Abstract

Background: Acute pancreatitis is a disease constituting a major portion of the referrals to tertiary care gastrointestinal centres. The present study was aimed to study the effectiveness of managing this disease at a peripheral institute. Methods: This is a prospective observational study conducted from September 2016 to September 2018 in a rural hospital. Patients with acute pancreatitis were evaluated for severity and those with severe disease were referred early to a higher centre. Mild cases which formed the majority of the cases were retained and treated as per the standard treatment protocol. These patients were evaluated and examined at regular intervals to assess their recovery and to identify the factors demanding referrals. Results: 72 patients, 42 females and 31 males, with a mean age of 37 years were included in the study. Gallstones were present in 62% of the patients. 63% of the cases had mild acute pancreatitis. Only 9.7% of the patients had a Computed tomography severity index score of more than 7. 15% of patients had a BISAP score of more than 2. Acute fluid collection was the most common complication seen in about 32% of patients followed by ascites (15%) and pleural effusion (12.5%) Most common reason for referral was the requirement of radiological intervention for the management of the disease, followed by acute respiratory distress syndrome and multi-organ dysfunction syndrome. The mean hospital stay was 7 days. Conclusion: The majority of the patients with acute pancreatitis can be managed at a peripheral facility without increasing the morbidity and mortality even for referred patients with severe disease.

Key words: Acute pancreatitis, Gallstones, Bedside index for severity of acute pancreatitis (BISAP) score, Computed tomography severity index (CTSI)