How To Treat Abdominal Compartment Syndrome In Acute Pancreatitis?

Main Category: GastroIntestinal / Gastroenterology
Article Date: 26 Sep 2008 - 5:00 PDT

email to a friend   printer friendly   opinions  

SAP is a serious type of acute pancreastitis (AP), with a serious pathological condition, always combined with pancreas necrosis and complicatins of toxic shock, with a mortality of 25% - 40% according to recent reviews. Patients with SAP tend to cause IAP elevation, and abrupt elevation of IAP eventually causes IAH. IAH causes organ dysfunction such as respiratory failure, circulatory failure, and renal failure, which are referred to ACS. About 11% of SAP patients suffer from the complication of ACS. SAP patients complicated with ACS tend to be overwhelming and the mortality reaches 66.7%. There are certain guidelines for treatment of SAP, but until now, there have been no standard treatments for ACS in SAP.

A research article published on 14 June 2008, in the World Journal of Gastroenterology addresses this question. The research team led by Dr. Zhang Min Jie from Affiliated central Hospital of Huzhou normal college administer Chinese traditional medicine Dachengqi Decoction and Glauber's salt combined with Routine non-operative conservative treatments, including continuous peripancreatic vascular pharmic infusion for treatment and predicting patient's conditions of ACS in SAP. Through comparision with the control group to demonstrate whether the TCM-wmtherapy is effective for treatment of ACS in SAP.

Through comparision with control group, we found that the ICP data in study group were lower than those in control group (P<0.05). APACHE Ⅱscores in study group were significantly less than which in control group (P<0.05), The ICP level and the cumulative scores of APACHE Ⅱin study group decreased earlier than which in control group (P<0.05). The relief time of abdominalgia and burbulence in study group were shorter than which in control group (P<0.05). The ascites quantity on 7th treatment day and the cysts formation rate in study group were less than which in control group (P<0.05). Hospitalization time in study group was shorter than which in control group (P<0.05). The mortality rate of study group was lower than which of control group, but have no significant difference (P>0.05). These results suggest that administering this therapeutic protocol can treating IAH through lower IAP, relaxing suffering symptom of ACS, slow down the pathological condition exacerbation, and accelerating the recovery of illness, So could prevent and treat ACS in SAP efficiently and therefore have great potential to be a new way for the treatment of ACS in SAP.

The results of this study describe a beneficial effect of Chinese traditional medicine on the relief of symptoms strength and duration, ascites retention, shortening of hospitalization period, and inhibiting cyst formation in SAP. Although the medication did not significantly improve the prognosis of the patients, the data are encouraging and provide a potentially important new clue for the treatment of ACS in SAP.

###

Reference: Zhang MJ, Zhang GL, Yuan WB, Ni J, Huang LF.Treatment of abdominl compartment syndrome with Chinese traditional medicine in severe acute pancreatitis. World J Gastroenterol 2008; 14(22): 3574-3578: http://www.wjgnet.com/1007-9327/14/3574.asp

Correspondence to: Min-Jie Zhang, Department of General surgery, the affiliated central Hospital of Huzhou normal college, Huzhou 313000, Zhejiang Province, China.

About World Journal of Gastroenterology

World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection and provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2003-2000 IF: 3.318, 2.532, 1.445 and 0.993. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.

About The WJG Press

The WJG Press mainly publishes World Journal of Gastroenterology.

Source: Lai-Fu Li
World Journal of Gastroenterology

• Additional
• References
• Citations