Comprehensive analysis of etiology, prognosis and clinical outcome of acute pancreatitis in a tertiary care center

Vinodh Duraisami, Gunasekaran Balraj, Vinyak Rengan


Background: Acute pancreatitis can be classified as mild and severe. Mild pancreatitis is explained by interstitial edema of the gland and it is usually a self-limiting form. Whereas in severe pancreatitis, there is pancreatic necrosis, severe systemic inflammatory response and multi-organ failure which may lead to mortality. To identify the most common etiological agent of acute pancreatitis in our institution.

Methods: Patients diagnosed with acute pancreatitis in Institute of General Surgery, Rajiv Gandhi Govt. General Hospital. 50 of them are to be selected on the basis of nonprobability (purposive) sampling method. Data pertinent to the scoring systems will be recorded within 24 h of admission to the hospital.

Results: 86% of patients had BISAP score less than 3 (mild) and 14% of patients had more or more than 3 (severe). The cases with mild, moderate and severe CTSI score were 76%, 20% and 4% respectively. Only two cases with BISAP score 3 or more had CTSI >6.

Conclusions: Alcohol is the most common etiological factor for acute pancreatitis in this regional population. The morbidity rate is 26% and the mortality rate in patients with severe pancreatitis was 4%. The BISAP score is more accurate in predicting disease severity and significantly than CTSI in this study.


Acute pancreatitis, Alcoholism, BISAP score, CTSI score

Full Text:



Georgios I. Papachristou GI, Venkata Muddana V, Dhiraj Yadav D, et al. Complications, and Mortality in Acute Pancreatitis. Am J Gastroenterol. 2010;105:435-41.

Gravante G, Garcea G, Ong SL, et al. Prediction of mortality inacute pancreatitis: A systematic review of the published evidence. Pancreatology. 2009;9:601-14.

Robins SL, Kumar V. Basic pathology. WB Sounders Company, West Washington Square, PA, USA. 1987:718-31.

Gao W, Yang HX, Ma CE. The value of BISAP score for predicting mortality and severity in acute pancreatitis: a systematic review and meta-analysis. PloS one. 2015 Jun 19;10(6):e0130412.

Tenner S, Baillie J, DeWitt V, Vege SS. American college of gastroenterology guideline: management of acute pancreatitis. Am J Gastroenterol. 2013;108(9):1400-15.

Moreau JA, Zinsmeister AR, Melton LJ 3rd, DiMagno EP. Gallstonepancreatitis and the effect of cholecystectomy. Mayo Clin Proc. 1988;63:466-73.

Choudari CP. Idiopathic pancreatitis: yield of ERCP correlated with patient age. Am J Gastroenterol. 1998;93:1654A.

Aliperti G. Complications related to diagnostic and therapeutic endoscopic retrograde cholangiopancreatography. Gastrointest Endos Clin North Am. 1996;6:379-407.

Steinberg WM, Goldstein SS, Davis ND, Shamma'a J, Anderson K. Diagnostic assays in acute pancreatitis. Ann Intern Med. 1985;102:576-80.

Singh VK, Wu BU, Bollen TL, Repas K, Maurer R, Johannes RS, et al. A prospective evaluation of the bedside index for severity in acute pancreatitis score in assessing mortality and intermediate markers of severity in acute pancreatitis. Ame J Gastroenterol. 2009 Apr;104(4):966.

42nd European Pancreatic Club (EPC) Meeting: Abstracts June 16-19, 2010, Stockholm, Sweden. Pancreatology. 2010;10(2-3):344.

Tenner S. Initial management of acute pancreatitis: Critical issues during the first 72 hours. Am J Gastroenterol. 2004;99:2489-94.

Uhl W1, Warshaw A, Imrie C, Bassi C, McKay CJ, Lankisch PG, et al. IAP guidelines for the surgical management of acute pancreatitis. Pancreatology. 2002;2(6):565-73.

Wu BU, Johannes RS, Sun X, Tabak Y, Conwell DL, Banks PA. The early prediction of mortality in acute pancreatitis: a large population-based study. Gut. 2008;57:1698-703.

Kumar V, Abbas AK, Fausto N, Aster JC. The Pancreas: Robbins and Cotran Pathologic Basis of Disease. Elsevier. 2010:893.

Ranson JHC. Etiological and prognostic factors in human acute pancreatitis. A review. Am J Gastroenterol. 1982;77:633.

Balthazar EJ, Ranson JHC, Naidich DP, Megibow AJ, Caccavale R, Cooper MM. Acute pancreatitis: Prognostic Value of CT. Radiology. 1985;156:767-72.

Khanna AK, Meher S, Prakash S, Tiwary SJ, Singh U, Srivastava A, et al. Comparison of Ranson, Glasgow, Predicting Severity, Organ Failure, Pancreatic Necrosis, and Mortality in Acute Pancreatitis. HPB Surgery. 2013;367581:1-10.

Papachristou GI, Muddana V, Yadav D, O'Connell M, Sanders MK, Slivka A, et al Comparison of BISAP, Ranson's, APACHE-II, and CTSI scores in predicting organ failure, complications, and mortality in acute pancreatitis. Am J Gastroenterol. 2010;105:435-41.

Cho JH, Kim TN, Chung HH, Kim KH. Comparison of scoring systems in predicting the severity of acute pancreatitis. World J Gastroenterol. 2015;21:2387-94.