A STUDY OF CORELATION OF CLINICAL PROFILE WITH BIOCHEMICAL & RADIOLOGICAL INVESTIGATIONS IN ACUTE PANCREATITIS
Dr. Santosh Dalavi and Dr. Swapnil Chopade*
Introduction: Acute pancreatitis is a common condition involving the pancreas. Gall stone disease and alcohol account for greater than 80% of all patients with acute pancreatitis, with biliary disease accounting for 45% and alcohol found in 35% of patients1 Acute pancreatitis includes a wide spectrum of disease, from one with mild self- limiting symptoms, to fulminant processes with multiorgan failure and high mortality. Given the wide spectrum of disease seen, the care of patients with pancreatitis must be highly individualized. Primary Objective: To study of correlation of clinical profile with biochemical & radiological investigations in acute pancreatitis. Secondary Objective: To study the outcome of treatment and complications of acute pancreatitis. Methods: After admission to the hospital, a detailed clinical history and examination of the patient was done. Routine investigations like Complete hemogram, Blood urea, Serum amylase; serum lipase were performed. USG Abdomen and contrast CT ABDOMEN. The patients were classified as having mild acute pancreatitis or severe acute pancreatitis. The treatment plan was focussed on adequate initial resuscitation and supportive care, early detection of complications and definitive treatment of the associated biliary disease. Observations & Results: Serum Lipase was the diagnostic test with a sensitivity of 0%. Serum amylase is a strong indicator of development of pseudocysts as 70% of patients with levels more than twice the upperlimit developed pseudocysts. Ultrasonography visualized pancreas on about 92% patients with findings of acute bulky oedematous & bulky hypoechoic pancreatitis whereas CT visualized pancreas in 100% patients. CT is a confirmative investigation in diagnosis and staging of Acute pancreatitis. CT Severity Index is prognostic score in assessing severity & outcome of disease. Conclusion: Acute pancreatitis is a clinical diagnosis supplemented by serum amylase, serum lipase, Ultrasonography & CECT. Ultrasonography visualized pancreas on about 92% patients and its limitations were overcome by CECT.
[Full Text Article]