[Acute pancreatitis in intensive care unit: review and evolution of 36 cases Víctor Lazarte E. Hospital. Trujillo, Perú]

Abstract

Introduction: Acute pancreatitis is a local inflammatory process that could be generalized by producing mild to severe gastroenteral manifestations, like multiple organ dysfunction and death.

Objective: To describe epidemiological, clinical, therapeutical characteristics and evolution of patients with AP of our unit and to compare with other studies of Peru and other countries.

Materials and methods: We realized a review of all cases with AP treated in ICU-INCU of Victor Lazarte Echegaray Hospital over 1 degrees January of 2004 to April, 30 of 2007.

Results: At the time of this study were admitted 40 patients with AP, just 36 clinics records were recovered, 24 of these were Severe Acute Pancreatitis (SAP) and 12 were Mild Acute Pancreatitis (MAP). Age mean was 55+/-16.7 years old (range 27-84 y.o.), male and female had equal predominance 18 (503). Biliar compliances were the most frequent etiology with 26 cases (72.2%). All patients (100%) had abdominal pain, 34 de 36 cases (94.4%) had nauseas and/or vomits. Seric amylase mean was 2580+/-1507.1 UA/L (range 380-6883 UA/L). Ranson score was 2.92+/-1.97 points (range 0-6 points) and APACHE II score was 11.86+/-8.27 points (range 0-31 points). Computed Tomography was realized in 22 patients with Tomography Severity Index mean was 4.41 +/- 2.79 points (range 0-10 points). Four patients with SAP (16.6%) developed pancreatic pseudocyst. Respiratory dysfunction was the systemic complication most frequent with 36.1% patients of all (13/36 cases), eight patients had multiple organ dysfunction. No patients with MAP dead. Eleven of 36 patients (30.6%) received prophylactic antibiotics. Length of stay in hospital and ICU-INCU were 7.7+/-5.3 days (range 1-26 days) y 14.8+/-9.7 days (range 1-53 days). Two patients with SAP were performed to surgery after AP was detected: one case was cholecystectomized for perfored pyocholecist and other one was cholecystectomized and drain of choledoco; no one of these dead.

Conclusion: Epidemiological, clinical, therapeutical characteristics and evolution of the patients with AP were similar to the majority of national and international reports.