Acute pancreatitis primary prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2]; Tarek Nafee, M.D. [3]

Overview

Primary prevention against the development of acute pancreatitis includes avoiding aspirin in children and alcohol abuse, genetic counselling for cystic fibrosis, immunization against mumps, and proper safety precautions to avoid abdominal trauma. Additionally, ERCP should be avoided in patients who may not benefit from the procedure (e.g. sphincter of Oddi dyscuntion). In patients who require ERCP, temporary placement of pancreatic duct stents and prophylaxis with NSAIDs and sublingual nitrates may prevent the development of pancreatitis.

Primary Prevention

To protect against acute pancreatitis, the best way preventing the disorders that cause it:[1][2][3]

  • Avoiding aspirin when treating a fever in children, especially if they may have a viral illness, to reduce the risk of Reye syndrome.
  • Do not abuse alcohol.
  • Genetic counseling - if family or personal history of cystic fibrosis is present.
  • Immunizing children against mumps and other childhood illnesses.
  • Using proper safety precautions to avoid abdominal trauma.
  • Avoid ERCP in patients who would not benefit from it.
  • In high risk of post-ERCP pancreatitis, placement of temporary pancreatic duct stent.
  • In high risk of post-ERCP pancreatitis, prophylaxis with rectal NSAIDs and sublingual nitrates.

References

  1. Ding X, Zhang F, Wang Y (2015). "Risk factors for post-ERCP pancreatitis: A systematic review and meta-analysis". Surgeon. 13 (4): 218–29. doi:10.1016/j.surge.2014.11.005. PMID 25547802.
  2. Sotoudehmanesh R, Eloubeidi MA, Asgari AA, Farsinejad M, Khatibian M (2014). "A randomized trial of rectal indomethacin and sublingual nitrates to prevent post-ERCP pancreatitis". Am J Gastroenterol. 109 (6): 903–9. doi:10.1038/ajg.2014.9. PMID 24513806.
  3. Forsmark CE, Vege SS, Wilcox M (November 17,2016). "Acute Pancreatitis". The New England Journal of Medicine: 1972–1981. doi:10.1056/NEJMra1505202. Retrieved November 25,2016. Check date values in: |access-date=, |date= (help)



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