Aurangzeb Khan, Yousaf Jan, Ihsan Ulhaq.
Current Concepts: Acute Pancreatitis, Aetiology, Management & Outcome.
Ophthalmol Update Jan ;13(1):29-33.

Background: Acute pancreatitis is a common surgical emergency. Timely diagnosis and early proper management can reduce both morbidity and mortality. Objective: To study the aetiology, management and outcome of acute pancreatitis at a tertiary care hospital. Material and Methods: This prospective descriptive study was conducted in department of General surgery, Rehman Medical Institute (RMI) Peshawar from August 2012 to August 2013 after taking permission from local ethical and research committee. All adult patients (> 12 years) presenting with acute pancreatitis at the surgical outdoor clinic and emergency department during the study period were included in the study. Patients with pancreatic malignancy and those initially managed elsewhere, later referred to RMI were excluded from the study. Results: This study included 50 patients of acute pancreatitis admitted in ICU and Surgical Ward, 23 (46%) were males and 27 (54%) were females. The mean age of patients was 44.2 years. Five patients were initially managed in ICU. The commonest etiological factor responsible for acute pancreatitis was gall stone (n=26, 52%) followed by idiopathic pancreatitis (n=13, 26%) and alcoholism. The commonest symptom was the pain in the epigastrium followed by nausea and vomiting. Serum amylase and lipase helped in initial diagnosis. CT scan was the most sensitive modality confirming acute pancreatitis. The commonest complication of acute pancreatitis included paralytic ileus, electrolyte disturbances, acute respiratory distress syndrome(ARD?s), renal failure,cardiovascular insufficiency, pancreatic pseudocysts and pulmonary infections. The average hospital stay for mild, moderate and severe pancreatitis was 5.2, 7.4 and 10.9 days respectively. All patients were put on injection Imipenem and metronidazole empirically. Morbidity in our study was 27 (54%). One patient (2%) died due to multi-organ failure. Conclusion: Acute pancreatitis is a multisystem disease with high degree of mortality. It needs prompt investigations and very aggressive management to prevent the development of the complications.

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