ABSTRACT
Background: Mortality for acute pancreatitis (AP) in Chile has fluctuated between 7 ana 10% in last years. Aim: To evaluate AP mortality over a period of 20 years in a clinical hospital in Santiago, Chile. Material and Methods: Review of the database of hospital discharges with the diagnosis of acute pancreatitis, between 1990 and 2010 and the medical records of those patients. Age, gender, length of hospital stay, surgeries, percutaneous interventions and mortality were registered. To compare the evolution of the disease over time, patients were divided in two groups: those hospitalized between 1990 and 1999 and those hospitalized between 2000 and 2010. Results: We reviewed the records of 1367 patients with a median age of 48 years (48% men). In the first period, 93 of637 (14.6%) patients died, whereas in the second period, 22 of 730 patients died (3.0%). In the first and second period, 41.9 and 25.3% of patients were subjected to surgical procedures. The hospital stay was shorter in the second group, compared with the first (14.2 and 25.9 days respectively). Conclusions: There was a decrease in mortality caused by AP in the last 10 years, probably associated with a better interdisciplinary management of these patients.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Hospital Mortality , Pancreatitis/mortality , Acute Disease , Chile/epidemiology , Retrospective StudiesABSTRACT
Background: Ménétrier disease is a rare disorder of the stomach, characterized by giant hypertrophic folds that usually involve the gastric body and fundus, associated to hypoalbuminemia due to serum protein loss across the gastric mucosa. We report a 55-years-old male presenting with abdominal pain, vomiting, weight loss and hypoalbuminemia. Diffuse hypertrophic gastric folds, elevated ulcerated sessile lesions and focal duodenal involvement were seen at endoscopy. Biopsies showed foveolar hyperplasia and glandular atrophy with cystic dilatation. A total gastrectomy was performed with a good outcome.
Subject(s)
Humans , Male , Middle Aged , Gastric Mucosa/pathology , Gastritis, Hypertrophic/pathology , Hyperplasia/pathology , Biopsy , Endoscopy, Digestive System , GastrectomyABSTRACT
Background: Identification of patients at risk for severe disease early in the course of acute pancreatitis (AP) is essential to optimize management and to improve outcomes. Aim: To assess BISAP score as a predictor of severity of AP. Patients and Methods: Retrospective review of AP patients between January 2009 and December 2010. BISAP, APACHE II and Balthazar scores were calculated. Length of stay, local complications, organ failure and mortality were registered. Accuracy of the scoring system for predicting severity was measured by the area under the receiver operating curve (AUC). Results: The medical records of 128 patients, median age 46.5 years (55.5% men), were reviewed. Mean hospital stay was 15 days, 18 patients (14%) had local complications, 7 patients (5.4%) developed organ failure and 2 patients died (1.6%). The AUC for BISAP score to detect organ failure was 0.977 (95% IC 0.947-1.000). A BISAP score > 3 had a sensitivity, specificity, positive and negative predictive value of 71.4, 99.1, 83.3 and 98.3% respectively. An APACHE II score > 8 had a sensitivity and specificity of 71.5 and 86.8% respectively. The figures for a Balthazar score > 6 were 42.8 and 98.3% respectively. There was a significant correlation between BISAP score and length of hospital stay. Conclusions: BISAP score was a useful method for predicting the severity of PA, with the advantage of being simple and based on parameters obtained on the first day of hospitalization. Its sensitivity and specificity were superior to APACHE II and Balthazar score in this cohort.