scholarly journals A study of etiological clinical biochemical and radiological profile of patients with acute pancreatitis in rural population

2021 ◽  
Vol 8 (9) ◽  
pp. 2624
Author(s):  
Shilpashree Channasandra Shekar ◽  
Suhas Narayana Swamy Gowda ◽  
Naveen Narayan ◽  
Ajay Nagraj ◽  
Vishnu Venugopal ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Ct Scan ◽  
Enzyme Level ◽  
Remote Organ ◽  
Organ Systems ◽  
Life Threatening ◽  
Systemic Manifestations ◽  
Common Sign ◽  
A Prospective Study ◽  
High Degree

Background: Pancreatitis has been recognized since antiquity. Acute pancreatitis is an acute inflammatory process of the pancreas with variable involvement of other tissues or remote organ systems, presenting with variable clinical and systemic manifestations, presenting with mild self-limiting disease to severe life-threatening multi-organ failure.Methods: This was a prospective study of 60 patients, who were admitted with the diagnosis of acute pancreatitis (AP) during the period from December 2017 to June 2019. The data was collected from the all the patients who met the inclusion criteria, and recorded in the proforma prepared for the study.Results: Out of 60 patients 86.7% were male and 13.3% were female. The highest incidence was noted in 40-51 years age group (35%). Alcohol was the most common cause (75% patients). Abdominal pain was the most common mode of presentation (100%), and epigastric tenderness was the most common sign (100%). More than 3-fold elevation of serum amylase and lipase was seen in 26.7% and 33.3% of patients respectively. USG and CT scan was diagnostic only in 58.5% and 76.7% of patients respectively. All patients were managed conservatively. There was no mortality.Conclusions: In AP patients one should not only rely on enzyme level elevations for diagnosing AP. Patients with only a small increase in amylase and/or lipase levels or even with normal levels may also have or develop acute pancreatitis. High degree of suspicion is required; USG, CT scan and enzyme levels study are complimentary to the clinical suspicion.

scholarly journals TOTAL CALCIUM AND ALBUMIN CORRECTED CALCIUM AS PROGNOSTIC SEVERITY MARKERS IN ACUTE PANCREATITIS

2021 ◽  
pp. 1-3
Author(s):  
Madhu B S ◽  
Vikas V
Keyword(s):  
Acute Pancreatitis ◽  
Mortality Rate ◽  
Severe Form ◽  
Total Calcium ◽  
Early Assessment ◽  
Predictive Values ◽  
Medical College ◽  
Remote Organ ◽  
Organ Systems ◽  
A Prospective Study

Aim: to assess the Total Calcium and Albumin-Corrected Calcium as prognostic severity markers and Organ dysfunction. Background: Acute pancreatitis having variable involvement of regional tissues or remote organ systems can lead to high mortality rate in severe form. Early assessment to identify severity becomes essential. Materials & Methodology: A prospective study was conducted in K.R.Hospital, Mysore Medical College & Research Institute, from November 2019 to July 2020. All cases of Acute Pancreatitis during this period were assessed for severity and Total Calcium and Albumin Corrected calcium were assessed in them to assess the severity and their correlation. Results: A total of 96 patients were included in the study and in accordance with the updated Atlanta Classification, 63 patients presented with mild AP, 22 with moderately severe AP, and 11 with severe AP. The maximum TC cut-off point was 7.5 mg/dL, with values of S, 90.9%; Sp, 78.8%; PPV, 35.7%, and NPV, 98.5%. The maximum ACC cut-off point was 7.25 mg/dL, with values of S, 81.8%; Sp, 80%; PPV, 34.6%; NPV, 97.1% respectively . Conclusions: TC and ACC, measured within the first 24 hours, are useful severity predictors in acute pancreatitis, with sensitivity and predictive values comparable or superior to those of the conventional prognostic scales.

SERUM D-DIMER AS A TOOL FOR ASSESSMENT OF SEVERITY IN PATIENTS OF ACUTE PANCREATITIS

2021 ◽  
pp. 8-10
Author(s):  
Vipul K. Srivastava ◽  
Rahul Khanna ◽  
Ramniwas Meena ◽  
Siddharth Khanna ◽  
Chandradeep Singh ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Degradation Products ◽  
Indirect Measure ◽  
Severity Of Disease ◽  
Classi Cation ◽  
Life Threatening ◽  
A Prospective Study ◽  
Time Of Presentation ◽  
Stable Molecule ◽  
D Dimer

Introduction: Acute Pancreatitis (AP) is a potentially life threatening disease with varying severity of presentation from mild pain to persistent organ failure. D-dimer is an indirect measure of brin degradation products. It is a stable molecule with half-life of 4-8 hours. Material &Method: This is a prospective study done on 60 patients of acute pancreatitis treated at Department of General Surgery, Sir Sunderlal Hospital IMS BHU Varanasi, UPfrom the period of 2016 to 2018. Patients with diagnosis of APas per revised Atlanta classication were taken and D-dimer level was assessed at the time of presentation and patients were followed to assess the severity of disease and outcome. The D-dimer values were correlated with the Glasgow-Imrie score as well as the CTseverity index (CTSI) Result: Median value of D-dimer was found to be 3.68 mg/IFEU among the cases and 0.3 mg/IFEU among healthy volunteers. D-dimer levels increased as per CTSI severity score ranging from 2.97 to >5.70 mg/IFEU along with increased mortality in patients whom D-dimer levels were found to be high. D-dimer also showed positive correlation with Glasgow–Imrie score. Conclusion: Determining the serum concentration of D-dimer on day of admission is helpful in earlier prediction and assessment of severity of AP.

scholarly journals Acute pancreatitis- a clinical update

2018 ◽  
Vol 50 (1-2) ◽  
pp. 35-40
Author(s):  
Md Abdul Ahad
Keyword(s):  
Acute Pancreatitis ◽  
Viral Infections ◽  
Gall Stone ◽  
Disease Process ◽  
Alcoholic Pancreatitis ◽  
Gallstone Pancreatitis ◽  
Common Cause ◽  
Organ Systems ◽  
Life Threatening ◽  
Rising Incidence

Acute pancreatitis is an acute inflammatory process of the pancreas that can range from mild interstitial pancreatitis to severe pancreatitis with pancreatic necrosis with variable involvement of regional tissues and remote organ systems. The incidence of pancreatitis varies in different countries and depends on causes e.g, gallstones, alcohol, metabolic factors and viral infections. Gall stones continue to be the leading cause of acute pancreatitis in most series. Alcohol, hypertriglyceridemia and drugs are also a common cause of acute pancreatitis. Gall stone pancreatitis is more common in women than in men. Alcohol is also a common cause of acute pancreatitis. Alcoholic pancreatitis is more common in men, and usually occurs in individuals with long standing alcohol abuse. The increased frequency of acute pancreatitis may be due to the rising incidence of obesity, a risk factor for the development of gallstones and by extension, gallstone pancreatitis. Acute pancreatitis occurs when there is abnormal activation of digestive enzymes within the pancreas. This occurs through inappropriate activation of inactive enzyme precursors called zymogens or proenzymes inside the pancreas, most notably trypsinogen. Acute pancreatitis is typically rapid in onset and most commonly encountered in its mild form. While mild cases are often successfully treated with conservative measures, such as fasting and aggressive intravenous fluid rehydration, severe cases may require admission to the intensive care unit or even surgery to deal with complications of the disease process. Acute pancreatitis may be accompanied by life threatening complications as well as significant morbidity and mortality despite treatment.Bang Med J (Khulna) 2017; 50 : 35-40

Abdominal CT scan in acute pancreatitis (AP), an aid to etiological diagnosis: A prospective study in 78 patients

2000 ◽  
Vol 118 (4) ◽  
pp. A1148
Author(s):  
David Karsenti ◽  
Nicolas Watteau ◽  
Beatrice Scotto ◽  
Bruno Giraudeau ◽  
Pascal Bourlier ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Prospective Study ◽  
Ct Scan ◽  
Abdominal Ct ◽  
Etiological Diagnosis ◽  
Abdominal Ct Scan ◽  
A Prospective Study

scholarly journals Plasmatic Oxidative and Metabonomic Profile of Patients with Different Degrees of Biliary Acute Pancreatitis Severity

Antioxidants ◽  
2021 ◽  
Vol 10 (6) ◽  
pp. 988
Author(s):  
Pedro Silva-Vaz ◽  
Ivana Jarak ◽  
Luís Rato ◽  
Pedro F. Oliveira ◽  
Sara Morgado-Nunes ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Inflammatory Biomarkers ◽  
Antioxidant Defenses ◽  
Healthy Controls ◽  
Plasma Metabolome ◽  
Remote Organ ◽  
Organ Systems ◽  
Biliary Acute Pancreatitis ◽  
Serological Biomarkers

(1) Background: Acute pancreatitis (AP) is an inflammatory process of the pancreas with variable involvement of the pancreatic and peripancreatic tissues and remote organ systems. The main goal of this study was to evaluate the inflammatory biomarkers, oxidative stress (OS), and plasma metabolome of patients with different degrees of biliary AP severity to improve its prognosis. (2) Methods: Twenty-nine patients with biliary AP and 11 healthy controls were enrolled in this study. We analyzed several inflammatory biomarkers, multifactorial scores, reactive oxygen species (ROS), antioxidants defenses, and the plasma metabolome of biliary AP and healthy controls. (3) Results: Hepcidin (1.00), CRP (0.94), and SIRI (0.87) were the most accurate serological biomarkers of AP severity. OS played a pivotal role in the initial phase of AP, with significant changes in ROS and antioxidant defenses relating to AP severity. Phenylalanine (p < 0.05), threonine (p < 0.05), and lipids (p < 0.01) showed significant changes in AP severity. (4) Conclusions: The role of hepcidin and SIRI were confirmed as new prognostic biomarkers of biliary AP. OS appears to have a role in the onset and progression of the AP process. Overall, this study identified several metabolites that may predict the onset and progression of biliary AP severity, constituting the first metabonomic study in the field of biliary AP.

scholarly journals COMPARATIVE STUDY BETWEEN BISAP SCORE AND RANSON SCORE IN PREDICTING SEVERITY OF ACUTE PANCREATITIS

2020 ◽  
pp. 16-17
Author(s):  
Kumari Pallavi ◽  
M. K. Nathani ◽  
C. M. Narayan ◽  
Debarshi Jana
Keyword(s):  
Acute Pancreatitis ◽  
Scoring System ◽  
Epigastric Pain ◽  
Multiorgan Failure ◽  
Severe Disease ◽  
Scoring Systems ◽  
Medical College ◽  
Severe Pancreatitis ◽  
Life Threatening ◽  
Systemic Manifestations

Background: Acute pancreatitis has widely variable clinical and systemic manifestations spanning the spectrum from a mild, self-limiting episode of epigastric pain to severe, life-threatening, multiorgan failure. Since the morbidity and mortality of Acute Pancreatitis differ markedly between mild and severe disease (mild < 5% vs severe 20–25%), it is very important to assess severity as early as possible. Various scoring systems like APACHE II scoring, RANSON scoring and BISAP have been used to asses Severity in Acute Pancreatitis. Aim and objective: To assess the accuracy of BISAP scoring system vs RANSON scoring system in predicting Severity in an attack of acute pancreatitis. Materials and methods: In this study, 60 in-patients presenting with features of acute pancreatitis at Department of Surgery, Govt. Medical College and Hospital, Bettiah, W. Champaran, Bihar from April 2019 to March 2020 had been studied. It was a perspective and a retro prospective study. BISAP score and Ranson’s score was calculated in all such patients based on data obtained within 48 hours of hospitalization. Results: According to Atlanta Revised criteria, 30 patients had mild pancreatitis, 20 patients had moderately severe pancreatitis, 10 patients had severe pancreatitis. Of the 60 patients, 37 patients had Ranson's score less than or equal to 3. 23 patients had a score of more than 3.Of the 60 patients, 39 patients had a BISAP score less than or equal to 3, 21 patients had a score more than 3. Conclusion: From this study, we can conclude that the BISAP scoring system is not inferior to Ranson’s scoring system in predicting the severity of acute pancreatitis. BISAP scoring system is very simple, cheap, easy to remember and calculate. BISAP scoring system accurately predicts the outcome in patients with acute pancreatitis. Moreover, the values in BISAP score are instantaneous and there is no time delay. Ranson’s score takes a minimum of 24 hours.

scholarly journals A clinical study of risk factors of acute pancreatitis in a tertiary care centre in north India

2017 ◽  
Vol 4 (6) ◽  
pp. 1878 ◽  
Author(s):  
Pawan Kumar Jha ◽  
Rajnish Chandran ◽  
Pradeep Jaiswal ◽  
Kumari Seema
Keyword(s):  
Risk Factors ◽  
Acute Pancreatitis ◽  
Tertiary Care ◽  
Gall Stone ◽  
North India ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Organ Systems ◽  
Mild Acute Pancreatitis ◽  
A Prospective Study

Background: According to Atlanta Symposium, acute pancreatitis (AP) was defined as an acute inflammatory process of the pancreas that may also involve peri-pancreatic tissues and/or remote organ systems. The objective of this study was to know the risk factors of acute pancreatitis in patients admitted in a tertiary care centre in north IndiaMethods: A prospective study was performed with admitted cases of patients with acute pancreatitis over 2 years period. Total 104 patients were selected for study. All data concerning aetiology were recorded and analysed in all patients forming study groups.Results: Among 104 patients with acute pancreatitis 68 (65%) were females and 36 (35%) were males. Mean age of our study group was 40.9 years and maximum incidence was seen in 36-45 years. Most common cause was biliary pancreatitis (63%) followed by alcohol (27%), idiopathic (6%), trauma (3%), infections (1%). In females, most common aetiology was gall stone (88%), in males most commonly by alcohol (78%). As per Atlanta classification 81 patients (77.8%) had acute mild pancreatitis and 23 patients (22.2%) had acute severe pancreatitis. Majority females (66.7%) were admitted in mild acute pancreatitis. The mean age of patients in mild acute pancreatitis was 39.6 years and in severe group was 45.4 years. Gall stone were the leading cause in both mild and severe acute pancreatitis.Conclusions: Females were more commonly affected than men by acute pancreatitis. The most common aetiology was gall stone followed by alcohol which was leading cause in the males.

scholarly journals Comparative study between BISAP score and Ranson score in predicting severity of acute pancreatitis

2021 ◽  
Vol 8 (3) ◽  
pp. 920
Author(s):  
V. Balasubramaniam
Keyword(s):  
Acute Pancreatitis ◽  
Scoring System ◽  
Epigastric Pain ◽  
Severe Disease ◽  
Systemic Complications ◽  
Surgical Units ◽  
System Versus ◽  
Life Threatening ◽  
Systemic Manifestations ◽  
Higher Sensitivity

Background: Acute pancreatitis has widely variable clinical and systemic manifestations spanning the spectrum from a mild, self-limiting episode of epigastric pain to severe, life-threatening, multi-organ failure. Since the morbidity and mortality of acute pancreatitis differ markedly between mild and severe disease (mild <5% versus severe 20–25%), it is very important to assess severity as early as possible. To assess the accuracy of the BISAP scoring system versus Ranson scoring system in predicting severity in an attack of acute pancreatitis.Methods: It is a prospective and retro prospective study that was conducted, from August 2018 to November 2019. All surgical units in the headquarters hospital, Ooty. BISAP score and Ranson’s score is calculated in all such patients based on data obtained within 48 hours of hospitalization.Results: Ranson’s score of more than 3 and the BISAP score of less than or equal to 3 had the best accuracy of predicting the severity of acute pancreatitis. Both Ranson’s score and BISAP score showed higher sensitivity in the prediction of systemic complications than that of local complications.Conclusions: From this study, we can conclude that the BISAP scoring system is not inferior to Ranson’s scoring system in predicting the severity of acute pancreatitis. BISAP scoring system is very simple, cheap, easy to remember and calculate. BISAP scoring system accurately predicts the outcome in patients with acute pancreatitis.

scholarly journals Systemic-Lupus-Erythematosus-Related Acute Pancreatitis: A Cohort from South China

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Yanlong Yang ◽  
Yujin Ye ◽  
Liuqin Liang ◽  
Tianfu Wu ◽  
Zhongping Zhan ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
South China ◽  
Lupus Erythematosus ◽  
Medical Records ◽  
Multiple Organ ◽  
Chinese People ◽  
Favorable Prognosis ◽  
Organ Systems ◽  
Life Threatening ◽  
Life Threatening Complication

Acute pancreatitis (AP) is a rare but life-threatening complication of SLE. The current study evaluated the clinical characteristics and risk factors for the mortality of patients with SLE-related AP in a cohort of South China.Methods. Inpatient medical records of SLE-related AP were retrospectively reviewed.Results. 27 out of 4053 SLE patients were diagnosed as SLE-related AP, with an overall prevalence of 0.67%, annual incidence of 0.56‰ and mortality of 37.04%. SLE patients with AP presented with higher SLEDAI score (21.70±10.32versus16.17±7.51,P=0.03), more organ systems involvement (5.70±1.56versus3.96±1.15,P=0.001), and higher mortality (37.04% versus 0,P=0.001), compared to patients without AP. Severe AP (SAP) patients had a significant higher mortality rate compared to mild AP (MAP) (75% versus 21.05%,P=0.014). 16 SLE-related AP patients received intensive GC treatment, 75% of them exhibited favorable prognosis.Conclusion. SLE-related AP is rare but concomitant with high mortality in South Chinese people, especially in those SAP patients. Activity of SLE, multiple-organ systems involvement may attribute to the severity and mortality of AP. Appropriate glucocorticosteroid (GC) treatment leads to better prognosis in majority of SLE patients with AP.

Presentation of Gall Stone Ileus as Gut Obstruction

JMS SKIMS ◽  
2019 ◽  
Vol 21 (2) ◽  
pp. 117-119
Author(s):  
Munir Ahmad Wani ◽  
Mubarak Ahmad Shan ◽  
Syed Muzamil Andrabi ◽  
Ajaz Ahmad Malik
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Ct Scan ◽  
Bowel Obstruction ◽  
Emergency Surgery ◽  
Gallstone Ileus ◽  
Gall Stone ◽  
Life Threatening ◽  
Life Threatening Complication ◽  
Gall Stone Ileus

Gallstone ileus is an uncommon and often life-threatening complication of cholelithiasis. In this case report, we discuss a difficult diagnostic case of gallstone ileus presenting as small gut obstruction with ischemia. A 56-year-old female presented with abdominal pain and vomiting. A CT scan was performed and showed an evolving bowel obstruction with features of gut ischemia with pneumobilia although no frank hyper density suggestive of a gallstone was noted. The patient underwent emergency surgery and a 60 mm obstructing calculus was removed from the patient's jejunum, with a formal tube cholecystostomy. JMS 2018: 21 (2):117-119

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