Evaluation of Acute Pancreatitis in a Tertiary Centre: A Prospective Observational Study | Chapter 13| Achievements and Challenges of Medicine and Medical Science Vol. 2

Background: The etiology and clinical manifestations of pancreatitis have great variations. Acute pancreatitis is a common condition characterized by diverse etiologies, clinical presentations, and diagnostic findings. The disease may be mild or severe, may lead to multi-organ failures and death. The most common cause is biliary tract diseases. Other causes are alcohol consumption, post-ERCP (Endoscopic retrograde cholangiopancreatography), trauma, idiopathic and drugs, viral infections, genetic mutations and connective tissue disorders.

Methods: This is a prospective observational study conducted at SGT Medical College, Budhera, Gurugram, Haryana, from January 2017 to June 2019 in 100 consecutive patients. The data was collected from case sheets and detailed clinical findings and investigations, treatment and complications from each patient. Analysis was made using software SPSS for Windows 7. The chi-square test and probability (p) value were used to establish the status of significance.

Results: Most of the patients were from the age group 41-55 years. The most common etiology of acute pancreatitis was gallstone, followed by alcohol-induced cases. Other causes were idiopathic, post ERCP and trauma. Pain, distention abdomen, vomiting, fever and jaundice were presenting features. Serum amylase, serum lipase, USG abdomen and CECT (Contrast-Enhanced Computed Tomography) abdomen were diagnostic investigations. Complications included local and systemic. Mortality was 7%. The results of the study are quite comfortable and it is probably due to meticulous care at all steps. A local complication rate of 16% was achieved in the study.

Conclusions: Acute pancreatitis is mild in most of the cases and recovery is good. Severe cases should be meticulously treated as mortality rates are higher. They should be treated in the ICU under the guidance of an intensivist. This study results show that patients with severe diseases should be meticulously monitored clinically, biochemically, hemodynamically and radiologically.

 

Author (s) Details

 

Kanwar Singh Goel
Department of General Surgery, Faculty of Medicine and Health Sciences, SGT Medical College, Budhera, Gurugram, Haryana, India.

 

Nikhil Goel
Department of Psychiatry, Shaheed Hasan Khan Mewati Government Medical College, Nuh, Haryana, India.

Sapna Goel
Department of Pathology, Shaheed Hasan Khan Mewati Government Medical College, Nuh, Haryana, India.

Tarun Gupta
Department of General Surgery, Faculty of Medicine and Health Sciences, SGT Medical College, Budhera, Gurugram, Haryana, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/acmms/v2/2872

A Rare Case: Treatise on Classical Hodg-kin Lymphoma-Mixed Cellularity Stage 3B with Vincristine-Induced Peripheral Neuropathy | Chapter 12 | Medical Research and Its Applications Vol. 6

Classical Hodgkin lymphoma is a lymphatic system cancer that affects 2-1 cases per 100,000 people annually in developed nations. We report a unique case of vincristine-induced peripheral neuropathy associated with acute pan-creatitis in a 16-year-old male patient suffering from classical Hodgkin lym-phoma (CHL) with the primary symptom of bilateral cervical lymphadenopathy. However, upon diagnosis, this youngster was found to have cervical lympho-ma, which differs from the other symptoms of the disease. Diagnosed in Feb-ruary 2023 with CHL, the patient was stratified based on the Ann Arbor staging of Hodgkin lymphoma guidelines by the European Network for Pediatric Hodg-kin Lymphoma (EURONET-PHL). Laboratory and physical examination con-firmed the clinical conditions of peripheral neuropathy and acute pancreatitis, which are adverse effects of chemotherapy, which were managed with IV Pipe-racillin Tazobactam (100 mg/kg) and opioid medications. The European Net-work-Paediatric Hodgkin Lymphoma Study Group (EuroNet-PHL) developed the standard protocol for the first-line therapy of Hodgkin lymphoma in children. Vincristine-induced neuropathy was treated with Morphine (10 mg orally) and Gabapentin (300 mg) was used to provide analgesia. His chemotherapy in-volved two cycles of an OEPA regimen, in accordance with guidelines for the treatment of CHL, and improved clinically. This case report is being offered to clinically enlighten people about the early diagnosis, treatment of CHL and adverse effects of the vincristine drug used in chemotherapy in pediatric pa-tients.

 

Author(s)details:-

 

Krithika Sri J. B.
Gleneagles Global Hospital, Chennai, Tamil Nadu, India.

 

Priyanka N.
Gleneagles Global Hospital, Chennai, Tamil Nadu, India.

 

Please See the book here :- https://doi.org/10.9734/bpi/mria/v6/282

Predicting Prognosis of Acute Pancreatitis Patient in a Tertiary Centre with Help of BISAP Scoring | Chapter 8 | Disease and Health Research - New Insights Vol. 1

 

Introduction: Acute pancreatitis is an acute inflammation of the prior normal pancreas. Gallstones are its leading cause, followed by alcohol; other etiological factors are hyperlipidemia, hereditary, hypercalcemia and post ERCP, etc. Its pathogenesis involves the activation of intrapancreatic digestive enzymes and the injury of acinar cells. Many scoring systems are available to assess the severity of acute pancreatitis, e.g., Ranson’s criteria, Glasgow score index, APACHE II and CTSI, but they have important limitations. BISAP score is a valuable tool in predicting severe Acute Pancreatitis in the early hours. BISAP score appears cheap, quick, and simple and hence, we conducted this study.

Material and Methods: This prospective observational study was carried out in 83 patients at SGT Medical College, Gurugram, India from September 2018 to March 2021. Patients with an established diagnosis of acute pancreatitis as per the revised Atlanta classification and definition by the International Census 2012 were included in the study. BISAP scores were calculated from laboratory values and radiological findings.

Results: In our patients with BISAP scores of 0, 1 and 2, there was no organ failure or mortality. At a score of 3, there was 1 (07.1%) organ failure and 1 (07.1%) mortality. At a score of 4, 4 (80.0%) patients had organ failure and 1(20.0%) patient died. We observed that the higher the BISAP score, the higher the percentage of severity, necrosis, organ failure, mortality and hospital stay. Our study revealed that with the cutoff value set at 3, the BISAP score has 39.6% sensitivity, 92.8% specificity, 60.3% PPV and 84.7% NPV.

Conclusion: Our study recommends that at the time of admission, if the BISAP score is low, our worry is less, if the BISAP score is high, we should counsel the patient and attendants about possible severity, necrosis, organ failure and mortality in acute pancreatitis. Patients should be meticulously managed. The present study concludes the increased accuracy of the BISAP score for risk stratification.

 

Author(s) Details

 

Dr. Kanwar Singh Goel (Professor & Head), M.S. (General Surgery)

Department of General Surgery, SGT Medical College, SGT University, Budhera, Gurugram, Haryana, India.

 

Dr. Nikhil Goel (Associate Professor and HOD)
Department of Psychiatry, Shaheed Hasan Khan Mewati Government Medical College, Nuh, India.

 

 

Dr. Sapna Singla (Assistant Professor)

Department of Pathology, Shaheed Hasan Khan Mewati Government Medical College, Nuh, India.

 

Please see the book here :- https://doi.org/10.9734/bpi/dhrni/v1/1247

Euglycemic Ketoacidosis due to Pancreatitis in a Patient without Diabetes | Chapter 14 | New Advances in Medicine and Medical Science Vol. 5

 We are detailing the case related to earlier healthy 40- year-traditional Female with a popular medical history of essential hypertension (HTN) and outside previous history of Diabetes Mellitus(DM). She was communicable for her HTN – Amlodipine 5 mg once a day. The patient bestowed in our Emergency Department with intestinal pain, pleuritic chest pain, nausea and disgorging. She also objected of shortness of respiration, generalized weakness and had inferior fever. On review of arrangements she was also erect to be diaphoretic and bearing Kussmaul respiration.After the lab studies were obtained she was erect to have severe metabolic upset stomach and was admitted to the Intensive care unit.The differential disease of her metabolic acidosis was broad, but she acted not have DM – her HbA1c was 5.2% and she was not drinking intoxicating. The screening for Methanol and ethylene glycol was negative. The patient did not have latent kidney or liver ailment.Also she did not have infection of blood with lactic acidosis to expound her severe metabolic upset stomach. She did not have likewise prolonged starvation. The drug screen of the patient was negative and she was not communicable any cure to explain her metabolic upset stomach.We are describing this case with harsh metabolic acidosis, cause we have found that the cause was harsh acute pancreatitis. The cause of the acute pancreatitis was not establish. It was not related to intoxicating, increased triglycerides or some medications. Her ultrasound of the gall bladder was negative for gall pouch stones but gently elevated ALT and AST ability have been related to gived gall bladder mud as a cause of her acute pancreatitis.The harsh metabolic ketoacidosis due to acute pancreatitis is the disputing diagnosis and only few cases were detailed in the literature.The method of acute pancreatitis causing harsh metabolic acidosis appears to be had connection with the lipolytic action of inflated lipase as well as increased glucagon and nearly decreased Insulin in the synopsis of acute pancreatic damage.

Author(s) Details:

Andre Manov,
Sunrise Health Care Consortium GME, Mountain View Hospital, North Tenaya Way, Las Vegas, Nevada, 2880, USA.

Ikechukwu Ogbu,
Sunrise Health Care Consortium GME, Mountain View Hospital, North Tenaya Way, Las Vegas, Nevada, 2880, USA.

Please see the link here: https://stm.bookpi.org/NAMMS-V5/article/view/10874

A Pictorial Review on Acute Pancreatitis: Definitions and Diagnosis | Chapter 6 | Emerging Trends in Disease and Health Research Vol. 8

The goal of the current study is to assess the early pancreatic fluid collections seen on MRI after acute pancreatitis. The pancreas, peripancreatic tissues, and other distant organs are frequently affected by the common inflammatory illness known as acute pancreatitis. According to the revised Atlanta categorization from 2012, acute pancreatitis can be mild, moderately severe, or severe. Significant changes have been made to the classification's nomenclature for acute fluid collection. The study also sought to: via computed tomography or magnetic resonance imaging, present an image-rich overview of several morphologic aspects of early-stage (within 4 weeks following symptom start) local sequelae related to acute pancreatitis; to assist the implications for gastrointestinal surgery, to facilitate communication among treating doctors, to clarify complex imaging concepts for pancreatic fluid collections, and to emphasise standardised reporting nomenclature. On the basis of the related morphologic descriptions, radiologists should be fully conversant with the standardised imaging terminology. It is crucial to direct implications of care plans for patients with acute pancreatitis. It is also necessary for correct documentation and reporting of academic research.

Author(s) Details:

Bo Xiao,
Sichuan Key Laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China.

Please see the link here: https://stm.bookpi.org/ETDHR-V8/article/view/7232