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This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the author's clinical recommendations.
A 56-year-old woman presents with severe epigastric pain and vomiting of 14 hours' duration, symptoms that had developed shortly after dinner the previous night. She has no history of alcohol use, takes no medications, and has no family history of pancreatitis. On physical examination, she has a heart rate of 110 beats per minute and moderate epigastric abdominal tenderness without peritoneal signs.
The Clinical Problem
Strategies and Evidence
Diagnosis
Management
Imaging Studies
ERCP
Hospitalization
Predicting Severe Acute Pancreatitis
Pancreatic-Fluid Collections, Pseudocysts, and Necrosis
Lack of Improvement
Use of Antibiotics
Nutritional Support
Surgery
Discharge Planning
Areas of Uncertainty
Guidelines
Summary and Recommendations
Source Information
From the Division of Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh, Pittsburgh.
Address reprint requests to Dr. Whitcomb at the University of Pittsburgh Medical Center Presbyterian, Mezzanine Level 2, C Wing, 200 Lothrop St., Pittsburgh, PA 15213, or at whitcomb@pitt.edu.
Related Letters:
Acute Pancreatitis
Famularo G., Minisola G., De Simone C., Whitcomb D. C.
Extract |
Full Text |
PDF
N Engl J Med 2006;
355:961, Aug 31, 2006.
Correspondence
This article has been cited by other articles:
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