A Clinicopathological Study of Necrotizing Pancreatitis with Special Emphasis on Need for Surgery and Its Outcome
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2019, Vol 18, Issue 3
Abstract
Necrotizing pancreatitis is one of the important causes of mortality in acute pancreatitis especially when it is infected. Intervention is very rarely indicated in patients with sterile necrosis but may be required in those who continue to deteriorate despite maximal supportive care. In contrast, patients with infected pancreatic or peri-pancreatic necrosis almost always require intervention. Although infected pancreatic necrosis has been considered an absolute indication for surgical intervention, cases successfully managed nonsurgically have been reported. This study assessed the course of necrotizing pancreatitis with and without surgical intervention. This observational study was conducted in NilRatan Sircar medical college & hospital, on patients admitted with Acute Pancreatitis and latter diagnosed to have Acute Necrotizing Pancreatitis (on the basis of Contrast Enhanced CT Scan of Whole Abdomen) during January 2015 to September 2016.Thirty patients who fulfilled the inclusion criteria were enrolled for the study .There was a male preponderance. 50% of cases occurred in the age group of 30 to 49 years. Gall stone was the most common etiological agent followed by alcoholism and also gall stone was most common cause of infected necrotizing pancreatitis being present in 67% cases. Esch.coli was the most common organism found in infected necrotizing pancreatitis. CRP >= 150mg/L was 82% sensitive and 56% specific in diagnosing severe pancreatitis with CTSI > 6 73% of patients with acute necrotizing pancreatitis had less than 50% necrosis .64% of the patients (n=22) were managed conservatively. Rest 8 patients with >50 % necrosis had to undergo necrosectomy. One patient out of the 22 patients managed conservatively and 3 patients out of the 8 managed surgically died of various complications.
Authors and Affiliations
Debasis Ray, Vishal Jalan, Sudeb Saha
Keywords
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- EP ID EP558111
- DOI 10.9790/0853-1803165158.
- Views 56
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