TY - JOUR

T1 - Confusion with the definition and diagnostic criteria for acute on chronic pancreatitis

T2 - review and recommendations

AU - Bouca-Machado, Tiago

AU - Andrea-Ferreira, Patricia

AU - Pedersen, Jan Bech

AU - Mortensen, Michael Bau

AU - Novovic, Srdan

AU - Windsor, John A.

AU - Olesen, Soren Schou

AU - Drewes, Asbjorn Mohr

PY - 2024

Y1 - 2024

N2 - Objectives Chronic pancreatitis (CP) is a fibroinflammatory disease complicated by episodes of acute inflammation (acute on chronic pancreatitis (ACP)). This entity is common, variably defined and can reflect different pathological mechanisms that requires different interventions. The aim of this study is to conduct a systematic review of how ACP is described, defined and diagnosed in the literature. Methods A systematic search was conducted from January 1993 to June 2020. All articles that used a term to describe ACP in adults were reviewed and definitions and diagnostic criteria were sought. Results After reviewing 2271 abstracts, 848 articles included a term to describe ACP. The most common descriptions were 'acute on/in CP' (374), 'acute exacerbation of CP' (345) and 'flare(-up) of CP' (43). Among the 848 articles, 14 included a pragmatic definition of ACP, and only 2 papers stated diagnostic criteria. These covered both acute inflammation and acute exacerbation of chronic abdominal pain. Conclusion There is no universally accepted term, definition or diagnostic criteria for ACP. A consensus definition is needed to improve quality and comparability of future articles as well as clinical management.

AB - Objectives Chronic pancreatitis (CP) is a fibroinflammatory disease complicated by episodes of acute inflammation (acute on chronic pancreatitis (ACP)). This entity is common, variably defined and can reflect different pathological mechanisms that requires different interventions. The aim of this study is to conduct a systematic review of how ACP is described, defined and diagnosed in the literature. Methods A systematic search was conducted from January 1993 to June 2020. All articles that used a term to describe ACP in adults were reviewed and definitions and diagnostic criteria were sought. Results After reviewing 2271 abstracts, 848 articles included a term to describe ACP. The most common descriptions were 'acute on/in CP' (374), 'acute exacerbation of CP' (345) and 'flare(-up) of CP' (43). Among the 848 articles, 14 included a pragmatic definition of ACP, and only 2 papers stated diagnostic criteria. These covered both acute inflammation and acute exacerbation of chronic abdominal pain. Conclusion There is no universally accepted term, definition or diagnostic criteria for ACP. A consensus definition is needed to improve quality and comparability of future articles as well as clinical management.

KW - Acute pancreatitis

KW - chronic pancreatitis

KW - inflammation

KW - pancreas

KW - definition

KW - diagnosis

KW - ATLANTA CLASSIFICATION

KW - SEVERITY

KW - FIBROSIS

KW - PATIENT

KW - DIET

KW - PAIN

U2 - 10.1080/00365521.2022.2035811

DO - 10.1080/00365521.2022.2035811

M3 - Review

C2 - 35119346

JO - Scandinavian Journal of Gastroenterology

JF - Scandinavian Journal of Gastroenterology

SN - 0036-5521

ER -