Acute Pancreatitis (AP) is a common disease with systemic complications, specifically pulmonary complications that are well-documented [1]. Here we present, to the best of our knowledge, the first reported case of tracheobronchomalacia as a respiratory complication of AP. A 54-year-old white male with multiple chronic comorbidities developed necrotizing acute pancreatitis (NAP) following a surgical procedure. Internal Medicine evaluated and managed his NAP according to protocol. Within one week of NAP onset, the patient developed rapid respiratory distress. Chest radiography and ABGs were unable to diagnose ARDS. A CT scan with IV contrast was completed to investigate a pulmonary embolus and found the tracheal diameter variations during inspiration and expiration of the respiratory cycle consistent with tracheobronchomalacia (TBM). The patient’s respiratory status continued to deteriorate requiring endotracheal intubation and mechanical ventilation with weaning trials proving to be futile. The patient eventually developed fungemia and expired after his family opted for palliative extubation. Airway collapse related to TBM is an under-recognized diagnosis which should be suspected in patients with NAP who develop acute respiratory distress in whom no specific etiology has been determined.

Acute pancreatitis is a disease which can present in a mild or severe form. In the last few years, the incidence of acute pancreatitis has been steadily rising. The treatment of severe cases is complex and nutrition is one of the key treatment factors. Enteral and parenteral nutrition are documented parts of acute phase treatment included in many guidelines. However, there is a controversy about the timing of initiation of peroral nutrition after the acute phase of severe pancreatitis has resolved. This dissertation shows the results of monocentric prospective randomized trial which compares the safety and effectivity of peroral nutrition compared to enteral nutrition in patients with severe acute pancreatitis during hospitalization as well as in long term after hospital discharge. Patients with severe acute pancreatitis were randomized into two groups - enteral nutrition versus peroral nutrition. The randomized nutrition strategy was initiated within the first 14 days of hospitalization. We monitored the length of hospital stay, tolerance of nutrition, complications, body weight and nutrition parameters. The two groups did not differ significantly in the length of hospital stay. The number of complications was similar between the groups, there was no significant difference in the rate of acute...

Acute pancreatitis is a disease which can present in a mild or severe form. In the last few years, the incidence of acute pancreatitis has been steadily rising. The treatment of severe cases is complex and nutrition is one of the key treatment factors. Enteral and parenteral nutrition are documented parts of acute phase treatment included in many guidelines. However, there is a controversy about the timing of initiation of peroral nutrition after the acute phase of severe pancreatitis has resolved. This dissertation shows the results of monocentric prospective randomized trial which compares the safety and effectivity of peroral nutrition compared to enteral nutrition in patients with severe acute pancreatitis during hospitalization as well as in long term after hospital discharge. Patients with severe acute pancreatitis were randomized into two groups - enteral nutrition versus peroral nutrition. The randomized nutrition strategy was initiated within the first 14 days of hospitalization. We monitored the length of hospital stay, tolerance of nutrition, complications, body weight and nutrition parameters. The two groups did not differ significantly in the length of hospital stay. The number of complications was similar between the groups, there was no significant difference in the rate of acute...