Online ISSN: 2515-8260

Keywords : acute pancreatitis

Clinical, etiological profile and outcomes of patients with acute pancreatitis in a tertiary care hospital, South India: A cross-sectional study

Dr. Anjaney Yadur, Dr. Dhanalaxmi Neginhal, Dr. Sagar Patil

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 12003-12009

Background: Acute pancreatitis, characterised by inflammation, auto-destruction and activation of pancreatic enzyme is a common gastro-intestinal cause of hospital admission. Understanding the etiology, clinical profile and clinical outcomes of these patients in regional setting is key for appropriate management.
Methods: A hospital based observational study was carried out between August 2011 and July 2013 among patients above 18 years of age who presented to the outpatient department with acute pancreatitis. Patients demographic, clinical information, and laboratory findings was obtained at admission. All patients were subjected to ultrasonography and patients with severe disease were subjected to Computed Tomography. The clinical severity and outcomes were recorded. Data was summarised as mean (SD) for continuous variables and proportions for categorical variables.
Results: Among 94 subjects included in the study, about 85% were males and 69% were aged less than 45 years. Abdominal pain (88%) was the most common clinical presentation, followed by vomiting (49%). Alcohol was the most common etiological factor seen in about 60% of the subjects. Ultrasonography revealed bulky pancreas in 38% and gallbladder calculi in 33% of the subjects. Acute kidney Injury was present among 3% of the patients. About 9% had severe disease and mortality was 2.1%. There was marked increase in the levels of pancreatic enzymes, BUN and serum creatinine among patients with severe disease when compared to patients with mild/moderate disease.
Conclusions: Acute pancreatitis is a leading causes of hospitalization due to gastro-intestinal cause. Clinical assessment along with radiological findings correlates well with the disease severity and mortality. Understanding the clinical and etiological profile of patients with acute pancreatitis would be helpful to plan the management strategies for the local setting.

A study of the clinical profile of acute pancreatitis and its correlation with Modified Glasgow score and modified CT severity indices

Dr. Nitin Kumar Chavan, Dr. Vinay HD, Dr. Shashanka Rajappa, Dr. Shankar Lal J

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 504-509

Although measurement of amylase and lipase is useful for diagnosis of pancreatitis, serial
measurements in patients with acute pancreatitis are not useful to predict disease severity,
prognosis, or for altering management. Routine abdominal computed tomography (CT) scan
is not recommended at initial presentation because there is no evidence that CT improves
clinical outcomes and the complete extent of pancreatic and peripancreatic necrosis may only
become clear 72 hours after the onset of acute pancreatitis. This was a prospective
observational study conducted in HIMS, Hassan from July 2020 to July 2021. Modified
Glasgow score showed Mild Acute Pancreatitis in 93 and Severe Acute Pancreatitis in 47
Patients. Using the modified CT severity index, the observers graded severity of the acute
pancreatitis as mild in 66, moderate in 31, or severe in 43 of the 140 patients with CT scans.

The Use of Urinary Amylase Levels in the Diagnosis of Acute Pancreatitis

Syed Mohammed Sajjad Husayni, Mohammed Naqi Zain, Mohammed Shazad Ahmed

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 5029-5038

Background:Acute pancreatitis is a relatively common but potentially fatal disease seen
in surgical practise. Clinical examination, laboratory investigations, and imaging
techniques are used to make a diagnosis of the disease. Patients usually present with
severe pain in the epigastric region that radiates to the back. Serum levels of amylase
and lipase that are more than three times the normal value usually indicate acute
pancreatic inflammation. When clinical and laboratory investigations fail to diagnose
the disease despite a strong suspicion of acute pancreatitis, radiological investigations
are used to make a diagnosis. Urinary clearance of pancreatic enzymes from the
circulation increases in acute pancreatitis. This is a study that will use urinary amylase
levels to diagnose acute pancreatitis in a non-invasive manner. Objectives: To diagnose
acute pancreatitis using urine amylase levels in conjunction with other specific tests
such as serum lipase and abdominal ultrasound, and to demonstrate that urine amylase
can be used to diagnose acute pancreatitis.
Materials and Methods: It is a case control study with 40 patients diagnosed with acute
pancreatitis and 40 patients admitted with other diagnoses. Patients admitted to Princes
Esra Hospital between November 2019 and May 2021 were chosen as cases and
controls. Serum amylase, serum lipase, and urinary amylase levels were measured in
both the case and control groups. After comparing serum amylase, serum lipase, and
urinary amylase levels in cases and controls, the sensitivity and specificity of these
enzymes were determined.The authors concluded that serum amylase had the highest
sensitivity (100 percent) and serum lipase had the highest specificity (100 percent) after
analysing serum amylase, serum lipase, and urinary amylase results in both cases and
controls (95 percent). Urine amylase's sensitivity and specificity were found to be
98.33% and 95%, respectively. The area under the curve for serum amylase, serum
lipase, and urinary amylase was found to be 0.987, 0.995, and 0.935, respectively, using
ROC curve analysis.
Conclusion: Because serum amylase, serum lipase, and urinary amylase have
comparable sensitivity and specificity, as well as comparable areas under the curve on
ROC analysis for the diagnosis of acute pancreatitis, the authors conclude that urinary
amylase can be used in the diagnosis of acute pancreatitis.

Demographic profile of patients with acute pancreatitis presenting to department of surgery, jorhat medical college: A clinical study

Richard Barla, MJ Gohain, Nilutpal Bora, NN Ganguly, AC Baro

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 1998-2007

Background: Acute Pancreatitis is a major health problem with significant morbidity and mortality. There is large geographical variability in incidence, disease severity and outcome with data related to prevalence rate lacking in our region. Present study is aimed to observe its demographic variability around the Jorhat Medical College.
Methods: First consecutive 50 cases of acute pancreatitis presented in the Jorhat Medical College during the study period from June 2020 to May 2021 were included in the study; data collected, systematically analyzed and statistically reviewed.
Results: Of the 50 cases, 33 (60%) were male while 17 (34%) were female. The mean age of the study sample is 37.04±13.52 (SD) years, ranging from 15 – 75 years. Majority of the patients are between 15-35 years. In 50% cases, alcohol is the most common aetiology followed by gallstones (36%), idiopathic in 10% cases. Alcohol is the most common aetiology among male and 15-35 years age group while gallstone is most common cause in females and 35-55 years age group. Among 50 cases, 41 (82%) are mild acute pancreatitis and 9 (18%) have severe acute pancreatitis. Majority of severe acute pancreatitis cases are male and alcoholic. Of 50 cases, among Hindus (n= 47) ethnic Assamese are 54%, Tea tribe 20%, Mising 10%, UP 6%, Bengali 4%, while Muslim 4% and Christian 2%. Gallstone is most common cause among ethnic Assamese and alcohol is the common cause in Tea tribe and Mising. Geographical distributions of the cases are as follows: Jorhat district 50% (n=25), Golaghat 32% (n= 16), Majuli 14% (n= 7) and Sivasagar 4% (n=2).
Conclusion: Acute pancreatitis is more common among male than female. Assamese are the most commonly affected ethnic group, gallstone being the most common cause among them. Alcohol is the most common aetiology in Tea tribes and Mising community. Male and alcoholics are more prone to severe acute pancreatitis. The incidence of acute pancreatitis is more in younger population 15-35 years and alcohol is the most common cause in this age group. Most of the cases are from Jorhat district followed by Golaghat, Majuli and Sivasagar.

Abdominal Compartment Syndrome Evaluation in Sever Acute Pancreatitis

Emad Mohammed Salah; Ibrahim Ali Heggy; AlsaiedAlnaimy Tamer; Rafek Kalifa Almabrok

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 991-996

ACS (abdominal compartment syndrome) is a serious condition that affects critically ill people. Because it predominantly affects individuals who are already sick, it may go unnoticed. The aim of study to find a link between IAP and the development of problems in patients with severe acute pancreatitis. We also wanted to see if there was a link between IAP and the development of complications in patients with severe acute pancreatitis (SAP). Patients and methods: This prospective study was conducted on 18 patients with AP hospitalised to the Surgical Intensive Care Unit at Zagazig University's Faculty of Medicine's General Surgery Department (SICU). During the first week after admission, all patients were divided into two groups based on their IAP. Patients with IAP 20 mmHg were assigned to the IAH group, whereas those with IAP 20mmHg were assigned to the normal IAP group. Results: Age, serum Lipase and APACHE were significantly higher among ACS cases and also ACS cases were significantly associated with DM. ACS cases were significantly associated with longer hospital stay also with bleeding, septic shock and mortality.The mean Lipase level was 959.72±103.58 with rang (800-1200). The mean Intra-abdominal pressure of studied patients was 12.94±4.12 and 38.9% of patients had IAH while 2 cases 11.1% had ACS. Conclusion: In patients hospitalised to the ICU with severe acute pancreatitis, IAH and ACS are common findings. IAH could make severe acute pancreatitis worse. Early detection of this possibly treatable aggravating condition could lead to early management and, in turn, a better prognosis. 

Comparative and correlative study of Balthazar computed tomography severity index and modified computed tomography severity index in predicting the outcome of acute pancreatitis

Dr. M Ramya,Dr. Sravan Kumar K,Dr. Pavan Kumar B,Dr. Manohar Kumar KR

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 2415-2520

In general acute pancreatitis is classified in to mild and severe pancreatitis. Mild pancreatitis
is also known as oedematous or interstitial pancreatitis, which is the cause for mild organ
failure and uneventful recovery. Severe pancreatitis also known as necrotizing pancreatitis is
associated with organ failure and leads to other complications like necrosis, infection and
pseudo cyst formation.Fifty cases of acute pancreatitis who presented to the emergency
department as acute abdomen were included in the study. Informed and written consent was
taken from all the participants. When the Modified CT Severity Index was applied, the
average duration of hospital stay in patients categorized as mild pancreatitis was 1.5 days in
moderate pancreatitis 6.9 days and in severe pancreatitis 14.2 days. None of the pat ients
categorized as mild pancreatitis had an adverse or fatal outcome. The majority (90%) of
patients requiring interventional procedure fell in the severe pancreatitis group.


F.Sh. Mavlyanov; M . Kh . Mukhammadiev; F.M. Shukurov; S.Zh. Kamolov

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 2, Pages 3003-3007

To explore the possibilities of different methods
of surgical treatment of severe acute pancreatitis , two groups of surgical
patients were selected depending on the method of surgical treatment,
which were produced by different types
of " open " and laparoscopic operations. To assess the effectiveness of
the applied methods of treatment, in the postoperative period, we used
the following laboratory and physiological parameters: progression
or regression systemic inflammatory response syndrome (SIRS ), neutro
phil-lymphocyte ratio ( NLR), as well as integral scales for assessing
severity Ranson , APACHE - II and SAPS . The results obtained
demonstrate the advantages of laparoscopic surgical methods

Monitoring Of Organ Failure Development In Patients With Acute Pancreatitis

F.Sh. Mavlyanov; M.Kh. Mukhammadiev; S. Zh. Kamolov; F.M. Shukurov; Sh. Kh Mavlyanov

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 3, Pages 2523-2528

Annotation. Systemic inflammatory response syndrome is a protective response of the body aimed at eliminating the agent that caused the inflammatory process (infection, trauma, burns and tissue necrosis, etc.). The severity of the response depends on the amount of damage inflicted. This study was conducted to assess the possibility of using the systemic inflammatory response syndrome as an independent predictor in the development of complications of acute pancreatitis. For this, the following clinical and laboratory parameters were studied: body temperature, pulse, respiratory rate and the number of leukocytes in the blood, which were obtained within the first 24 hours after hospitalization and before the development of organ failure. The relationship between the presence of systemic inflammatory response syndrome and the development of organ failure was investigated.