The Clinical Analysis of Acute Necrotizing Pancreatitis.
- Author:
Il Young PARK
;
Myung Hwan KI
;
Keun Ho LEE
;
Hae Myng JEON
;
Sung LEE
;
Dong Gu KIM
;
Eung Kook KIM
;
Seung Nam KIM
- Publication Type:Original Article
- Keywords:
Acuie necrotizing pancreatitis
- MeSH:
Abdominal Pain;
Acute Kidney Injury;
Alcoholism;
Amylases;
Aspartate Aminotransferases;
Biliary Tract Diseases;
C-Reactive Protein;
Diabetes Mellitus;
Drainage;
Early Diagnosis;
Female;
Fistula;
Hemorrhage;
Humans;
L-Lactate Dehydrogenase;
Male;
Mortality;
Nausea;
Necrosis;
Oxidoreductases;
Pancreas;
Pancreatitis, Acute Necrotizing*;
Postoperative Complications;
Sepsis;
Subphrenic Abscess;
Tachycardia;
Vomiting
- From:Korean Journal of Hepato-Biliary-Pancreatic Surgery
1998;2(1):109-115
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Acute necrotizing pancreatitis often progresses into infection, sepsis, multiorgan failure and then, mortality and morbidity which are very high. From January 1988 to December 1996, 14 patients with surgically proved acute necrotizing pancreatitis at the Department of Surgery, Catholic University were analysed. 1) The patients consisted of 12 men and 2 women ranging in age from 27 to 74 years. 2) The ethiological factors included excessive alcohol abuse in 8 patients, biliary tract disease in 2 patients and unknown in 4 patients. 3) In clinical findings, the majority of the patients complained of sudden severe upper abdominal pain, nausea and vomiting, tachycardia, and abdominal distension. 4) Serum amylase level did not increase in 50% although the necrosis was severe, but aspartate transaminase increased in 13 cases. The lactic dehydrogenase and C-reactive protein increased in all tested cases. 5) In regards to diagnostic methods, computerized tomography was highly effective in getting early diagnosis and in finding the complications. 6) Early necrosectomy and drainage procedure was safe and effective. 7) Postoperative complications included pulmonary complications in 3 patients, pancreas fistula in 2, pancreas pseudocyst in 2, acute renal failure in 2, Diabetes mellitus in 2, gastrointestinal bleeding 1, and subphrenic abscess in 1 case. 8) Mortality rate was 36 %. In conclusion, computerized tomography may be used for early detection of acute necrotizing pancreatitis;. Aspartate transaminase, Lactate dehydrogenase and C-reactive protein may be good diagnostic and prognostic indicators upon admission. Necrosectomy and drainage should be chosen as the best surgical treatment in acute necrotizing pancreatitis patients.
