PANCREATITIS AGUDA
PANCREATITIS AGUDA
Dr. Armando Rangel Gómez
Dr. Armando Rangel Gómez
Residente de Medicina Familiar
Residente de Medicina Familiar
H. G. Z. no. 4
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HISTORIA
HISTORIA
Herophilus 300 A.C. descubrió el Páncreas.
Herophilus 300 A.C. descubrió el Páncreas.
A
A
n
n
d
d
r
r
e
e
a
a
s
s
V
V
e
e
s
s
a
a
l
l
i
i
u
u
s
s
e
e
n
n
1
1
5
5
4
4
1
1
r
r
e
e
a
a
l
l
i
i
z
z
a
a
n
n
l
l
a
a
p
p
r
r
im
im
e
e
r
r
a
a
ilustración del páncreas.
ilustración del páncreas.
En 1642
En 1642
Johan Wirsung
Johan Wirsung
describe el conducto que
describe el conducto que
lleva su nombre.
lleva su nombre.
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HISTORIA
HISTORIA
Ru
Ru
do
do
lf
lf
He
He
id
id
en
en
ha
ha
im
im
de
de
sc
sc
ub
ub
ri
ri
ó
ó
y
y
pu
pu
bl
bl
ic
ic
o
o
en
en
1875 el ciclo secretorio de la célula acinar
1875 el ciclo secretorio de la célula acinar
pancreática.
pancreática.
W
W
.
.
B
B
a
a
l
l
s
s
e
e
r
r
e
e
n
n
1
1
8
8
8
8
2
2
d
d
e
e
s
s
c
c
r
r
i
i
b
b
i
i
ó
ó
l
l
a
a
necrosis
necrosis
g
g
r
r
a
a
s
s
a
a
i
i
n
n
t
t
r
r
a
a
b
b
d
d
o
o
m
m
i
i
n
n
a
a
l
l
,
,
s
s
i
i
e
e
n
n
d
d
o
o
R
R
o
o
b
b
e
e
r
r
t
t
L
L
a
a
n
n
g
g
e
e
r
r
h
h
a
a
n
n
s
s
q
q
u
u
i
i
e
e
n
n
l
l
a
a
r
r
e
e
l
l
a
a
c
c
i
i
o
o
n
n
o
o
a
a
l
l
a
a
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HISTORIA
HISTORIA
Hans Chiari en 1896 observo durante
Hans Chiari en 1896 observo durante
au
au
t
t
o
o
ps
ps
i
i
as
as
la
la
oc
oc
u
u
r
r
r
r
en
en
c
c
ia
ia
f
f
r
r
ec
ec
ue
ue
n
n
t
t
e
e
d
d
e
e
ne
ne
cr
cr
os
os
is
is
pa
pa
nc
nc
re
re
át
át
ic
ic
a
a
,
,
in
in
te
te
rp
rp
r
r
et
et
án
án
do
do
la
la
como una
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HISTORIA
HISTORIA
L
L
a
a
p
p
r
r
i
i
m
m
e
e
r
r
a
a
cirugía
cirugía
“terapéutica”
“terapéutica”
e
e
n
n
l
l
a
a
pancreatitis aguda fue realizada en 1894 por
pancreatitis aguda fue realizada en 1894 por
W. Korte en Berlín.
W. Korte en Berlín.
Bernard Riedel realiza la clásica
Bernard Riedel realiza la clásica
descripción
descripción
de esta enfermedad en 1896.
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DEFINICION
DEFINICION
L
L
a
a
p
p
a
a
n
n
c
c
r
r
e
e
a
a
t
t
i
i
t
t
i
i
s
s
a
a
g
g
u
u
d
d
a
a
e
e
s
s
u
u
n
n
p
p
r
r
o
o
c
c
e
e
s
s
o
o
i
i
n
n
f
f
l
l
a
a
m
m
a
a
t
t
o
o
r
r
i
i
o
o
a
a
g
g
u
u
d
d
o
o
d
d
e
e
l
l
p
p
á
á
n
n
c
c
r
r
e
e
a
a
s
s
,
,
desencadenado por la activación inapropiada
desencadenado por la activación inapropiada
d
d
e
e
l
l
a
a
s
s
e
e
n
n
z
z
i
i
m
m
a
a
s
s
p
p
a
a
n
n
c
c
r
r
e
e
á
á
t
t
i
i
c
c
a
a
s
s
,
,
c
c
o
o
n
n
lesión
lesión
t
t
i
i
s
s
u
u
l
l
a
a
r
r
y
y
r
r
e
e
s
s
p
p
u
u
e
e
s
s
t
t
a
a
i
i
n
n
f
f
l
l
a
a
m
m
a
a
t
t
o
o
ri
ri
a
a
l
l
o
o
c
c
a
a
l
l
,
,
y
y
respuesta inflamatoria y compromiso variable
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Clínica features of acutedisease Clínica features of acutedisease
Pancreatitis Aguda
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PANCREATITIS AGUDA HEMORRAGICA
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PANCREATITIS GRAVE
PANCREATITIS GRAVE
Necrosis
Necrosis
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DEFINICION
DEFINICION
La
La
p
p
an
an
c
c
re
re
a
a
ti
ti
ti
ti
s
s
se
se
c
c
la
la
si
si
fi
fi
c
c
a
a
c
c
om
om
o
o
a
a
gu
gu
d
d
a
a
a
a
menos que existan hallazgos por tomografía
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DEFINICION
DEFINICION
L
L
a
a
P
P
A
A
e
e
s
s
h
h
a
a
b
b
i
i
t
t
u
u
a
a
l
l
m
m
e
e
n
n
t
t
e
e
u
u
n
n
p
p
r
r
o
o
c
c
e
e
s
s
o
o
reversible.
reversible.
D
D
t
t
t
t
d
d
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Tabla1.
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Tabla 3.
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Pancreatitis Aguda
Pancreatitis Aguda
La Obesidad Empeora el Prognostic
La Obesidad Empeora el Prognostic
El efecto puede ser
El efecto puede ser
mayor con una
mayor con una
relación
relación
cintura/cadera
cintura/cadera
elevada
elevada
Mecanismos Posibles
Mecanismos Posibles
%
%
Pacientes
Pacientes
0
0
10
10
20
20
30
30
40
40
50
50
60
60
Pancreatitis Grave
Pancreatitis Grave
Complicaciones
Complicaciones
Sistémicas
Sistémicas
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Líquido
Líquido
Deshilachad
Deshilachad
o (grasa)
o (grasa)
Necrosis
Necrosis
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PROGRE
PROGRE
SION
SION
A
A
NECROSI
NECROSI
S
S
PANCREA
PANCREA
TICA
TICA
Páncreas
Páncreas
Necrosis
Necrosis
pancreática
pancreática
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TRATAMIENTO
TRATAMIENTO
MEDIDAS DE APOYO
MEDIDAS DE APOYO
Reemplazo agresivo de líquidos y electrolitos
Reemplazo agresivo de líquidos y electrolitos
CONTROLAR:
CONTROLAR:
Signos vitales
Signos vitales
Diuresis
Diuresis
