Clinical approach, diagnosis and medical management of acute pancreatitis among patients attending tertiary care hospital in Prakasam district, Andhra Pradesh, India

Authors

  • Nikhitha Konda Department of Gastroenterology, Vijaya Sree Hospitals Gastro and Liver Care Centre, Ongole, Andhra Pradesh, India
  • D. Venkateswarlu Department of Gastroenterology, Vijaya Sree Hospitals Gastro and Liver Care Centre, Ongole, Andhra Pradesh, India
  • B. Thirumala Rao Department of Community Medicine, Government Medical College, Ongole, Andhra Pradesh, India
  • V. Suresh Department of Gastroenterology, Vijaya Sree Hospitals Gastro and Liver Care Centre, Ongole, Andhra Pradesh, India
  • Aamani Shaik Department of Gastroenterology, Vijaya Sree Hospitals Gastro and Liver Care Centre, Ongole, Andhra Pradesh, India
  • D. Manasa Department of Medical and Health, Primary Healthcare Centre, Maddipadu, Andhra Pradesh, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20232112

Keywords:

Acute pancreatitis, Clinical profile, Treatment, Outcome

Abstract

Background: There has been an increase in the incidence of acute pancreatitis reported globally and despite of improvements in access to care and interventional techniques, acute pancreatitis continues to be associated with significant morbidity and mortality. The present study was aimed to assess the clinical profile of acute pancreatitis and to assess the efficacy of various severity indices in view of   outcome of patients.

Methods: A hospital based prospective cross-sectional study was conducted from October 2022-March 2023 in Gastro and Liver care center in Ongole, Prakasam District, Andhra Pradesh India. All consecutive 72 patients with a diagnosis of acute pancreatitis were included in this study.

Results: Out of total acute Pancreatitis cases   61 (84.7%) were males and 11 (15.3%) were females and acute abdominal pain (97.2%) and decreased appetite (95.8%) were the most common presenting complaints, 54.2% cases were due to Alcoholism, followed by hyperlipidemia with 20.8% and Gall stones 13.9%.  All 72 (100%) received pancreatic supplements, 68 (94.4%) were given pain killers, and 65 (90.3%) were taken anti-ulcer agents. Twenty-three (31.9%) patients with 0 to 3 points as per CTSI Score and 4-6 range points were observed in 47 (65.3%) pancreatitis patients. Maximum (40.3%) were improved on 2nd day, 22 (30.6%) were on 3rd day.  Positive correlation noticed between Amylase and in diagnosing acute Pancreatitis, it is significant at 0.05 level.

Conclusions: Early assessment of the clinical severity and identification of patients at risk is important for early intensive management and timely intervention and to improve quality of life. So, it is mandatory to assess the clinical severity using different scoring systems. and appropriate treatment based on guidelines.

Metrics

Metrics Loading ...

References

Banks PA. Epidemiology, natural history, and predictors of disease outcome in acute and chronic pancreatitis. Gastrointest Endosc. 2002;56(Suppl):S226-30.

Mofidi R, Madhavan KK, Garden OJ, Parks RW. An audit of the manage¬ment of patients with acute pancreatitis against national standards of practice. Br J Surg. 2007;94(7):844-8.

Pezzilli R, Uomo G, Gabbrielli A, Zerbi A, Frulloni L, De Rai P, et al. A prospective multicentre survey on the treatment of acute pancreatitis in Italy. Dig Liver Dis 2007;39(9):838-46.

Spanier BW, Dijkgraaf MG, Bruno MJ. Epidemiology, aetiology and outcome of acute and chronic pancreatitis: an update. Best Pract Res Clin Gastroenterol. 2008;22(1):45-63.

Shen HN, Lu CL, Li CY. Epidemiology of first-attack acute pancreatitis in Taiwan from 2000 through 2009: a nationwide population-based study. Pancreas. 2012;41(5):696-702.

Forsmark CE, Baillie J, AGA Institute Clinical Practice and Economics Committee; AGA Institute Governing Board. AGA Institute technical review on acute pancreatitis. Gastroent. 2007;132:2022-44.

Sharma, M, Banerjee D, Garg PK. Characterization of newer subgroups of fulminant and sub fulminant pancreatitis associated with a high early mortality. Am J Gastroenterol. 2007;102(12):2688-95.

Gao YJ, Li YQ, Wang Q, Li SL, Li GQ, Ma J, et al. Analysis of the clinical features of recurrent acute pancreatitis in China. J Gastroenterol. 2006;41:681-5.

Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD, Sarr MG, et al. Classification of acute pancreatitis-2012: revision of the Atlanta classification and definitions by international consensus. Gut 2013;62(1):102-11.

Banks PA, Freeman ML. Practice guidelines in acute pancreatitis. Am J Gastro-enterol. 2006;101(10):2379-400.

Forsmark CE, Baillie J, AGA Institute Clinical Practice and Economics Committee, AGA Institute Governing Board. AGA Institute technical review on acute pancreatitis. Gastroent. 2007;72(3):257-81.

Tenner S, Baillie J, DeWitt J, Vege SS. American College of Gastroenterology guideline: management of acute pancreatitis. Am J Gastroenterol. 2013;108(9):1400.

Kimura Y, Arata S, Takada T, Hirata K, Yoshida M, Mayumi T, et al. Gallstone-induced acute pancreatitis. J Hepat Pancreat Sci. 2010;17(1):60-9.

Cappell MS. Acute pancreatitis: etiology, clinical presentation, diagnosis, and therapy. Med Clin North Am. 2008;92(4):889-923.

Lippi G, Valentino M, Cervellin G. Laboratory diagnosis of acute pancreatitis: in search of the Holy Grail. Crit Rev Clin Lab Sci. 2012;49(1):18-31.

Ranson JH, Rifind KM, Roses DF, Fink SD, Eng K, Spencer FC. Prognostic signs and the role of operative management in acute pancreatitis. Surg Gynecol Obstet. 1974;139:69-81.

Knaus WA, Draper EA, Wagner DP, Zimmerman JE. APACHE II: a severity of disease classification system. Crit Care Med. 1985;13(10):818-29.

Singh VK, Wu BU, Bollen TL, Repas K, Maurer R, Johannes RS, et al. A pro-spective evaluation of the bedside index for severity in acute pancreatitis score in assessing mortality and intermediate markers of severity in acute pancrea- titis. Am J Gastroenterol. 2009;104(4):966-71.

Baillargeon JD, Orav J, Ramagopal V, Tenner SM, Banks PA. Hemoconcentration as an early risk factor for necrotizing pancreatitis. Am J Gastroenterol. 1998;93(11): 2130-4.

Martinez J, Sanchez-Paya J, Palazon JM, Suazo-Barahona J, Robles-Diaz G, Perez-Mateo M. Is obesity a risk factor in acute pancreatitis? A meta-analysis. Pan- creatology. 2004;4(1):42-8.

Peery AF, Dellon ES, Lund J, Crockett SD, McGowan CE, Bulsiewicz WJ. Burden of gastrointestinal disease in the United States: 2012 update. Gastroenterology. 2012;143(5):1179-87.

Ramu R, Paul V, Devipriya S, Philip NC. Etiology, clinical profile and outcome of acute pancreatitis in a tertiary care teaching hospital in rural South India: a ten-year retrospective study. Int Surg J 2019;6(10):3794-9.

Lee MG, Chung A, Miles A, Terry SI, Royes CA. Chronic pancreatitis in Jamaica. West Indian Med J. 1992;41(2):61-3.

Reddy MS, Ramana PV, Bhavani C, Lakshmi RP, Khizar SM. A study on etiology, severity, management and outcome of acute pancreatitis in tertiary care teaching hospital. Inter J Res Rev. 2020;7(1):534-44.

Vengadakrishnan K, Koushik AK. A study of the clinical profile of acute pancreatitis and its correlation with severity indices. Int J Health Sci (Qassim). 2015;9(4):410-7.

Casas JD, Díaz R, Valderas G, Mariscal A, Cuadras P. Prognostic value of CT in the early assessment of patients with acute pancreatitis. Am J Roentgenol. 2004;182(3):569-74.

Barreto SG, Tiong L, Williams R. Drug-induced acute pancreatitis in a cohort of 328 patients. A single-centre experience from Australia. JOP J Pancreas. 2011;12(6):581-5.

Lerch MM, Aghdassi A. Gallstone-related pathogenesis of acute pancreatitis. Pancreapedia Exocrine Pancreas Knowledge Base. 2016; Available at: https://www.pancreapedia.org/reviews/gallstone-related-pathogenesis-of-acute-pancreatitis. Accessed 3 November 2018.

Raghuwanshi S, Gupta R, Vyas MM, Sharma R. CT Evaluation of Acute Pancreatitis and its Prognostic Correlation with CT Severity Index. J Clin Diagnos Res. 2016;10(6):TC06-11.

Reid GP, Williams EW, Francis DK, Lee MG. Acute pancreatitis: A 7 year retrospective cohort study of the epidemiology, aetiology and outcome from a tertiary hospital in Jamaica. Ann Med Surg (Lond). 2017;20:103-8.

Harindranath RH, Narendranath L. A clinical study on acute pancreatitis and its different etiologies in Bowring & Lady Curzon hospitals, Bengaluru. J Evolution Med Dent Sci. 2016;5(3):196-200.

Ghatak R, Masso L, Kapadia D, Kulairi ZI. Medication as a cause of acute pancreatitis. Am J Case Rep. 2017;18:839-41.

Manrai M, Kochhar RK, Thandassery RB, Alfadda AA, Sinha SK. The revised Atlanta classification of acute pancreatitis: a work still in progress ? JOP. 2015;16:356-64.

Erlinger S. Gallstones in obesity and weight loss. Eur J Gastroenterol Hepatol. 2000;12(12):1347-52.

Stender S, Nordestgaard BG, Tybjaerg-Hansen A. Elevated body mass index as a causal risk factor for symptomatic gallstone disease: A Mendelian randomization study. Hepatol. 2013;58(6):2133–41.

Ikard RW. Gallstones, cholecystitis and diabetes. Surg Gynecol Obstet. 1990;171(6):528-32.

Diabetes Foundation India. Diabetes Foundation (India) 2019. Available at: http://www.diabetesfoundation.in. Accessed on 25 April 2023.

Matull WR, Pereira SP, O’Donohue JW. Biochemical markers of acute pancreatitis. J Clin Pathol. 2006;59(4):340-4.

Matull WR, Pereira SP, O’donohue JW. Biochemical markers of acute pancreatitis. J Clin Pathol. 2006;59(4):340-4.

Esmaili HA, Mehramuz B, Maroufi P, Ghasemi A, Pourlak T. Diagnostic value of amylase and lipase in diagnosis of acute pancreatitis. Biomed Pharmacol J. 2017;10(1):389-94.

Ahlawat V, Godara R. Clinical study of demographic profile, etiology, severity and outcome of acute pancreatitis in a tertiary care teaching hospital in Northern India. J Gastrointest Dig Syst. 2018;8:575.

Shah AP, Mourad MM, Bramhall SR. Acute pancreatitis: current perspectives on diagnosis and management. Inflammat Res. 2018;11:77-85.

Pongprasobchai S, Vibhatavata P, Apisarnthanarak P. Severity, treatment, and outcome of acute pancreatitis in Thailand: the first comprehensive review using revised Atlanta classification. Gastroenterology research and practice. 2017;17(1):2017.

Ahlawat V, Godara R. Clinical study of demographic profile, etiology, severity and outcome of acute pancreatitis in a tertiary care teaching hospital in Northern India. J Gastrointest Dig Syst. 2018;8:575.

Downloads

Published

2023-06-30

How to Cite

Konda, N., Venkateswarlu, D., Rao, B. T., Suresh, V., Shaik, A., & Manasa, D. (2023). Clinical approach, diagnosis and medical management of acute pancreatitis among patients attending tertiary care hospital in Prakasam district, Andhra Pradesh, India. International Journal of Research in Medical Sciences, 11(7), 2631–2638. https://doi.org/10.18203/2320-6012.ijrms20232112

Issue

Section

Original Research Articles