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

Study about Pancreaticopleural Fistula: A Cause of Recurrent Pleural Effusions in Chronic Pancreatitis | Chapter 10 | Recent Developments in Medicine and Medical Research Vol. 2

 PPF, or pancreaticopleural fistula, is a rare yet dangerous consequence of chronic pancreatitis. In middle-aged males with a history of alcohol consumption, PPF should be considered in the differential diagnosis of recurrent and large pleural effusions. Because the patients often report with respiratory symptoms associated to the pleural effusion rather than pancreatitis, the diagnosis requires a high index of suspicion. Dyspnea, or chest tightness, may be evident at first, with or without a history of stomach pain or steatorrhea. The gold standard for diagnosis is abdominal computer tomography (CT) or magnetic resonance cholangiopancreatography (MRCP). Treatment options include conservative, surgical, and endoscopic treatments. Patients with PPF are given conservative treatment at first, but if their condition does not improve, they are exposed to surgery or ERCP treatment.

Study goals are as follows:

Identify the unusual cause of recurrent pleural effusion, the Pancreaticopleural Fistula (PPF).

PPF was assessed in individuals with chronic pancreatitis who had recurring pleural effusions.

PPF management solutions are available.

Author (S) Details

Harveen Kaur
Department of Pulmonary Medicine, Government Medical College, Amritsar, Punjab, India

Dilbag Singh
Department of Pulmonary Medicine, Government Medical College, Amritsar, Punjab, India

N. C. Kajal
Department of Pulmonary Medicine, Government Medical College, Amritsar, Punjab, India.

 

View Book :-

https://stm.bookpi.org/RDMMR-V2/article/view/4281