Devipriya, R (2020) Prospective study of Clinical Outcome in Alcoholic Acute Pancreatitis. Masters thesis, Government Mohan Kumaramangalam Medical College, Salem.
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Abstract
BACKGROUND: Acute Alcoholic pancreatitis is a common disease with wide clinical variation. It may vary in severity, from mild self-limiting to pancreatic necrosis with life-threatening sequelae. Severity of acute Alcoholic pancreatitis is linked to the presence of systemic organ dysfunctions and/or necrotizing pancreatitis. AIM AND OBJECTIVES The present study was aimed to assess the clinical profile and to assess the efficacy of various severity indices in predicting the outcome of patients. METHODOLOGY: This was a prospective study done in Salem Medical College and Hospital. All patients with a diagnosis of acute Alcoholic pancreatitis were included in this study. Along with routine lab parameters, serum amylase, lipase, lipid profile, calcium, CRP, LDH, CT abdomen, CXR and 2D Echo were done. RESULTS: Out of 142 patients alcohol induced pancreatitis was higher (51%) than gall Stone induced pancreatitis. This can be explained by the greater incidence of alcohol abuse in Tamilnadu. Incidence of alcoholic pancreatitis is mostly seen in young males, particularly of middle age group. All the patients had significant alcohol history. Out of them 85.7% were associated with smoking history. In this study alcohol which is mostly abused by men than women and younger age group than old prevalence is more in young males. Most of the patients had no comorbidities (73.8%), ICU stay seen in 46.4% , < 2 week . (77.4%) patients of the study population had mild pancreatitis, while> 2 weeks (22.6%) patients had Severe acute pancreatitis. .Duration of discharge is directly proportional to the severity of pancreatitis. (70.2.%) patients of the study population had mild pancreatitis, while (29.7%) patients had SAP as determined by CT, which is taken as standard to predict the severity of pancreatitis for the most common symptom of abdominal pain or it could be that of a referral bias. Three pancreatic scores were taken in the study HAPS, BISAP, GLASCOW and SIRS, all of which have easily obtainable variables and can be calculated at the time of admission. CONCLUSION: Initial assessment of, LDH, HAPS Score ,SIRS and Glascow score could be reliable indicators of outcome in acute pancreatitis. Prolonged hazardous drinking can result in progressive and irreversible damage to the pancreas gland. This occurs on the background of pancreatic inflammation, acinar atrophy and, ultimately, fibrosis and can result in significant exocrine and endocrine insufficiency. Some individuals may develop this condition with alcohol intakes as low as 20 g/day; others may need to drink in excess of 200 g/day before evidence of the disease develops; others may never develop this condition no matter how much they drink or for how long. In susceptible individuals the longer the duration of drinking the greater the risk of developing significant pathology. Acute alcohol-related pancreatitis may present as an acute episode of abdominal pain, nausea and vomiting and in severe cases can be accompanied by profound metabolic abnormalities and circulatory collapse. These acute episodes may recur, often precipitated by an increase in alcohol intake. Complications such as narrowing of the common bile duct, localized leakage of pancreatic fluid and pancreatic exocrine and endocrine insufficiency may develop resulting in jaundice, pseudocyst formation, malabsorption and diabetes. In some individuals, however, the clinical course is insidious with progression to pancreatic insufficiency without acute inflammatory episodes.
| Item Type: | Thesis (Masters) |
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| Additional Information: | 221711402 |
| Uncontrolled Keywords: | Keywords: Acute pancreatitis, C-Reactive Protein, LDH, Severity index. |
| Subjects: | MEDICAL > General Surgery |
| Depositing User: | Subramani R |
| Date Deposited: | 11 Feb 2021 03:18 |
| Last Modified: | 11 Feb 2021 03:18 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/14050 |
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