Etiological factors affecting the clinical features, prognosis and management of acute pancreatitis
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.
Ryan VanWoerkom., Douglas G. Adler. Acute Pancreatitis: Review and Clinical Update. Hospital Physician.2009,45(1): 9-19
Timothy B. Gardner, Santhi Swaroop Vege, Suresh T. Chari, Randall K. Pearson, Jonathan E. Clain, Mark D. Topazian, Michael J. Levy, Bret T. Petersen., The Effect of Age on Hospital Outcomes in Severe Acute Pancreatitis. Pancreatology 2008; 8:265-270.
Sakorafas, George H. Tsiotou, Adelais G. Clinical Reviews: Pancreatic and Biliary Diseases. Etiology and Pathogenesis of Acute Pancreatitis: Current Concepts. J of Clinl Gast 2000; 30(4):343-356.
Baig SJ, Rahed A, Sen S. A prospective study of the etiology, severity and outcome of acute pancreatitis in Eastern India. Trop Gastroenterol. 2008; 29(1):20-2.
Saraswat VA, Sharma BC, Agarwal DK, Kumar R, Negi TS, Tandon RK., Biliary microlithiasis in patients with idiopathic acute pancreatitis (RIAP) and unexplained biliary pain: response to therapy. J Gastroenterol Hepatol. 2004; 19(10):1206-11.
Corfield A P, Cooper M J, Williamson R C. Acute pancreatitis: a lethal disease of increasing incidence. Gut 1985; 26:724-729.
Trapnell JE, Duncan E.HL. Patterns of incidence in Acute pancreatitis. Br Med J 1975; 2: 179-83.
Acosta JM, Pellegrini CA, Skinner DB. Etiology and pathogenesis of acute biliary pancreatitis. Surgery 1980; 88: 118-25.
Ranson JHC. Acute pancreatitis - where are we? Surg Clin N Am 1981; 61: 55-70.
Jacobs ML, Daggett WM, Civetta JM et al. Acute pancreatitis: analysis of factors influencing survival. Ann Surg 1977; 185: 43-51.
Juan Miguel Acosta, and Carlos Luis Ledesma. Gallstone Migration as a Cause of Acute Pancreatitis. N Engl J Med 1974; 290:484–487.
12. Frey CF, Zhou H, Harvey DJ, White RH. The incidence and case-fatality rates of acute biliary, alcoholic, and idiopathic pancreatitis in California, 1994– 2001. Pancreas 2006; 33:336–44.
Elta GH. Sphincter of Oddi dysfunction and bile duct microlithiasis in acute idiopathic pancreatitis. World J Gastroenterol 2008; 14:1023–6. 22.
David C. Whitcomb. Acute Pancreatitis. New England Journal of Medicine; 2006; 20(354):2142-2150.
Steinberg WM, Lewis JH. Steroid-induced pancreatitis: does it really exist? Gastroenterology 1981; 81:799-808.
Bourke JB. Incidence and mortality of acute pancreatitis. Br Med J 1977; 2: 1668-1669.
Bohidar N.P., Pramod K. Garg, Sudeep Khanna, Rakesh K. Tandon., Incidence, Etiology, and Impact of Fever in Patients with Acute Pancreatitis Pancreatology 2003; 3:9-13.
Benifla, Mony, Weizman, Zvi. Liver, Pancreas, and Biliary Tract: Clinical Research. Acute Pancreatitis in Childhood: Analysis of Literature Data, J of Clin Gast 2003; 37(2):169-172.
Andrew Kingsnorth, Derek O'Reilly, Acute pancreatitis. BMJ 2006; 332:1072.
Balthazar E J, Robinson D L, Megibow A J and Ranson J H. Acute pancreatitis: value of CT in establishing prognosis. Radiology, 1990; 174: 331-336.
Jaakkola M, Nordback I., Sillanaukee P. Löf K., Koivula T. Blood tests for detection of alcoholic cause of acute pancreatitis., Lancet 1994; 343: 1328–29.
Jennifer K, Carrol, Brian Herrick, Teresa, Suzanne P. Lee., Acute Pancreatitis: Diagnosis, Prognosis, and Treatment. Am Fam Physician 2007; 75:1513-20.
Sharma, Virender Kumar; Howden, Colin WProphylactic Antibiotic Administration Reduces Sepsis and Mortality in Acute Necrotizing Pancreatitis: A Meta-Analysis. Pancreas 2001; 22(1) 28-31.
Andrew Kingsnorth, Derek O'Reilly, Acute pancreatitis. BMJ 2006; 332:1072.
Isto Nordback, Jubani Sand, Rauni Saaristo, Hannu Paajanen. Early Treatment with Antibiotics reduces the need for Surgery in Acute Necrotizing Pancreatitis. A Single-Center Randomized Study. J. Gastrointest surg, 2001; 5:113-120.
Marc GH Besselink, Hjalmar C van Santvoort, Erik Buskens, Marja A Boermeester, Harry van Goor, Harro M Timmerman et al. Acute Pancreatitis Study Group Probiotic prophylaxis in predicted severe acute pancreatitis: a randomized, double-blind, placebo-controlled trial. The Lancet 2008; 371(9613): 651 – 659.
Wig, J. D, Kochhar, R. Ray, J. D, Rao, D. V, Krishna; Gupta, N. M. Ganguly, N. K. Endotoxemia Predicts Outcome in Acute Pancreatitis., Journal of Clinical Gastroenterology:., March 1998
Kelly, Wagner DS., Gallstone pancreatitis: a prospective randomized trial of the timing of surgery. Surgery 1988; 104(4):600-5.
Bank, Simmy, Singh, Pankaj, Pooran, Nakechand; Stark, Bernard. Liver, Pancreas, and Biliary Tract: Clinical Reviews: Pancreatic and Biliary Disease., Evaluation of Factors That Have Reduced Mortality From Acute Pancreatitis Over the Past 20 Years., J of Clin Gast 2002; 35(1):50-60.
Osborne H., Imrie C. W., Carter D. C. Biliary surgeries in the same admission for gallstone-associated acute pancreatitis. Br J of Sur 1981; 68(11):758–761.
Lankisch PG, Burchard-Reckert S, Petersen M, Lehnick D, Schirren CA, Stöckmann F, Köhler H., Etiology and age have only a limited influence on the course of acute pancreatitis. Pancreas 1996; 13(4):344-9.
Anson, Rifkind KM, Turner JW., Prognostic signs and non-operative peritoneal lavage in acute pancreatitis. Sur, Gynec & Obs 1976, 143(2):209-19.
Copyright (c) 2015 Acta Medica Scientia
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
A) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
B) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
C) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).