Acute Pancreatic Nine Years of Surgical ICU Experience

Abstract

Acute pancreatitis has a variety of presentations from self-limiting abdominal pain to development of local and systemic complications resulting in sepsis, multi-organ dysfunction, extended intensive care stay and death. Very good quality of life in survivors justifies an optimal therapy in an intensive care setup. The records of 91 patients with acute pancreatitis were reviewed retrospectively. There was a significant difference (p < 0.001) between those with edematous pancreatitis and those with necrotic pancreati-tis as regards the length of ICU stay and severity scores: Ranson and SOFA (Sepsis-related Organ Failure Assess-ment). The most common cause of pancreatitis was biliary (70.3%) followed by hyperlipidemia (12.1%), post ERCP (5.5%), trauma (4.4%), idiopathic (6.6%) and in one case, ascariasis. Common associated diseases were hypertension (33%) and diabetes mellitus (25.3%). Six patients with necrotic pancreatitis died. It is concluded that acute pancreatitis treated in an in-tensive care unit has a favorable outcome and that a com-bination of Ranson and SOFA scores with CT index helps in establishing the prognosis.