Association between acute pancreatitis and peptic ulcer disease

Abstract

Aim: To evaluate the relationship between peptic ulcer disease (PUD) and acute pancreatitis.

Methods: A cohort of 78 patients with acute pancreatitis were included in this study. The presence of PUD and the Helicobacter pylori (H. pylori) status were assessed by an endoscopic method. The severity of acute pancreatitis was assessed using Ranson's score, the Acute Physiology and Chronic Health Evaluation (APACHE) II score, computed tomography severity index and the clinical data during hospitalization, all of which were compared between the patients with and without PUD. The risk factors for PUD were also evaluated.

Results: Among 78 patients, 41 patients (52.6%) with acute pancreatitis suffered from PUD, but only 13 (31.7%) patients with PUD were infected by H. pylori. On univariate analysis, male gender, an etiology of alcohol-induced pancreatitis, a history of smoking or alcohol consumption, elevated triglyceride and C-reactive protein levels, and high APACHE II score were significantly associated with PUD. However, on multivariate logistic regression analysis, the APACHE II score (odds ratio: 7.69; 95% confidence interval: 1.78-33.33; P < 0.01) was found to be the only independent risk factor for PUD.

Conclusion: Patients with acute pancreatitis are liable to suffer from PUD. PUD is associated with severe acute pancreatitis according to the APACHE II score, and treatment for PUD should be considered for patients with severe acute pancreatitis.

Keywords: Acute Physiology and Chronic Health Evaluation II score; Acute pancreatitis; Helicobacter pylori; Peptic ulcer disease.

Figure 1

Receiver operating characteristic curve for Acute Physiology and Chronic Health Evaluation II score in predicting the severity of acute pancreatitis (receiver operating characteristic area under the curve, 0.75; 95% confidence interval: 0.64-0.86).