English

Abstract

AIM: To measure C-reactive protein (CRP) levels in patients of acute pancreatitis and evaluate if CRP levels predict the severity of pancreatitis by correlating these levels with- 1. C T Severity Index (CTSI). 2. Presence of complications. 3. Time taken for recovery. METHOD: Between the years 2007 and 2009 fifty patients diagnosed to have acute pancreatitis were included in this study. Their CRP levels were sent on second day of admission and CT scan done after 72 hours of admission. RESULTS: CRP levels of 63mg/dl and above are significantly associated with increased time to recovery (R>7D), (p-0.004). A significant association was seen between the presence of complications and a CTSI >7, (p-0.0002). There was no significant correlation or association between the CRP levels and CTSI as indicated by a value of 0.040528 (test of correlation) and p- <0.05. CONCLUSION: High serum CRP levels have predicted prognosis as well as mortality in this study. CTSI can be a very accurate predictor of development of complications in a case of acute pancreatitis. INTRODUCTION: Acute pancreatitis is major cause of acute abdominal pain. The clinical presentation of the acute pancreatitis is variable. Most of these patients recover without specific complications. Some patients however display severe complications such as pancreatic as cites and pancreatic necrosis; these patients show high morbidity and mortality. The role of diagnostic markers (pancreatic enzymes such as amylase and lipase) as prognostic indicators has been a failure. Other biochemical markers like CRP, pro-calcitonin and the like are under evaluation as prognostic indicators. CRP estimation is cheap and easily available. In this study we have attempted to see if a single and early estimation of CRP levels is an effective predictor of morbidity and mortality in acute pancreatitis. We have attempted association between CRP, radiological imaging, and the clinical features and outcome of acute pancreatitis. MATERIALS AND METHODS: Between the years 2007 and 2009 fifty patients admitted in LTMGH in the departments of General Medicine and General Surgery with a diagnosis of acute pancreatitis were studied. This is an observational study to evaluate whether the C-reactive protein (CRP) levels predict the severity of pancreatitis by co-relating these levels with CT severity index. Tests of association were applied between CRP levels and presence of complications, and time taken for recovery. These patients were diagnosed on the basis of presenting symptoms and clinical signs and serum amylase & lipase levels. In patients in whom diagnosis was confirmed, serum CRP levels were sent on day 2 of admission and patients subjected to a contrast enhanced CT scan of the abdomen in 72 hours after admission. Patients were observed for development of complications, both local and