الفهرس 
AcknowledgementsOnly 14 pages are availabe for public view
 |  | from | 124 |  |  |
| | | from | 124 | | |
Abstract
Acute pancreatitis is an inflammatory disease of the pancreas that resolves without serious complications in 80% of cases, but may cause morbidity and mortality in up to 20% of patients. The incidence of acute pancreatitis (AP) has been increasing world the annual incidence of acute pancreatitis ranges from 13 to 45/100,000 alcohol. Diagnosis of acute pancreatitis is confirmed if at least two of the following three features present 1) Abdominal pain characteristic of acute pancreatitis. 2) Serum amylase and/or lipase greater than 3 times the upper limit of normal. 3) radiographically demonstrated acute pancreatitis on abdominal ultrasound or CT scan if indicated . The two most common etiological factors of acute pancreatitis are gallstones and alcohol abuse, Other causes of acute pancreatitis include structural abnormalities like pancreas divisum, neoplasms, metabolic disorders, drugs, trauma, iatrogenic causes (e.g. post ERCP pancreatitis), infections, vascular disorders (ischemia), genetic causes (e.g. trypsinogen mutations), and lastly a remaining group of cases which cannot be classified and is referred to as idiopathic pancreatitis . The aim of the work is to evaluate etiology, clinical characteristics and outcome of acute pancreatitis in patients at Assiut University Hospital which is important in guiding management and preventing complications and recurrence which will be reflected on decreasing morbidity and mortality in patients with acute pancreatitis. The current study was done at Assiut University Hospital and includes 50 patients who were diagnosed to have acute pancreatitis aiming to assess different etiologies, clinical characteristics and outcome of acute pancreatitis. Mean age those patients was 50.96 ± 9.71years with range between 24 and 73 years. 30 (60%) patients were males and 20 (40%) patients were females. Diabetes mellitus and hypertension presented in 15 (30%) and 13 (26%) patients respectively. The most frequent aetiology in the current study was gall stones in 28 patient (56%). The aetiology was idiopathic in 13 (26%) patients. It was noticed that acute pancreatitis occurred secondary to ERCP in 6 (12%) patients and hypertriglyceridemia in 3 (6%) patients. Based on Ranson’s criteria; 30 (60%) patients had mild pancreatitis and 9 (18%) patients had moderate pancreatitis while 25 (50%) and 14 (28%) patients had mild and moderate pancreatitis respectively based on CT’s findings. It was noticed that 11 (22%) patients had sever pancreatitis based on either CT’s findings or Ranson’s criteria Conclusion Acute pancreatitis remains a significant cause of morbidity and mortality. Most patients with mild acute pancreatitis will recover with conservative measures, although patients who develop more severe pancreatitis require aggressive management and can still have poor outcome The current study included 50 patients with acute pancreatitis. The mean age of those patients was 50.96±9.71years. The study included 30 male patients and 20 female patients. The most frequent etiology in the current study was gall stones which cause acute pancreatitis in 28 patients (56%). The etiology was idiopathic in 13 (26%) patients. It was noticed that acute pancreatitis occurred secondary to ERCP in 6 (12%) patients and hypertriglyceridemia in 3 (6%) patients. The majority of patients improved and only four patients died. Old age, presence of comorbidities, and leucocytosis were risk factors for a severe attack while old ages, presence of comorbidities, severe pancreatitis, and presence of complications were associated with mortality Recommendations Routine investigations as LFTS, KFTS, CBC, serum calcium, LDH, amylase, lipase and blood glucose should be evaluated at time of admission for any patient suspected to have acute pancreatitis for early diagnosis, severity scoring and management of acute pancreatitis which will affect the outcomes Treatable causes of acute pancreatitis should be identified and managed appropriately to prevent recurrence of acute pancreatitis. Our study recommends further studies that include more patients, more clinical and laboratory methods for early diagnosis and detection of the cause of acute pancreatitis and the outcomes.