CLINICO-PATHOLOGICAL PATTERN OF ACUTE PANCREATITIS – A SINGLE CENTRE STUDY

Abstract

Objectives: To review the aetiology, presentation and outcomes of acute pancreatitis over a period of three years.

Study Design: Observational study

Place and Duration of Study: This study was conducted at the Department of General Surgery, Combined Military Hospital Sialkot Cantonment from Aug 2012 to Jul 2015.

Patients and Methods: This was a prospective study from a general surgery unit. The patients included had confirmed acute pancreatitis. Possible aetiology, clinical presentation, complications and the outcome were documented.  

Results: One hundred and twenty cases of acute pancreatitis were recorded in three years. Male to female ratio was 1 : 2.1. Mean age was 46.03 + 9.777. Gallstone disease was noted in 76.6% while alcohol ingestion in 15.8%. All the patients had epigastric pain with 66.6% of patients having radiation to the back. Serum amylase was raised in all the cases with a mean of 1331.17 U/L + 533.761. Ultrasound was diagnostic in 74.1% cases, while the CT scan performed in all the cases was confirmatory. Five percent patients had a fatal outcome and died in the initial fourteen days of admission due to the multiorgan failure. No surgical intervention was contemplated during the acute phase of the disease and all the patients were managed conservatively. Pancreatic pseudocyst was seen in 11.6% cases. All the patients with gall stones were subjected to cholecystectomy.   

Conclusion: Gall stones were the commonest cause of acute pancreatitis followed by alcoholism. Pain epigastrium was the frequent presentation with serum amylase and CT scan abdomen as diagnostic investigations. Acute pancreatitis remains a significantly morbid clinical condition with acceptable mortality rate in aggressive management.

Keywords: MODS, Septicaemia, Renal failure, ARDS.