Acute pancreatitis
Acute pancreatitis
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DOI：
10.1053/j.semdp.2005.07.001
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发表时间：
2004-11-01
影响因子：
2.3
通讯作者：
Klöppel, G
中科院分区：
文献类型：
--
作者：
Klöppel, G
急性胰腺炎的特点是胰腺出现坏死性炎症改变。可区分三种类型的坏死：(1)间质组织坏死，随后还可累及腺泡和导管细胞，(2)导管坏死，和(3)腺泡坏死。第一种类型的坏死本质上是自体消化性的，是最常见的急性胰腺炎的典型形式，与酒精、胆管疾病、代谢状况和其他罕见因素有关。临床上，这些类型的胰腺炎可能是轻微的，也可能是严重的(亚特兰大分类)。轻度胰腺炎也称为水肿性胰腺炎，因为胰腺有水肿性肿胀，并伴有微小的间质(脂肪)坏死。重症或坏死性胰腺炎表现为胰腺，尤其是胰周组织的大面积出血性坏死。导管类型的坏死是罕见的，可见于伴有长时间循环衰竭的胰腺炎。腺泡型坏死是由感染性因素引起的。急性胰腺炎的并发症，如假性囊肿、出血和感染，决定了疾病的进程。(C)2005 Elsevier Inc.保留所有权利。
Acute pancreatitis is characterized by the occurrence of necroinflammatory changes in the pancreas. Three types of necrosis may be distinguished: (1) interstitial tissue necrosis, which subsequently may also involve acinar and ductal cells, (2) ductal necrosis, and (3) acinar necrosis. The first type of necrosis is autodigestive in nature and is typical of the most common forms of acute pancreatitis, which are associated with alcohol, bile duct disease, metabolic conditions, and other rare factors. Clinically, these types of pancreatitis may be either mild or severe (Atlanta classification). The mild form is also known as edematous pancreatitis, because there is edematous swelling of the pancreas combined with tiny foci of interstitial (fat) necrosis. Severe or necrotizing pancreatitis shows large areas of often hemorrhagic necrosis of the pancreatic and particularly the peripancreatic tissue. The ductal type of necrosis is rare and may be seen in pancreatitis associated with prolonged circulatory failure. The acinar type of necrosis is caused by infectious agents. Complications of acute pancreatitis, such as pseudocyst, bleeding, and infection, determine the course of the disease. (c) 2005 Elsevier Inc. All rights reserved.