The incidence,etiology,complications and outcome in patients of acute pancreatitis ,a retrospective and prospective study.

Abstract

BACKGROUND: Acute pancreatitis (AP) is a common disease with a wide clinical variation.AP may vary in severity, from mild self-limiting pancreatic inflammation to pancreatic necrosis with life-threatening sequelae.

OBJECTIVES: The objective of the study was to know the incidence, etiology, complications and outcome in patients of AP, a retrospective and prospective study.

STUDY DESIGN: Observational study over a period of 5 years.

PARTICIPANTS:  The study was performed with admitted cases of AP  in emergency and wards over a period of 5 years

METHOD: Prospective and retrospective study was performed with admitted cases of AP over a period of 5 years.

RESULT: A total of 650 patients were analyzed .Among 650 patients 415(64%) patients were females and 235(36%) patients were males.Most common cause was biliary pancreatitis270(41%),which included gall stones 165(48%),gall stone with CBD stones 85(25%),post cholecystectomy CBD stones 14(4%),GB sludge 20(5.9%) followed by idiopathic pancreatitis 188(28%),biliary worms 55 (8.4%),hypertriglycredemia 20(3%) ,hyperpapathyroidism 20(3%),drugs 21(3%),alcohol 8(1.2%),pancreatic divisum 5(.7%),annular pancrease(.3%).48% had mild pancreatitis,24% moderate AP,27% severe AP.Gall stone were the leading cause of AP in mild and severe cases followed by idiopathic AP.Alcohol was least common cause of AP.68 patents AP with CBD stones underwent ERCP.Over all mortality rate was 13% in AP.98 patients had infected pancreatic necrosis.Gm –ve organism being the most common .High CRP ,hematocrit>44,blood sugar >200 ,waist circumference >100,BMI>25 risk factors for worsening of AP.

CONCLUSION: Females were more commonly affected than men in AP. Gallstone was the most common etiology , followed by idiopathic AP. Mortality was high in SAP.

IMPLICATION: Gallstone is mc cause of AP in our study. Obesity is a risk factor for GS formation and AP. All major complications of AP are more common and more severe in obese patients. Thus the unregulated breakdown of fat in obesity can convert AP into SAP.