰腺炎的可能性。我们仍需要更多的研究来探讨这一主题,并评估针对真正的 IAP 的新诊断方案,包括先进的测试和治疗策略。
Idiopathic acute pancreatitis (IAP)-a review of the literature and algorithm proposed for the diagnostic work-up of IAP.
Background and objective: This narrative review addresses idiopathic acute pancreatitis (IAP) and its epidemiology, diagnosis, clinical course and treatment during the last decade. As there is no previously validated protocol for finding the aetiology of acute pancreatitis (AP), the primary aim of this study is to find, describe and unify evidence about the diagnostic work-up of AP to diagnose the true IAP. By finding the aetiology with the highest possible yield it may be possible to reduce recurrent AP (RAP) episodes and related morbidity and thereby decrease health care costs and possibly improve patients' quality of life.
Methods: This narrative review includes articles retrieved from PubMed search with publications from 2013-2023. Cross references were used when found relevant.
Key content and findings: The rates of aetiologies of AP and the diagnostics performed behind these numbers vary widely between different studies, time periods and different geographical regions, as there is no unified algorithm in diagnostic work-up of IAP. In this study, we describe an up-to-date summary of epidemiology, diagnostic course and treatment of IAP, and propose an algorithm of IAP diagnostics in light of recent scientific studies and their outcomes and address possible treatments of IAP.
Conclusions: Although aetiology is key for AP management, there is still no validated protocol for aetiological diagnosis. IAP is relevant due to its recurrence rate and possible evolution to chronic pancreatitis. We still need more studies addressing this topic and evaluating new diagnostic protocols with advanced tests and treatment strategies in true IAP.