Open AccessPancreatic injury in patients with septic shock: A literature review
Author(s) -
Anis Chaari,
Karim Abdel Hakim,
K Bousselmi,
M. Etman,
M. El Bahr,
Ahmed Saka,
Eman Hamza,
Mohamed Saleh Ismail,
Elsayed Mahmoud Khalil,
Vipin Kauts,
William Casey
Publication year - 2016
Publication title -
world journal of gastrointestinal oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.924
H-Index - 26
ISSN - 1948-5204
DOI - 10.4251/wjgo.v8.i7.526
Subject(s) - medicine , pancreatic injury , septic shock , acute pancreatitis , pancreatitis , shock (circulatory) , sepsis , intensive care medicine , pancreas , pathophysiology , mortality rate , organ dysfunction , gastroenterology
Sepsis and septic shock are life threatening condition associated with high mortality rate in critically-ill patients. This high mortality is mainly related to the inadequacy between oxygen delivery and cellular demand leading to the onset of multiorgan dysfunction. Whether this multiorgan failure affect the pancreas is not fully investigated. In fact, pancreatic injury may occur because of ischemia, overwhelming inflammatory response, oxidative stress, cellular apoptosis and/or metabolic derangement. Increased serum amylase and/or lipase levels are common in patients with septic shock. However, imaging test rarely reveal significant pancreatic damage. Whether pancreatic dysfunction does affect the prognosis of patients with septic shock or not is still a matter of debate. In fact, only few studies with limited sample size assessed the clinical relevance of the pancreatic injury in this group of patients. In this review, we aimed to describe the epidemiology and the physiopathology of pancreatic injury in septic shock patients, to clarify whether it requires specific management and to assess its prognostic value. Our main finding is that pancreatic injury does not significantly affect the outcome in septic shock patients. Hence, increased serum pancreatic enzymes without clinical features of acute pancreatitis do not require further imaging investigations and specific therapeutic intervention.