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Original Article

A clinical study of complications of acute pancreatitis and their outcome

Sajjad Hussain, Rakesh Saraf.

Aim: The aim was to study the complications of acute pancreatitis, the outcome of complications, and to find out methods of improving the outcome.
Materials and Methods: This is a descriptive study of patients admitted with acute pancreatitis. The management and outcome of the complications were recorded in detail. For determining the severity and predicting the course of acute pan- creatitis, a multiple organ system failure (MOSF) scoring system was utilized.
Results: 104 patients were evaluated, with biliary stones as the most common cause (51.92%), and mild attack in 67 (64.42%) patients and severe pancreatitis in 37 (35.58%) patients. The MOSF scoring system had the sensitivity, speci- ficity, and positive predictive value of 96.96%, 92.95%, and 86.48%, respectively. In local complications, ascites was the most common (31.73%), and in systemic complications, pleural effusion was the most common complication. Recurrence was seen in 19.23%. Overall, mortality was 13.46%, with a mortality rate of 37.83% in severe acute pancreatitis. Although conservative management was done in all patients to start with, 12.5% of patients were operated.
Conclusion: Ascites was the most common local complication, whereas pleural effusion was the most common systemic complication. Shock, acute respiratory distress syndrome, acute renal failure, pancreatic abscess, infection of the pancre- atic necrosis, upper gastrointestinal bleed, hypocalcaemia, portal vein thrombosis, and hepatic encephalopathy were com- plications with the poorest prognosis. It is important to identify patients with acute pancreatitis who have an increased risk of complications and death. The MOSF scoring system is simple to use, has better clinical utility, and helps in directing pre- cious resources to patients who benefit the most from intensive therapy. Patients with severe pancreatitis require intensive monitoring and support of a failing system in intensive care unit, the lack of which resulted in higher mortality in our study.

Key words: Acute pancreatitis, complications, intensive care, multiple organ system failure scoring system, pancreatic necrosis

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