Clinical Profile And Outcome Of Severe Acute Pancreatitis

Clinical Profile of Pancreatitis

Authors

  • Sanjeev Kumar Singla
  • Narender Pal Jain
  • Shweta Gupta
  • Satpal Singh Virk
  • Pawan Inder Attri
  • Pulkit Sethi

DOI:

https://doi.org/10.70284/njirm.v4i6.2252

Keywords:

A acute pancreatitis , conservative , intervention, necrotizing , treatment

Abstract

Background and Objectives: Around 20% of the patients of acute pancreatitis develop acute severe pancreatitis in the form of extensive pancreatic or peripancreatic fat tissue necrosis with associated peripancreatic collections. These patients run a protracted clinical course, multiorgan failure, high morbidity and mortality. Methods: Clinically and radiologically diagnosed 30 patients of acute severe necrotizing pancreatitis were prospectively evaluated for the clinical outcome with respect to extent of pancreatic necrosis and severity in terms of CTSI. Results: 18 patients had pancreatic necrosis between 30-50% (Group A) whereas 12 patients had necrosis more than 50% (Group B). The rate of organ dysfunction and mortality (11.11% versus 50.50%) the rate of was significantly higher in the group B. Multiorgan failure (MOF) was present in 5.56% of group A and 58.33% of group B patients. 66.67% patients were managed conservatively of whom 80% survived and 33.33% patients underwent surgical intervention of whom 60% survived. Conclusion: CECT is the modality of choice to help stage the severity of pancreatic necrosis, depict severity of inflammatory processes and local complications. Patients with pancreatic necrosis with transient end organ dysfunction can be treated conservatively with favorable outcome. The need for intervention should be individualized and based on the clinical condition of patient.

References

1. Slavin J, Ghaneh P, Sutton R, Hartley M, Rowland P, Garvey C et al. Management of
necrotizing pancreatitis. World J Gastroenterol 2001; 7(4): 476-81.
2. Beger HG. and Rau BM. Severe acute pancreatitis: Clinical course and management. World J Gastroenterol 2007; 13(38): 5043-51.
3. Buchler MW, Gloor B, Muller CA, Friess H, Seiler CA and Uhl W. Acute necrotizing pancreatitis: Treatment Strategy According to the status of Infection: Annals of Surgery 2000; 232(5): 619-626.
4. Santvoort HCV, Bakker OJ, Bollen TL, Besselink MG, Ali UA, Schrijver AM et al. A Conservative and minimally invasive approach to necrotizing pancreatitis improves outcome. Gastroentrology 2011; 141(4): 1254-1263.
5. Balthazar EJ. Acute pancreatitis: assessment of severity with clinical and CT evaluation. Radiology 2002; 223: 603-13
6. Mortele KJ, Wiesner W, Intriere L, Shankar S, Zou KH, Kalantari BN, et al. A modified CT Severity Index for evaluating acute pancreatitis: improved correlation with patient outcome. AJR 2004; 183: 1261-65.
7. Besselink MGH, Verwer TJ, Schoenmaeckers EJP, Buskens E, Ridwan BU, et al. Timing of Surgical Intervention in Necrotizing Pancreatitis. Arch Surg 2007; 142(12): 1194-1201.
8. Sivasankar A, Kannan DG, Ravichandran P, Jeswanth S, Balachandar TG and Surendran R. Outcome of severe acute pancreatitis: Is there a role for conservative management of infected pancreatic necrosis? Hepatobiliary Pancreatic Dis Int.2006; 5: 599-604.
9. Munoz A and Katerndahal DA. Diagnosis and Management of Acute Pancreatitis. Am Fam Physician 2000; 62(1): 164-74.
10. Pal KM, Kasi PM, Tayyeb M, Mosharraf SM and Fatmi Z. Correlates of Morbidity and Mortality in Severe Necrotizing Pancreatitis. ISRN Surgery. Vol 2012. Article ID 215193, 5 pages doi:10.5402/2012/215193.
11. Alsfasser G, Schwandner F, Pertschy A, Hauenstein K, Foitzik T and Klar E. Treatment of Necrotizing Pancreatitis: Redefining the Role of Surgery. World J Surg 2012; 36: 1142-47.

Downloads

Published

2013-12-31

How to Cite

Singla, S. K., Jain, N. P., Gupta, S., Virk, S. S., Attri, P. I., & Sethi, P. (2013). Clinical Profile And Outcome Of Severe Acute Pancreatitis: Clinical Profile of Pancreatitis. National Journal of Integrated Research in Medicine, 4(6), 72–75. https://doi.org/10.70284/njirm.v4i6.2252

Issue

Section

Original Articles

Most read articles by the same author(s)

<< < 1 2