Despite improvements in the supportive management of severe
acute pancreatitis over the last decade, the morbidity and mortality rate remains high. The main feature of this condition is
pancreatic necrosis leading to
sepsis, with both localized and systemic inflammatory response syndromes. Early pathophysiological changes of the pancreas include alterations in microcirculation,
ischemia reperfusion injury, and leukocyte and
cytokine activation. The efficacy of hyperbaric
oxygen (HBO)
therapy in improving these pathophysiological disturbances is documented for various conditions. However, its effect in the treatment of severe
acute pancreatitis is undetermined. This report documents the case of a 56-year-old woman presenting with severe
acute pancreatitis treated by HBO
therapy. The severity of disease was based on an Acute Physiology and Chronic Health Evaluation (APACHE II) illness grading score of 11 and a Baltazar based computed tomography severity index (CTSI) score of 9. Administration of 100%
oxygen was commenced within 72 h of presentation at a pressure of 2.5 atmospheres for 90 min and given twice daily for a total of 5 days.
Therapy was well tolerated with improvements in APACHE II and CTSI grading scores. HBO
therapy for severe
acute pancreatitis appeared to be safe and may have a role in improving treatment outcomes. Further study is required.