The Severity of Acute Pancreatitis According to Modified Balthazar Classification in Patients With Pancreatic Cancer

Abstract

Objective: Although acute pancreatitis (AP) is a self-limited disease under supportive and medical treatment, it can have life-threatening potential in some patients. Results of studies reporting outcomes of AP-associated pancreatic malignancy are controversial. The aim of this study was to evaluate the severity and prognosis of pancreatic cancer (PC)–related AP by modified Balthazar score. Methods: A total of 354 patients hospitalized and followed up in our clinic between 2013 and 2019 were included in the study. Demographic data of all patients were recorded. The etiology of all cases was determined. According to the etiology, the cases were divided into 2 groups: AP related to pancreatic malignancy and AP due to nonmalignant causes. The patients underwent computed tomography of the abdomen within the first 12 hours of admission and after 3 to 7 days. Patients were evaluated and classified by modified Balthazar classification. Results: Malignancy-related AP was detected in 18 (5.1%) patients. A total of 336 cases (94.9%) were related to nonmalignant causes. There was no statistically significant difference in the severity of AP in both groups at admission and after 3 days ( p > 0.05). The changes (regression, progression, or no change) in the disease severity at the first and the subsequent imaging were examined. There was no significant relationship between the 2 groups ( p > 0.05). Conclusion: AP may be the clinical manifestation of PC or PC may induce AP in various ways. It was shown that the underlying malignancy did not adversely affect the severity and course of AP.

Analysis of the effect of a root cause analysis in elderly patients with acute pancreatitis: a randomized trial

“…Finally, the RCA intervention model not only enhanced cooperation between medical staff, but also solved problems related to insufficient inspections and the low number of night shift nursing staff. Notably, following the RCA intervention, nursing staff training was strengthened, and a scientific scheduling system was formulated, which effectively reduced the occurrence of complications and improved patients' and their families' levels of satisfaction with nursing (20).…”

Is there a correlation between the initial calcium level and Balthazar classification in patients with acute pancreatitis?

“…[ 1 , 4 , 5 ] While mild and moderate pancreatitis affects only itself and adjacent organs locally, multiple organ failure may develop in severe pancreatitis due to both local and systemic effects. [ 1 , 3 , 4 , 8 ] It is known that morbidity and mortality decrease in patients with severe AP with early initiation of treatment and close monitoring. [ 18 ] For this reason, it is important to determine the course of the disease using laboratory and radiological parameters.…”

“…[ 2 ] While a life-threatening course is observed in 2–3% of the patients, the mortality can be up to 50% in severe AP. [ 3 – 8 ]…”

Bidirectional relationship between acute pancreatitis and pancreatic cancer

“…Other symptoms associated with PDAC such as poor appetite, diarrhea or loose stool secondary to steatorrhea, unintentional weight loss, and recent or new-onset diabetes, should raise the concern for malignancy in patients presenting with acute pancreatitis [42]. Although studies have reported that most PDAC-AP patients present with mild acute pancreatitis, based on clinical or imaging criteria for the classification of acute pancreatitis, in some patients, the presentation of PDAC-AP may be associated with severe necrotizing pancreatitis [7,43,[45][46][47][48].…”