Etiology, clinical profile and outcome of acute pancreatitis in a tertiary care teaching hospital in rural South India: a ten year retrospective study

Abstract

Background: Acute pancreatitis is a complex condition with diverse local and systemic complications, dealt by the surgeons all over the world. There were no previous detailed studies regarding the etiology, clinical profile and outcome of acute pancreatitis in rural Kerala.Methods: This is a hospital based study by retrospective chart analysis of all acute pancreatitis cases from the past 10 years in this tertiary care centre which have clinical/ laboratory/ radiological findings suggestive of acute pancreatitis.Results: Among 436 cases studied 318 (72.9%) were males and 118 (27.1%) were females. Epigastric pain without radiation to the back (51.6%) was the most common clinical presentation. Alcohol was the most common etiological factor seen in 42.4% followed by idiopathic pancreatitis (IP) (36.9% cases) and then by gallstone/biliary pancreatitis (14.5%). Acute fluid collection was the most common local complication seen in 29.1% cases and respiratory system involvement was the most common organ involvement seen in 16.5% of cases.Conclusions: Epigastric pain without radiation to the back was the most common clinical presentation. Incidence of alcoholic pancreatitis (42.4%) and idiopathic pancreatitis (36.9%) was slightly higher in our study, which should prompt us to look with further studies for identifiable new aetiologies in the idiopathic group. This work provides the first known regional description of the etiology, clinical profile and outcome of acute pancreatitis. Due to institutional and population similarities, this may represent the status of developing countries in general. This will help in formulating a hospital policy which would be beneficial.

Clinical approach, diagnosis and medical management of acute pancreatitis among patients attending tertiary care hospital in Prakasam district, Andhra Pradesh, India

“…As per one of the South Indian Study out of the total 436 cases, alcohol induced pancreatitis was higher (42.431%) followed by idiopathic pancreatitis (36.9%). 22 Our study results are consistent with the findings of Vengadakrishnan et al, from the study done at SRM Medical College, Chennai were alcohol induced pancreatitis was higher (51%). 25 As per Casas et al, in their study of 148 patients, found gall stones (57%), alcohol consumption (21%) are the causes of acute pancreatitis which is in contrast to present study.…”

“…14 It was observed in Ramu et al study that triad of epigastric pain, nausea and vomiting was present in 256 (58.5%) of cases. 22 In the study done by Sameer et al in People's college of medical sciences and research center, Bhopal the triad of epigastric pain, nausea and vomiting was seen in 75% patients. 29 Abdominal pain was present in all cases which were in concordance with the study done by Reid et al where abdominal pain was present in 96.7% cases.…”

“…Pancreatitis is a contributing factor in causing an additional deaths every year in various countries and rising a heavy economic burden, and health costs annually in the United States. 22 Unpredictable diagnostic delay often leads to belated and ineffective interventions and practice of guidelines for standardization of management of the patient, will in turn give better outcomes. In this study out of total 72 acute pancreatitis cases 61 (84.7%) were males and 11 (15.3%) were females, and the male preponderance of 2.7:1 seen in Ramu et al study and similar findings noticed in Jamaican study where a male preponderance was 4:1.…”

“…In this study out of total 72 acute pancreatitis cases 61 (84.7%) were males and 11 (15.3%) were females, and the male preponderance of 2.7:1 seen in Ramu et al study and similar findings noticed in Jamaican study where a male preponderance was 4:1. 22,23 A study conducted in Andhra Pradesh on acute pancreatitis revealed that 95% patients were found to be males and 5% were females. 24 In our study it was found that 39 (54.2%) cases were due to Alcoholism, second most common was found to be hyperlipidemia among 15 (20.8%) cases, followed by gall stones in 10 (13.9%) cases even though the etiology of acute pancreatitis varies alcohol consumption and gall stones predominate in most of the countries.…”

Step-Up Management in Acute Pancreatitis: A Tertiary Care Center's Experience From Southern India

“…Most of our patients were in the mean age of 37.4 ± 12.3 years in whom alcohol consumption was more prevalent. Similar findings were noted in two case series from southern India by Ramu et al and Vengadakrishnan and Koushik [ 7 , 8 ]. Worldwide demographic data published by Matta et al showed similar findings in the Indian population, while biliary pancreatitis was the most common etiology in the rest of the world [ 9 ].…”