Evaluation of clinical profile of acute pancreatitis in a tertiary centre
DOI:
https://doi.org/10.18203/2349-2902.isj20210368Keywords:
Acute pancreatitis, Serum amylase, CECT abdomen, MortalityAbstract
Background: Acute pancreatitis is a disease for which patients are in large numbers, etiology, clinical presentation and examinations are varied. Disease may be mild or severe, may lead to multi organ failures and death. Most common cause is biliary tract diseases. Other causes are alcohol consumption, post ERCP, trauma, idiopathic and drugs, viral infections, genetic mutations and connective tissue disorders.
Methods: This is a prospective observational study conducted at SGT medical college, Budhera, Gurugram, Haryana, from January 2017 to June 2019 in 100 consecutive patients. Data collection included detailed recording of demography of patient, clinical presentation, any history of biliary tract disease, alcohol consumption, trauma, ERCP, comorbidities. Data was also collected about investigations done, treatment, recovery, complications and any intervention.
Results: Most of the patients were from age group 41-55 years. Female patients were more than male patients. Etiology was mostly gall stone, alcohol, idiopathic, post ERCP and trauma. Pain, distention abdomen, vomiting, fever and jaundice were presenting features. Serum amylase, serum lipase, USG abdomen and CECT abdomen were diagnostic investigations. Complications included local and systemic. Mortality was 7%.
Conclusions: Acute pancreatitis is mild in most of the cases and recovery is good. Severe cases should be meticulously treated as mortality rates are higher. They should be treated in ICU under the guidance of intensivist. Our study results show that patients with severe diseases should be meticulously monitored clinically, biochemically, haemodynamically and radiologically.
References
Bradley EL III. A clinically based classification system for acute pancreatitis, Summary of the international symposium on acute pancreatitis, Atlanta Ga, September 11 through 13, 1992. Arch Surg. 1993;128:586-7.
Bradley EL III, Dexter ND. Management of severe acute pancreatitis. Ann Surg. 2010;251:6.
Munzo A, Katerndahl DA. Diagnosis and management of acute pancreatitis. American Family Physician. 2000;62:164-74.
Gao YJ, Li YQ, Wang Q, Li SL, Li GQ, Ma J, et al. Analysis of clinical features of acute pancreatitis in Shandong Province, China. J Gastroenterol Hepatol. 2007;22:340-4.
Banks PA, Freeman ML. Practice guidelines in acute pancreatitis. Am J Gastroenterol 2006;101:2379-400.
Papachristou GI, Muddana V, Yadav D, O'Connell M, Sanders MK, Slivka A Whitcomb DC. Comparison of BISAP, Ranson's, APACHE-II, and CTS scores in predicting organ failure, complications, and mortality in acut pancreatitis. Am J Gastroenterol. 2010;105(2):435-41..
Uhl W, Warshaw A, Imrie C. IAP guidelines for the surgical management of acute pancreatitis. Pancreatology. 2002;2:565-73.
Toouli J, Brook S M, Bassi C, Working Party Report: Guidelines for the management of acute pancreatitis. J Gastroenterol Hepatol. 2002;17: S582-9.
Pederzoli P, Bassi C, Vesentini S. A randomized multicentre clinical trial of antibiotic prophylaxis of septic complications in acute necrotizing pancreatitis with imipenem. Surg Gynecol Obstet. 1993;176:480-3.
Windsor JA, Fearon KCH, Ross JA. Role of serum endotoxin and antiendotoxin core antibody levels in predicting the development of multiple organ failure in acue pancreatitis. Br J Surg. 1993;80:1042-6.
Toh SK, Phillip S, Johnson CD. A prospective audit against national standards of the presentation and management of acute pancreatitis in the South of England. Gut. 2000;46:239-43.
Shen HN, Lu CL. Incidence, resource used, and outcome of acute pancreatitis with/without intensive care: a nation wide population based study in Taiwan. Pancreas. 2011;40:10-5.
Imrie CW. Changing patterns of incidence and mortality from acute pancreatitis in Scotland 1961-85. Br J Surg. 1990;77:731-4.
Appelros S, Borgstrom A. Incidence, etiology and mortality of acute pancreatitis over 10 years in a defined urban population in Sweden. Br J Surg. 1998;86:465-70.
Garg PK, Khanna S, Bohidar NP. Incidence, spectrum and antibiotic sensitivity pattern of bacterial infection among patients with severe acute pancreatitis. J Gastroenterol Hepatol. 2001:16:1955-9.
