Akut pankreatitli olgularımız: Kılavuz önerilerinden ne kadar uzak?

Abstract

Background and Aim: Acute pancreatitis is an inflammatory disease of the pancreas, with variable involvement of peripancreatic tissue or remote organ systems. The etiology of the disease shows significant differences among geographic areas. In our study we aimed to enlighten the data of our region. Methods: Between January 2003 and December 2006 hospitalized patient with acute pancreatitis were retrospectively examined. Patients were evaluated according to race, age, etiology, symptomatology, data of laboratory and imagination, severity of attack, proportion of complication, proportion of mortality and treatment. Results: Of the 62 patients included into the study 33 (53.2%) were women, 29 (46.8%) were men and their mean age was consecutively 46,1 and 56,0. Etiologic dispersal was 29 (46.8%) billiary, 8 (12.9%) hypertrigliseridemia, 1 (1.6%) hypercalcemia, 1 (1.6%) alcohol, 1 (1.6%) malignancy. Twenty-two (35.5%) patients were considered to be idiopathic. Twenty-three of billiary patients (33.3%) were severe type. All of the billiary pancreatitis patients were applicated ERCP in the first 72 hours. Amilaz levels of patients with hyperlipidemia were determined lower than the other causes. Seven (31.8%) of the idiopathic patients were women and 15 (68.2%) of them were men and 31.8 % of these were severe pancreatitis type. In severe pancreatitis cases Ranson's score, CRP level, albumin level and duration of admission in the hospital were significantly different from mild acute pancreatitis. Computed tomography was taken in all the patients. While billiary pancreatit was present in two of the four patients death, two of them were idiopathic. In fine needle aspiration apllied in the six of severe patients infected necrosis was determined in four of them and they were transferred to surgary clinic. While mortality rate was 6.5% in total, in severe pancreatitis type this rate was determined as 22.2%. Mean age of the patients died was 65.5. In 16 (25.8%) patient in total pulmonary, in four of them (6.5%) multiorgans deficiency, in three of them (4.8%) local complication were determined. Conclution: In the management of acute pancreatitis it should be more conservative about computed tomography and ERCP. Idiopathic group has been determined higher compared with data. In our study our mortality rates and our general approachment algoritm has been compatible with guideline recommendation.