RESUMO
OBJECTIVE: Significant changes in the management of acute pancreatitis have taken place since the 2004 Pamplona Consensus Conference. The objective of this conference has been the revision and updating of the Conference recommendations, in order to unify the integral management of potentially severe acute pancreatitis in an ICU. PARTICIPANTS: Spanish and international intensive medicine physicians, radiologists, surgeons, gastroenterologists, emergency care physicians and other physicians involved in the treatment of acute pancreatitis. LEVELS OF EVIDENCE AND GRADES OF RECOMMENDATION: The GRADE method has been used for drawing them up. DRAWING UP THE RECOMMENDATIONS: The selection of the committee members was performed by means of a public announcement. The bibliography has been revised from 2004 to the present day and 16 blocks of questions on acute pancreatitis in a ICU have been drawn up. Firstly, all the questions according to groups have been drawn up in order to prepare one document. This document has been debated and agreed upon by computer at the SEMICYUC Congress and lastly at the Consensus Conference which was held with the sole objective of drawing up these recommendations. CONCLUSIONS: Eighty two recommendations for acute pancreatitis management in an ICU have been presented. Of these 84 recommendations, we would emphasize the new determinants-based classification of acute pancreatitis severity, new surgical techniques and nutritional recommendations. Note. This summary only lists the 84 recommendations of the 16 questions blocks except blocks greater relevance and impact of its novelty or because they modify the current management.
Assuntos
Cuidados Críticos/normas , Pancreatite/diagnóstico , Pancreatite/terapia , Doença Aguda , Hemodiafiltração , Humanos , Pancreatite/classificação , Pancreatite/cirurgiaAssuntos
Anticorpos Monoclonais Humanizados/efeitos adversos , Hepatite Autoimune/etiologia , Hepatite Autoimune/patologia , Esclerose Múltipla Recidivante-Remitente/tratamento farmacológico , Feminino , Hepatite Autoimune/fisiopatologia , Humanos , Pessoa de Meia-Idade , Esclerose Múltipla Recidivante-Remitente/fisiopatologia , NatalizumabRESUMO
Intestinal tuberculosis is less common than pulmonary tuberculosis. Its clinical and endoscopic features are nonspe-cific, so diagnostic suspicion must be high in order to make an early diagnosis and prevent iatrogenia. Pharmacotherapy is often effective, with an excellent clinical and endoscopic evolution. Surgical treatment is reserved for complications. We present the case of cecal tuberculosis diagnosed endoscopically; this is the second case diagnosed in a few months in our center. In this case there were no risk factors, such as recent travel, risk of contacts or inmunosupression.