A STUDY OF AETIOLOGY, CLINICAL FEATURES AND MANAGEMENT OF ACUTE PANCREATITIS IN A TERTIARY CARE HOSPITAL IN SOUTHERN ODISHA

Abstract

Rajendra Das1, Koresh Prasad Dash2, Rasananda Mangual3, Tapas Kumar Rout4, Rama Narayan Sahu5

BACKGROUND
Acute pancreatitis is a common condition involving the pancreas. The estimated incidence is about 3% of cases presenting with pain abdomen in the UK. The hospital admission rate for acute pancreatitis is 9.8/100,000 per year in UK and annual incidence may range from 5-50/100,000 worldwide. Gall stone disease and alcohol account for greater than 80% of all patients with acute pancreatitis, with biliary disease accounting for 45% and alcohol found in 35% of patients.
Given the wide spectrum of disease seen, the care of patients with pancreatitis must be highly individualised. Patients with mild acute pancreatitis generally can be managed with resuscitation and supportive care. Aetiological factors are sought and treated, if possible, but operative therapy essentially has no role in the care of these patients. Those with severe and necrotising pancreatitis require intensive therapy, which may include wide operative debridement of the infected pancreas or surgical management of local complications of the disease.
AIM OF THE STUDY
1. To study the age and sex prevalence of acute pancreatitis.
2. To study the various aetiological factors of acute pancreatitis.
3. To study the clinical presentation and management of acute pancreatitis.
MATERIALS AND METHODS
Patients admitted to the Department of General Surgery at M.K.C.G Medical College and Hospital, Berhampur were taken up for the study. Totally, 49 patients with 53 episodes of acute pancreatitis were studied from September 2013 to August 2015.
RESULTS AND CONCLUSIONS
Acute pancreatitis is a common cause of acute abdomen in patients presenting to the surgical emergency department. Alcohol being the most common cause of acute pancreatitis in this part of the country, it has a male preponderance and most commonly presents in the 4th decade of life. It is mainly a clinical diagnosis supplanted with biochemical and radiological findings. The management is mainly conservative, with surgery reserved for patients with biliary pancreatitis and those developing complications secondary to acute disease. In those developing necrosis, there is a trend toward delaying necrosectomy. Recent results support the use of minimally invasive procedures for the various complications associated with acute pancreatitis.

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