Clinico-pathological study of acute pancreatitis: a prospective study of 30 cases

Background: The incidence of acute pancreatitis (AP) has increased during the past 20 years. Aim of this study was to review various clinical parameters like etiological factors, age, sex, clinical signs & symptoms and various biochemical criteria like serum amylase, lipase, blood sugar, and serum calcium in assessment of acute pancreatitis. Methods: We conducted prospective study on 30 patients admitted in our Hospital, who were diagnosed clinically as acute pancreatitis associated with raised serum amylase levels more than 160 somogyi units/100ml. Results: The incidence was higher in males (66.66%) as compared to females. Most common etiological association was gallstone (50%) followed by alcohol (9%), idiopathic (16.66%). Most common clinical sign was abdominal tenderness (93.33%) followed by tachycardia (66.66%), tachypnoea (53.33%), rigidity (53.33%), jaundice (40%), epigastric lump (13.33%). Most common clinical symptom was abdominal pain (100%), nausea/vomiting (90%), abdominal distension (83.33%), fever (53.33%). Increase of serum lipase may be a better diagnostic tool because it found to be normal in some non-pancreatic conditions also. Blood sugar >200mg%, serum calcium < 8 mg% are important poor prognostic indicators and show increased severity of disease and mortality risk. In our study complications encountered were pleural effusion (10%), renal failure (6.66%), ARDS (3.33%), cardiac arrhythmias (3.33%). Conclusions: Our study emphasizes that early diagnosis and assessment of severity of disease by various clinical signs, symptoms and biochemical criteria supported by radiological investigations is very important to minimize the complications of acute pancreatitis.