Etiological factors affecting the clinical features, prognosis and management of acute pancreatitis
Abstract
Aim: There are various etiological factors causing acute pancreatitis; of them to identify the most common aetiological factor affecting the severity of symptoms, complications and mortality in acute pancreatitis.
Patients and methods: The study was conducted in Sungai Petani hospital in the State of Keddah, Malaysia. A total of 64 patients were admitted with symptoms of acute pancreatitis were retrospectively studied for symptoms, investigation results and prognosis.
Results: Out of 64 patients admitted for acute pancreatitis gall stone disease was noticed in 38 patients of them Malays were 34 and others were 4.Alcohol consumption was observed in 26 patients of them 24were Indians and 2were Thai. Vomiting, jaundice, fever were more common in Malays. The symptoms are more due to gallstone induced acute pancreatitis than in alcohol induced pancreatitis. Serum enzymes like serum alanine transferase, amylase and LDH level in blood and urine amylase and diastase were elevated more commonly in Malays than in Indians. Serum albumin and PO2 decreased in more Malays than in Indians. Both local and systemic complications were common in Malays. More Malay patients underwent surgery for gall stones.
Conclusion: The lipase/amylase ratio index, erythrocyte mean corpuscular volume, and gamma glutamyl transferase could not distinguish alcoholic from non-alcoholic acute pancreatitis. Patients with gallstone pancreatitis should have cholecystectomy, ideally during the same admission.  Early imipenem- cilastatin therapy appears to significantly reduce the need for surgery and complications.
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