Clinical profile of patients with acute pancreatitis in a tertiary care centre in Tripura: A retrospective study

Background: Acute Pancreatitis is a common disease with wide clinical variation and its incidence is increasing. Acute pancreatitis is an inflammatory process leading to abdominal pain, progressive destruction of exocrine tissue and in some patients a loss of endocrine tissue as well, with multiple organ failure and high mortality. Severity of acute pancreatitis is linked to the presence of systemic organ dysfunction and/or necrotizing pancreatitis. Aims and Objective: The present study was aimed to study the clinical profile of acute pancreatitis, the etiology and complications of acute pancreatitis received treatment in the Department of Surgery, Tripura Medical College & Dr. BRAM Teaching Hospital, Agartala, Tripura. Materials and Methods: This was a hospital based retrospective study which was conducted from January 2019 to December 2019. All patients with a diagnosis of acute pancreatitis were included in this study in order to find out the clinical presentations from the available clinical, laboratory and radiological data. Result: Of the 100 patients in this study, 96 were male and 4 were female. Minimum age in our study was 10 years and maximum were 70 years. Maximum numbers of patients were below 45 years of age. Alcohol was identified as the most important etiological factor associated with acute pancreatitis. Among the known etiological factors 90% of the cases were related to alcoholism and 4% were due to gall stone disease. Abdominal pain and vomiting were the most common symptoms in our study. Epigastric tenderness was present in 90% of the cases and guarding/rigidity in 50% of cases. 14% patients showed jaundice as a sign of acute pancreatitis. There was no major difference between the CT grading system and clinical grading system. Most of the patients recovered with conservative treatment. Adverse outcome was noted in one patient with acute necrotizing pancreatitis. Conclusion: Acute pancreatitis is one of the leading causes of increase in morbidity and mortality to society. Clinical assessment along with radiological findings correlated well with the morbidity and mortality. Our study identifies alcoholism as one of the most important etiological factors.

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Clinical Profile and Underlying Cause of Acute Pancreatitis among a Group of Bangladeshi Patients

Medicine Today ◽

10.3329/medtoday.v32i1.44823 ◽

2020 ◽

Vol 32 (1) ◽

pp. 21-24

Author(s):

ANM Saifullah ◽

Madhu Sudan Saha ◽

Bimal Chandra Shil ◽

Ali Monsur Md Shariful Islam ◽

Arifa Akhter ◽

...

Keyword(s):

Acute Pancreatitis ◽

Abdominal Pain ◽

Gall Stone ◽

Clinical Profile ◽

Medical Emergency ◽

High Morbidity ◽

Cross Sectional ◽

Medical College ◽

North East ◽

Medicine Today

Introduction:Acute Pancreatitis is a medical emergency, which is one of the most common conditions for hospital admission. Very few studies have yet investigated in Bangladesh. Objective of this study was to define demographic characteristics, clinical profile & underlying etiologies. Materials and Methods: This hospital based cross sectional descriptive study was performed in Sir Salimullah Medical College Mitford Hospital, Dhaka & North East Medical College, Sylhet, Bangladesh from January 2015 to December 2017. One hundred and five consecutive patients of acute pancreatitis (AP) were enrolled for this study. Clinical features and investigations were systematically recorded. Diagnosis of acute pancreatitis was made by the presence of the two of the three following criteria: i. abdominal pain consistent with the disease ii. serum amylase and /or lipase greater than three times from the upper limit of normal, and/or iii. characteristic findings of abdominal imaging. Results: Total of 105 patients took part in the study, of them 65 were male. The mean age was 42.76 ±15.88. Abdominal pain & vomiting was the most common mode of presentation. Gall stone and hypertriglyceridaemia were responsible of 20% of acute pancreatitis. Ascariasis also causes acute pancreatitis in two patients. Conclusion: Acute pancreatitis is a condition associated with high morbidity and mortality. Ascariasis also causes acute pancreatitis in endemic area. Patients usually respond conservative treatment but endoscopic treatment is effective in few cases. Surgery is rarely required. Medicine Today 2020 Vol.32(1): 21-24

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Acute pancreatitis prevalence in children with cystic fibrosis and PIP score prediction applicability

Romanian Journal of Medical Practice ◽

10.37897/rjmp.2021.2.23 ◽

2021 ◽

Vol 16 (2) ◽

pp. 248-253

Author(s):

Valentina-Daniela COMĂNICI ◽

◽

Ioana Florentina CODREANU ◽

Anca BĂLĂNESCU ◽

Alina Angelica BELIVACĂ ◽

...

Keyword(s):

Cystic Fibrosis ◽

Acute Pancreatitis ◽

Abdominal Pain ◽

Retrospective Study ◽

Pediatric Population ◽

Pancreatic Insufficiency ◽

Exocrine Pancreatic Insufficiency ◽

Substitution Therapy ◽

Imaging Evaluation ◽

Female Predominance

One of the affected organs in cystic fibrosis (CF) is the pancreas, mainly translated into exocrine pancreatic insufficiency. Although rare, acute pancreatitis (AP) has been described, mostly in pancreatic sufficient patients. Objectives. Estimating AP prevalence in CF pediatric population of the I.N.S.M.C. „AlessandrescuRusescu” CF centre. Material and methods. 5 year retrospective study (2011-2016) including INSMC CF centre pediatric population aged 3-18 years. PA diagnosis was established on the presence of minimum 2 criteria between: characteristic abdominal pain, x3 normal value for age elevation of amylase/lipase, medical imaging evaluation suggestive for AP. Patients were evaluated with different criteria including PIP score of predicting AP risk. Outcomes. 48 patients were included with a slight female predominance (54%). 3 of them presented diagnostic criteria for AP (6,25%), all heaving pancreatic insufficiency and high PIP score (low risk of developing AP); 2 of them have low compliance with pancreatic enzymes substitution therapy; one of them presented recurrent episodes of AP. Conclusions. AP is a rare CF complication. It can be easily missed due to a large number of abdominal pain and emesis causes in CF patients. Although it is usually associated with pancreatic sufficiency, all our patients were pancreatic insufficient.

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Clinicopathological Profile and Outcome of Acute Pancreatitis

Journal of Bangladesh College of Physicians and Surgeons ◽

10.3329/jbcps.v38i2.45632 ◽

2020 ◽

Vol 38 (2) ◽

pp. 86-92

Author(s):

Md Anisur Rahman ◽

Most. Umme Habiba Begum ◽

Praveen Kumar Sharmam ◽

Atul Jha ◽

Rahul Jain ◽

...

Keyword(s):

Acute Pancreatitis ◽

Organ Dysfunction ◽

Hospital Care ◽

Hepatic Dysfunction ◽

Necrotizing Pancreatitis ◽

Tertiary Care ◽

Gall Stone ◽

Aged Patients ◽

Chronic Alcohol Abuse ◽

Clinicopathological Profile

Background: Acute pancreatitis is an important cause of morbidity and mortality among gastrointestinal disorders. But little is known about etiology and clinical profile in Indian population. Objective: To know clinicopathological profile, etiology and outcome of acute pancreatitis in study patients. Material and methods: This observational cross-sectional study was conducted in a tertiary care and research hospital in New Delhi India from May 2018 to November 2018. Total 30 established cases of acute pancreatitis were included in the study. Data were collected and processed by using SPSS version20 and result was obtained in tables and diagrams. Results: Among 30 patients, 21(70%) were male and 9(30%) female; 18 to 89 yrs of aged patients were included in the study with mean age 41.6±17.5 years, of 18-30 years of aged patients were more affected (10, 33.3%); patients of different occupation were studied;26(86.7%)patients were non-smoker and 4(13.3%) smoker; 16(53.3%) were non-alcoholic and 14(46.7%) patients had a habit of alcoholism of whom, all were male; patients who used to take e”5 units of alcohol per day were frequently affected (10, 71.4%) by acute pancreatitis, though it did not spared occasional drinkers (2, 14.3%);22(73.3%) patients had interstitial pancreatitis and 8(26.7%) had acute necrotizing pancreatitis;14(46.7%) patients had acute pancreatitis due to alcohol, 10 (33.3%) patients had gall stone, 2(6.7%) patients developed pancreatitis after ERCP;29(96.7%) patients presented with abdominal pain, 28 (93.3%) had vomiting, 21 (70%) patients had jaundice, 10 (33.3%) had fever, 18 (60%) patients had anemia, 17 (56.7%) patients develop ascites, 19 (63.3%) patients develop pleural effusion, 7(23.3%) patients developed ileus, and 3(10.0%) patients developed circulatory shock; 25(83.3%) patients developed organ dysfunction during in hospital care, of whom 11(36.7%) patients had transient and 14(46.7%) had persistent organ dysfunction; 5(16.7%) patients were complicated with pseudocyst, 6(20%) had walled of necrosis (WON), 7(23.3%) developed sepsis, 14(46.7%) developed renal dysfunction, 23(76.7%) developed hepatic dysfunction, 8(26.7%) developed respiratory dysfunction, 6(20%) developed pneumonia; 8(26.7%) patients had been suffering from different comorbidity; ultrasound of abdomen were abnormal in all 30(100%) patients; As per CTSI score, severe pancreatitis 14(46.7%), moderate pancreatitis 14(46.7%) and mild pancreatitis 2(6.7%); 24(80%) patients received only medical treatment and 6(20%) patients needed surgical or radiological intervention; 19(63.3%) patients were improved symptomatically, 8(26.7%) patients were cured and 3(10%) patients died during in hospital care. Conclusion: Alcohol was the predominant etiology of acute pancreatitis, mostly affecting young and middle aged male, but mortality was more in gall stone related pancreatitis. Hepatic dysfunction was observed frequently that may attribute to effect of chronic alcohol abuse. J Bangladesh Coll Phys Surg 2020; 38(2): 86-92

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Acute pancreatitis associated with acute viral hepatitis: case report and review of literature

Revista do Instituto de Medicina Tropical de São Paulo ◽

10.1590/s0036-46652009000600008 ◽

2009 ◽

Vol 51 (6) ◽

pp. 349-351 ◽

Cited By ~ 5

Author(s):

Danilo Bora Moleta ◽

Fábio Toshio Kakitani ◽

Adma Silva de Lima ◽

João César Beenke França ◽

Sonia Mara Raboni

Keyword(s):

Acute Pancreatitis ◽

Abdominal Pain ◽

Case Report ◽

Acute Hepatitis ◽

Viral Hepatitis ◽

Acute Viral Hepatitis ◽

Hepatitis Virus ◽

Common Disease ◽

Review Of Literature ◽

Hepatitis Case

This case report, along with the review presented, describes a patient diagnosed with acute viral hepatitis, who developed a framework of intense abdominal pain and laboratorial alterations compatible with acute pancreatitis. The association of acute pancreatitis complicating fulminant and non-fulminant acute hepatitis virus (AHV) has been reported and several mechanisms have been proposed for this complication, but so far none is clearly involved. As acute hepatitis is a common disease, it is important to stimulate the development of other studies in order to determine local incidence and profile of patients presenting this association in our environment.

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Incidence and clinical profile of ectopic pregnancies in a tertiary hospital; A two-year Retrospective study

Bhutan Health Journal ◽

10.47811/bhj.103 ◽

2020 ◽

Vol 6 (2) ◽

pp. 6-11

Author(s):

Sonam Gyamtsho ◽

Karma Tenzin ◽

Tshering Choeda ◽

Karma Lhaden ◽

Tandin Om

Keyword(s):

Risk Factors ◽

Abdominal Pain ◽

Retrospective Study ◽

Ectopic Pregnancy ◽

Inflammatory Disease ◽

Vaginal Bleeding ◽

Morbidity And Mortality ◽

Clinical Presentations ◽

History Of ◽

Ectopic Pregnancies

Introduction: Ectopic pregnancy is an emergency and a life-threatening condition which is an important cause of major maternal morbidity and mortality. This study was designed to determine incidence, common identified risk factors, clinical presentations, management, morbidity and mortality due to ectopic pregnancy at the national referral hospital in Thimphu, Bhutan. Methods: This was a retrospective study of all cases of ectopic pregnancies for a period of two years from 1st January 2018 to 31st December 2019. Socio-demographic characteristics, risk factors, clinical presentations, investigations and mode of treatments were extracted. Simple descriptive statistics such as frequencies, percentages, mean and range were utilised. Results: There were 9603 pregnant women admitted for delivery, out of which 122 were ectopic pregnancies. The incidence of ectopic pregnancy was 12.7/1000 pregnancies. Majority of them were in the age group of 21-30 years and 32.69% of the affected were nulliparous. While Pelvic inflammatory disease was seen in 41.35%, 20.19% were unmarried. Abdominal pain, amenorrhea, and vaginal bleeding were the most common symptoms. Among the ectopic pregnancies, 99.5% were diagnosed with ultrasound. A total of 94.23% had undergone surgical intervention, of which only 1% had laparoscopic surgery. No maternal mortality had occurred. Conclusions: Women with past history of pelvic inflammatory disease, previous miscarriage, unmarried, and nulliparous presenting with history of amenorrhea, abdominal pain, vaginal bleeding should be a high index of suspicion for ectopic pregnancy. Timely diagnosis and intervention in the form of surgical or medical management will reduced the morbidity and mortality due to ectopic pregnancy.

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A clinical study on epidemiology and etiological factors of acute pancreatitis-hospital based study in South India

International Surgery Journal ◽

10.18203/2349-2902.isj20213971 ◽

2021 ◽

Vol 8 (10) ◽

pp. 3060

Author(s):

Rajesh S. ◽

Raju P. V.

Keyword(s):

Acute Pancreatitis ◽

South India ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Gall Stone ◽

Geographical Location ◽

High Morbidity ◽

Care Hospital ◽

Etiological Factors ◽

Males And Females

Background: Acute pancreatitis is an important cause of acute abdomen with high morbidity and mortality. This study aimed to evaluate the epidemiology and etiological factors of acute pancreatitis in a tertiary care hospital in South India.Methods: This retrospective study was carried among 70 patients. Data was collected and analysis done based on age, gender, etiology and severity of acute pancreatitis.Results: Males were found more commonly affected than females in the ratio (M:F) of 5:1. Mean age of the study group was 37.2 years and maximum incidence was seen in the age group of 31 to 40 years. Overall alcohol was the most common etiological factor followed by idiopathic cause and gall stone disease.Conclusions: Males were more commonly affected than females with acute pancreatitis. Alcohol and gall stones were the leading cause of acute pancreatitis in males and females respectively. Alcohol was the most common cause in this geographical location.

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Surgery Management of Pancreatitis with Complication: A Review Article

Endocrinology and Disorders ◽

10.31579/2640-1045/111 ◽

2022 ◽

Vol 6 (1) ◽

pp. 01-03

Author(s):

Nanda Rachmad Putra Gofur ◽

Aisyah Rachmadani Putri Gofur ◽

Soesilaningtyas Soesilaningtyas ◽

Rizki Nur Rachman Putra Gofur ◽

Mega Kahdina ◽

...

Keyword(s):

Acute Pancreatitis ◽

Abdominal Pain ◽

Necrotizing Pancreatitis ◽

Clinical Manifestations ◽

Healing Time ◽

Acute Necrotizing Pancreatitis ◽

Close Monitoring ◽

Necrotic Tissue ◽

Acute Necrotizing ◽

Walled Off Necrosis

Introduction: Acute pancreatitis is an inflammatory disease of the pancreas with clinical manifestations that vary from mild to severe manifestations to death. The incidence of pancreatitis varies in various countries in the world and depends on the cause such as alcohol, gallstones, and metabolic factors. The clinical picture and the main symptom in patients with acute pancreatitis is abdominal pain. Abdominal pain varies from mild to severe and excruciating. Abdominal pain that is felt is constant and dull, and is usually felt in the epigastrium and periumbilicus and often spreads to the back, chest, waist, and lower abdomen. Discussion: The onset of acute pancreatitis, the patient should be evaluated for hemodynamic status immediately and receive the necessary resuscitation measures. Patients with acute pancreatitis should receive aggressive intravenous rehydration (250 - 500 ml/hour with isotonic crystalloid fluid) as early as possible with close monitoring, unless contraindicated with cardiovascular and/or renal comorbidities. It is most effective within the first 12-24 hours, but after that the benefits may diminish. Debridement (necrosectomy) is the gold standard in infected acute necrotizing pancreatitis and peripancreatic necrosis. Indications for intervention either through radiological, endoscopic or surgical procedures in necrotizing pancreatitis are suspected or proven infected necrotizing pancreatitis with clinical deterioration, especially after the necrotic tissue has been encapsulated with thick walls (walled-off necrosis). Sterile necrotizing pancreatitis with persistent organ failure several weeks after the onset of acute pancreatitis, particularly after the necrotic tissue has been encapsulated with thick walls (walled-off necrosis). Conclusion: Surgical management is often used in pancreatitis associated with gallstones. Cholecystectomy within 48 hours of the complaint can increase healing time. In addition, cholecystectomy performed early may not increase the risk of complications secondary to surgery. Surgery is not performed in acute necrotizing pancreatitis until the inflammation is reduced and the fluid accumulation no longer increases in size.

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Clinical profile, degree of severity and underlying factors of acute pancreatitis among a group of Bangladeshi patients

IMC Journal of Medical Science ◽

10.3329/imcjms.v12i1.35170 ◽

2018 ◽

Vol 12 (1) ◽

pp. 6-10

Author(s):

Indrajit Kumar Datta ◽

Md Nazmul Haque ◽

Tareq M Bhuiyan

Keyword(s):

Acute Pancreatitis ◽

Gall Stone ◽

Clinical Findings ◽

Clinical Profile ◽

Clinical Feature ◽

Specific Clinical Feature ◽

The Mean ◽

Severity Of The Disease ◽

Degree Of Severity ◽

Recorded Diagnosis

Background and objectives: Acute pancreatitis is a common condition for hospital admission. In Bangladesh, no study has yet investigated the clinical profile, degree of severity and underlying factors of acute pancreatitis. The aim of the present study was to determine the clinical profile, degree of severity and underlying factors of acute pancreatitis in a cohort of Bangladeshi patients.Methods: This prospective study was conducted from April 2016 to March 2017 on patients admitted with acute pancreatitis at Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) General Hospital, Dhaka, Bangladesh. History and clinical features of each patient was systematically recorded. Diagnosis of acute pancreatitis was made by clinical findings, serum amylase and lipase levels (> 3 times the upper limit of normal values), evidences of acute pancreatitis by ultrasonography and computed tomography (CT). Severity of acute pancreatitis was classified according to the revised version of Atlanta classification.Results: A total of 40 patients with acute pancreatitis were enrolled in the study. Male and female were equally distributed. The mean age was 44.3±2.7 years. Among 40 cases, 26 (65.0%) and 14 (35%) had moderate and severe acute pancreatitis respectively. No specific clinical feature including ascites or pleural effusion was found significantly related to severity of the disease. Gall stone and metabolic (hypertriglyceridaemia/hypercalcemia) causes were present in 62.5% cases, but none had significant association with the severity of the disease.Conclusion: The present study has demonstrated that no specific observed clinical feature or underlying factor was related to the degree of severity of acute pancreatitis in a cohort of Bangladeshi patients.IMC J Med Sci 2018; 12(1): 6-10

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Ascaris infection, a rare cause of necrotizing pancreatitis in a child

Journal of Chitwan Medical College ◽

10.3126/jcmc.v10i1.28081 ◽

2020 ◽

Vol 10 (1) ◽

pp. 88-90

Author(s):

Aditya Prakash Yadav ◽

Rishi Kumar Karki ◽

Binod Kumar Rai

Keyword(s):

Acute Pancreatitis ◽

Abdominal Pain ◽

Necrotizing Pancreatitis ◽

Exploratory Laparotomy ◽

Mortality Rates ◽

High Morbidity ◽

Provisional Diagnosis ◽

Intraoperative Diagnosis ◽

Biliary Ascariasis ◽

Upper Abdominal

Necrotizing pancreatitis is a very rare in children and is associated with high morbidity & mortality rates. We report a case of 5yr old boy who presented with upper abdominal pain, vomiting and non-passage of stool for 1day. After resuscitation and investigating the child, a provisional diagnosis of biliary ascariasis (BA) with acute pancreatitis was made. The child developed peritonitis after 2 days of admission and exploratory laparotomy was planned. An intraoperative diagnosis of necrotizing pancreatitis was made and the child was successfully managed.

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Severity, Treatment, and Outcome of Acute Pancreatitis in Thailand: The First Comprehensive Review Using Revised Atlanta Classification

Gastroenterology Research and Practice ◽

10.1155/2017/3525349 ◽

2017 ◽

Vol 2017 ◽

pp. 1-7 ◽

Cited By ~ 3

Author(s):

Supot Pongprasobchai ◽

Peeradon Vibhatavata ◽

Piyaporn Apisarnthanarak

Keyword(s):

Acute Pancreatitis ◽

Retrospective Study ◽

Mortality Rate ◽

Necrotizing Pancreatitis ◽

Median Length ◽

Comprehensive Review ◽

Ringer’S Lactate ◽

The Mean ◽

Lactate Solution ◽

Overall Mortality

Background.Severity and outcome of acute pancreatitis (AP) in Thailand are unknown.Methods. A retrospective study of 250 patients with AP during 2011–2014 was performed. Severity, treatment, and outcome were evaluated. Severity was classified by revised Atlanta classification.Results. The mean age was 58 years and 56% were men. Etiologies were gallstones (45%), alcohol (16%), postendoscopic retrograde cholangiopancreatography (14%), and idiopathic (15%). Overall, 72%, 16%, and 12% of patients had mild, moderately severe, and severe AP, respectively. Two major types of initial intravenous fluid were normal saline (64%) and Ringer’s lactate solution (RLS, 28%). Enteral nutrition was given in 77% of patients with severe AP, median duration 48 hours, and via a nasogastric tube in 67% of patients. Necrotizing pancreatitis (NP) developed in 7% of patients, and 29% of them developed infection (median 17 days). The median length of stay was 6, 9, and 13 days, and the mortality rate was 1%, 3%, and 42% in mild, moderately severe, and severe AP, respectively. The overall mortality rate was 6%.Conclusion. The severity of AP in Thailand was mild, moderately severe, and severe in 72%, 16%, and 12% of patients, respectively. NP was not prevalent. Mortality was high in severe AP. Most treatments complied with standard guidelines except the underuse of RLS.

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