Acute Pancreatitis: Clinical Profile of 60 Patients

Abstract

Introduction Acute pancreatitis (AP) is a common differential diagnosis of acute pain abdomen and cannot be considered self-limiting as it has serious early and long-term impacts. Depending on severity, AP is divided into mild, moderately severe, and severe AP. Management of AP involves accurate diagnosis, high-quality supportive care, monitoring for early detection and treatment of complications, and prevention of relapse. Aim To assess the etiological risk factors, clinical profile, and complications in patients with AP. Methods The present study was conducted on 60 eligible patients admitted to the Department of Medicine, Government Medical College, and Hospital of Northern India. A diagnosis of AP was established based on the revised Atlanta classification (2012) for the classification of AP, and relevant data were collected and statistically analyzed. Results Most of the AP patients were in the 21-40 year age group. The majority were males (88.3%). Alcohol was the most common etiological factor in 76.7% of patients followed by cholelithiasis in 10% of patients. Pain abdomen was the most common presenting clinical feature occurring in 96.7% of patients and vomiting in 65% of the patients. Acute fluid collection was the most common pancreatic complication occurring in 26.7% of the patients, pancreatic edema was seen in 21.7%, and pancreatic necrosis in 15%. Among extrapancreatic complications, ascites was most commonly seen in 50% of patients followed by pleural effusion in 15%, shock in 15%, multiple organ dysfunction syndrome (MODS) in 15%, and hypocalcemia in 11.7% of patients. Conclusion AP should be one of the differentials for patients presenting with pain abdomen, especially when probable risk factors such as alcohol abuse and cholelithiasis are present. A high index of suspicion to diagnose AP is needed as timely management may prevent systematic complications, thus improving the outcome. Poor prognostic indicators are raised levels of total serum bilirubin, raised serum lipase, reduced serum albumin, and low platelet count among AP patients.

Keywords: acute pancreatitis; alcohol; multi organ dysfunction syndrome; pancreatic necrosis; serum lipase.