[Acute pancreatitis: classification and study of 96 patients]

Abstract

Acute pancreatitis is a multifaceted disease as expressed by its multiple etiologies, varying clinical presentations, radiological appearances and pathological changes. This variability has lead to a confusing range in terminology that has complicated the precise classification of this entity. A uniform interdisciplinary classification is necessary to facilitate assessment of acute pancreatitis. An international symposium held in 1992, attended by experts in fields including surgery, radiology, and pathology, formulated a nomenclature to describe acute pancreatitis. We retrospectively studied 96 cases of acute pancreatitis to test the efficacy of this classification as regards severity of the disease process and its complications. The initial severity of the pancreatitis was assessed, complications and their treatment noted and the various imaging modalities and their indications reviewed. The most efficacious investigation was computed tomography with intravenous contrast injection. Good correlation with the newer classification was noted in assessing the severity of the illness and its complications, as well as aiding in interdisciplinary communication. Particular difficulty was noted differentiating infected necrosis, pancreatic abscess and infected psuedocysts. Our results correlate well with the current literature, with the exception of a higher relative incidence of pancreatitis among females. This probably reflects the lower incidence of alcoholism in Israel among men, with biliary lithiasis among females primary in the etiology of the disease.