Acute pancreatitis remains a common disorder with devastating consequences. Although most episodes are mild and self limiting, upto a fifth of patients develop a severe attack that can be fatal. Inspite of technical advances in medical and surgical fields acute pancreatitis remains a major cause of morbidity and mortality. So, this challenging subject is taken up for the present study in which we will be studying the clinical profile and management of acute pancreatitis in our hospital.
Aims & objectives of the study: To study the, clinical presentation and complications of acute pancreatitis and the treatment modalities that can be offered in our institution and the outcome
Methodology: This prospective study conducted at Dept. Of Gen. Surgery DCMS Hyderabad.
Results: The present study included 40 patients with acute pancreatitis, 28 males and 12 females (M : F ~ 2.44 : 1). The peak incidence was in the fourth decade with the median age of 35 years. The commonest etiology was gall stones disease accounted for 35.7% of cases followed by alcohol (31%) and idiopathic (16.7%) Pain and vomiting were the commonest presenting complaints. 3 patients had jaundice. Serum Amylase and Serum Lipase together gave high sensitivity (80%) for diagnosis. Computed Tomography was very sensitive, non-invasive tool for diagnosis and imaging of complications. The enteral route was used for nutritional support in 13 patients and total parenteral nutrition was given to 3 patients. The median hospital stay was 12 days (Range – 3 to 85 days) and 23 patients required ICU care (2 to 56 days). Out of 40 patients 53% had a mild disease while 47% had a severe attack. The overall mortality rate was 7% and mortality rate among severe cases was 28.33%.
Conclusion: The incidence of acute pancreatitis was found to be in a younger age group in our study. Serum Amylase and Lipase both (80% sensitivity) should be used for diagnosis where ever possible. Scoring systems help to identify patients who are more likely to have a severe attack and they should be referred to higher centers if adequate facilities are not available. Severe cases should be managed in well equipped ICU. Support of specialist in radiology, endoscopy and surgery is essential. Timely intervention by endoscopist and surgeons are crucial to reduce morbidity and mortality.