ACUTE PANCREATITIS IN ADULT ETHIOPIANS: EXPERIENCE FROM ST. PAULâ€™S MILLENNIUM MEDICAL COLLEGE HOSPITAL, ADDIS ABABA
Background: Acute pancreatitis is a disease of variable severity, and a high index of clinical suspicion supported by relevant laboratory and imaging studies is necessary to make early diagnosis and improve patient outcome. Objective: This study aims to revise the most common presenting symptoms and signs of acute pancreatitis and the diagnostic modalities used in adult Ethiopian patients.
Methods: A cross-sectional descriptive study was conducted among adult patients with acute pancreatitis admitted to St. Paulâ€™s Millennium Medical College Hospital from January 2005 - December 2011. Data on clinical presentation and outcome of illness was collected from medical records using a structured and pretested questionnaire and analyzed using SPSS Version 16.
Results: A total of 40 patients were admitted to the hospital during the study period. Medical records were retrieved for 30 of them. The male to female ratio was 5:1 and the mean age was 40 years. The majority (76.7%) of patients presented within 3 days of onset of illness. Abdominal pain and vomiting were the most common presenting symptoms seen in 86.7% and 60%, respectively. Tachycardia (60%) abdominal distention (73%) and tenderness (80%) were physical findings. Serum amylase level was elevated in all patients, but was highly elevated in 16 (40%). Ultrasound examination showed features of acute pancreatitis in six (31.6%). Acute pancreatitis was diagnosed on clinical evaluation in 18 (60%) of the cases and intra-operatively in 12 (40%). Six (20%) of the cases died and five of them were among those who underwent surgery.
Crockett S, Wani S, Gardner T, Falck-Ytter Y, Barkun A; American Gastroenterological Association Institute Guideline on Initial Management of Acute Pancreatitis, Gastroenterology 2018;154:1096â€“1101.
Vege SS, DiMagno MJ, Forsmark CE, Martel M, Barkun AN. Initial Medical Treatment of Acute Pancreatitis: American Gastroenterological Association Institute Technical Review, Gastroenterology 2018;154(4):1103-1139.
Yadav D, Lowenfels AB. Trends in the epidemiology of the first attack of acute pancreatitis: a systematic review. Pancreas 2006;33:323â€“330.
Gullo L, Migliori M, Olah A, et al. Acute pancreatitis in five European countries: etiology and mortality. Pancreas 2002;24:223â€“227.
Weitz G, Woitalla J, WellhÃ¶ner P, Schmidt K, BÃ¼ning J, Fellermann K. Does Etiology of Acute Pancreatitis Matter? A Review of 391Consecutive Episodes JOP. J Pancreas (Online) 2015 Mar 20; 16(2):171-175.
Mitchell S.Cappell, Acute Pancreatitis: Etiology, Clinical Presentation, Diagnosis, and Therapy. Medical Clinics of North America Volume 92, Issue 4, July 2008, Pages 889-923
Tenner S, Baillie J, Vege S. American College of Gastroenterology Guideline: Management of Acute Pancreatitis. Am J Gastroenterol 2013;108:1400â€“1415
Banks PA, Bollen TL, Dervenis C, et al. Classification of acute pancreatitis - 2012: revision of the Atlanta classification and definitions by international consensus. Gut 2013:62:102â€“111.
Satish Munigala, Dhiraj Yadav, Case-fatality from acute pancreatitis is decreasing but its population mortality shows little change. Pancreatology, 2016; 16:542â€“550.
Anderson F, Thomson S, Clarke D, Loots E. Acute pancreatitis: Demographics, aetiological factors and outcomes in a regional hospital in South Africa. SAJS; 2008;46(3):83-86.
Negi, Mokta J, Sharma B, Sharma R, Jhobta A, Bodh V, Ranjan A. Clinical Profile and Outcome of Acute Pancreatitis: A Hospital-Based Prospective Observational Study in Sub Himalayan State, Journal of the Association of Physicians of India, March 2018, Vol.66
Siddiqui Z, et.al. Presentation and Outcome of Acute Pancreatitis at PIMS, Islamabad, Ann Pak Inst Med Sci 2007;3(2):67-70.
Pongprasobchai S, Vibhatavata P, Apisarnthanarak P, Severity, Treatment, and Outcome of Acute Pancreatitis in Thailand: The First Comprehensive Review Using Revised Atlanta Classification, Hindawi Gastroenterology Research and Practice 2017, Article ID 3525349, https://doi.org/10.1155/2017/3525349
G.P. 104 Reid et al, Acute pancreatitis: A 7-year retrospective cohort study of the epidemiology, aetiology and outcome from a tertiary hospital in Jamaica. Ann Med Surg 2017; 20:103-108.
Nesvaderani N, et al. Epidemiology, aetiology and outcomes of acute pancreatitis: A retrospective cohort study. Intern J Surg 2015;23:68-74
Ahmed K, Ahad MA, Alim MA, Ekram ARMS. Clinical profile of acute pancreatitis in a teaching hospital, Bang Med J Khulna 2016;49:7-12