Saxena Rahul, Kumar Shishir, Nafe Zaid, Chattoraj Ashok, Chauhan Shivraj
Department of General Surgery, Tata Main Hospital, Jamshedpur, IND.
Department of Gastroenterology, Tata Main Hospital, Jamshedpur, IND.
Cureus. 2023 Feb 14;15(2):e34996. doi: 10.7759/cureus.34996. eCollection 2023 Feb.
To analyze the etiologies and the varying clinical presentations and to validate the clinical, biochemical, and radiological signs with severity and prognosis of acute pancreatitis.
A retrospective study of 1316 patients diagnosed with acute pancreatitis in an industrial hospital in Jamshedpur, Jharkhand, was conducted, and their clinicoradiological profiles, etiological factors, and outcomes were studied.
A total of 1316 cases were enrolled, out of which maximum cases (411 [31.23%]) were from the age group of 30-44 years, and the mean and median age were 44.54 and 47 years, respectively. A total of 731 (55.45%) patients had social habits (i.e., alcohol and smoking), and 585 (44.45%) patients did not have any social habits. Based on the etiology of acute pancreatitis (AP), the majority of cases were due to alcoholism (710 [53.95%]) followed by gallstone (343 [26.06%]) and idiopathic pancreatitis (217 [16.48%]). As per the severity of AP, most patients showed mild pancreatitis (937 [71.20%]) followed by moderate (312 [23.71%]) and severe pancreatitis (67 [05.09%]). Mild and moderate pancreatitis patients were shown in 85 and 28 cases, respectively, suggestive of chronic pancreatitis after repeated episodes of AP. But severe pancreatitis shown in 19 cases had hypocalcemia + shock + multi-organ dysfunction syndrome (MODS). In mild, moderate, and severe AP, the mortality rates were 19 (02.03%), 44 (14.10%), and 21 (31.34%), respectively. Overall, 1232 (93.62%) of AP cases recovered and were discharged in stable condition, but 84 (06.38%) cases expired.
AP is a common cause of acute abdomen in patients presenting to the surgical emergency department. The management is mainly conservative with surgery limited to only a few selected cases, depending upon the severity of the disease.
分析急性胰腺炎的病因、不同临床表现,并验证急性胰腺炎的临床、生化及放射学征象与严重程度及预后的关系。
对恰尔肯德邦贾姆谢德布尔一家工业医院确诊的1316例急性胰腺炎患者进行回顾性研究,分析其临床放射学特征、病因及预后。
共纳入1316例病例,其中最多病例(411例[31.23%])来自30 - 44岁年龄组,平均年龄和中位数年龄分别为44.54岁和47岁。共有731例(55.45%)患者有社交习惯(即饮酒和吸烟),585例(44.45%)患者无任何社交习惯。基于急性胰腺炎(AP)的病因,大多数病例是由酒精中毒引起(710例[53.95%]),其次是胆结石(343例[26.06%])和特发性胰腺炎(217例[16.48%])。根据AP的严重程度,大多数患者表现为轻度胰腺炎(937例[71.20%]),其次是中度(312例[23.71%])和重度胰腺炎(67例[5.09%])。轻度和中度胰腺炎患者分别有85例和28例提示在AP反复发作后出现慢性胰腺炎。但19例重度胰腺炎患者出现低钙血症 + 休克 + 多器官功能障碍综合征(MODS)。在轻度、中度和重度AP中,死亡率分别为19例(2.03%)、44例(14.10%)和21例(31.34%)。总体而言,1232例(93.62%)AP病例康复并病情稳定出院,但84例(6.38%)病例死亡。
AP是外科急诊科患者急性腹痛的常见原因。治疗主要是保守治疗,手术仅限于少数特定病例,具体取决于疾病的严重程度。