Episode 283: 282. New Guidelines For Management of Acute Pancreatitis

Episode 283: 282. New Guidelines For Management of Acute Pancreatitis

https://journals.lww.com/ajg/fulltext/2024/03000/american_college_of_gastroenterology_guidelines_.14.aspx


2 of the 3 following criteria: (i) abdominal pain consistent with the disease, (ii) serum amylase and/or lipase greater than 3 times the upper limit of normal, and/or (iii) characteristic findings from abdominal imaging



Fluid--

  • Moderately aggressive fluid resuscitation with lactated Ringer's solution should be started (NEJM JW Gen Med Oct 1 2023 and Am J Gastroenterol 2023; 118:2258), defined as a bolus of 10 mL/kg followed by infusion of 1.5 mL/kg/hour (NEJM JW Gen Med Oct 15 2022 and N Engl J Med 2022; 387:989), and additional boluses can be given if a patient has evidence of hypovolemia.



Feeding-- Early oral feeding (within 24–48 hours) should begin with a low-fat solid diet (as opposed to liquid) for patients with mild AP.




Surgery-

Patients with mild acute biliary pancreatitis should undergo cholecystectomy early, preferably before discharge.

  • Following a second episode of AP with no identifiable cause, in patients fit for surgery, we suggest performing a cholecystectomy to reduce the risk of recurrent episodes of AP.

Jaksot(387)

Episode 353: 252. 2.4 Million to Prevent 4 Hospitalizations!

Episode 353: 252. 2.4 Million to Prevent 4 Hospitalizations!

Packer M et al. Tirzepatide for heart failure with preserved ejection fraction and obesity. N Engl J Med 2024 Nov 16; [e-pub].https://doi.org/10.1056/NEJMoa2410027  In the industry-funded SUMMIT trial...

13 Joulu 202411min

Episode 352: 251. Safety of Triptans in Patients Who Have or Are at High Risk for Cardiovascular Disease

Episode 352: 251. Safety of Triptans in Patients Who Have or Are at High Risk for Cardiovascular Disease

Wang Z et al. Safety of triptans in patients who have or are at high risk for cardiovascular disease: A target trial emulation. Mayo Clin Proc 2024 Nov; 99:1722. (https://doi.org/10.1016/j.mayocp.2024...

12 Joulu 20246min

Episode 351: 250. STROKE part 3 CME

Episode 351: 250. STROKE part 3 CME

STROKE part 3 CME

29 Marras 20249min

Episode 350: 249. STROKE - LA closure, alteplase vs tenecteplase, and thrombectomy

Episode 350: 249. STROKE - LA closure, alteplase vs tenecteplase, and thrombectomy

CME FOR FREEE

27 Marras 202417min

Episode 349: 248. Stroke- UIA, CHAD-VASC, HAS-BLED, SPARC, PFO

Episode 349: 248. Stroke- UIA, CHAD-VASC, HAS-BLED, SPARC, PFO

CME --- Stroke- UIA, CHAD-VASC, HAS-BLED, SPARC, PFO

26 Marras 202436min

Episode 348: 247. Early diagnostic paracentesis improves outcomes of hospitalized patients with cirrhosis and ascites

Episode 348: 247. Early diagnostic paracentesis improves outcomes of hospitalized patients with cirrhosis and ascites

Beran A et al. Early diagnostic paracentesis improves outcomes of hospitalized patients with cirrhosis and ascites: A systematic review and meta-analysis. Am J Gastroenterol 2024 Nov; 119:2259. (https...

22 Marras 20246min

Episode 347: 246.  Acupuncture vs Sham Acupuncture for Chronic Sciatica From Herniated Disk

Episode 347: 246. Acupuncture vs Sham Acupuncture for Chronic Sciatica From Herniated Disk

Acupuncture vs Sham Acupuncture for Chronic Sciatica From Herniated Disk: A Randomized Clinical Trial | Complementary and Alternative Medicine | JAMA Internal Medicine | JAMA Network  In a randomized ...

21 Marras 20248min

Episode 346: 245. Duration of benefit and risk of dual antiplatelet therapy after mild ischemic stroke

Episode 346: 245. Duration of benefit and risk of dual antiplatelet therapy after mild ischemic stroke

And now a secondary analysis of the trial focused on the timing of major ischemic events and the potential tradeoffs of benefits and risks,------ maybe there is magic sauce where the benefit is drasti...

20 Marras 20247min

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