The mortality of severe @entity656 still ranges between 10 and 20%. Nowadays, @entity39 is the leading cause of @entity204 . Despite advances in intensive care therapy, however, early and worsening multi-system organ failure remains a source of substantial morbidity and still accounts for 20 to 50% of the deaths. In recent years, the @entity1850 and the relevant cascades of inflammatory mediators have been implicated as the key factor in the emergence of remote tissue damage. Early multi-system organ failure that supervenes in the first week is typically associated with a sterile necrotizing process. There are no pathophysiological, clinical or economical data to support the practice of debridement of sterile @entity39 to prevent or to control early multi-system organ failure. This issue has never been addressed in a controlled study. Besides intensive care support, non-surgical therapeutic modalities including urgent endoscopic sphincterotomy for impacted stones, antibiotic prophylaxis for the prevention of @entity788 and early jejunal nutrition have been specifically developed hopefully to attenuate @entity881 , to obviate the need of surgical drainage and to improve survival. Fine needle aspiration of @entity39 areas must be incorporated in any conservative therapeutic strategy in order to identify and not to jeopardize those with infected @entity39 that remains an absolute indication for drainage. A specific treatment of @entity656 is still lacking, so far. However, there is ample experimental and pathophysiological evidence in favour of immunomodulatory therapy in severe @entity656 . The administration of one or several antagonists of inflammatory mediators possibly combined with a protease inhibitor may at last provide the opportunity to interfere with the two major determinants of prognosis: the severity of @entity881 and the extent of @entity39 areas that creates the culture medium for bacterial superinfection. These benefits remain to be substantiated in a controlled study, however.

Early multi-system organ failure associated with XXXX : a plea for a conservative therapeutic strategy.

@entity788 :: ('MESH:D010190', 'Disease') :: ['pancreatic infection'] @entity656 :: ('MESH:D019283', 'Disease') :: ['acute pancreatitis'] @entity39 :: ('MESH:D009336', 'Disease') :: ['necrotic', 'necrosis', 'infected pancreatic necrosis'] @entity1850 :: ('MESH:D018746', 'Disease') :: ['systemic inflammatory response syndrome'] @entity881 :: ('MESH:D009102', 'Disease') :: ['multiple organ failure'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death']
@entity656 :: (MESH:D019283,Disease) :: ['acute pancreatitis']
