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Introduction@#About 20-30% of patients with acute pancreatitis have a severe disease and mortality rate among inpatients were 15%. There are many causes of acute pancreatitis (AP), but most common cause of AP is an alcohol. According to some studies in our country, alcohol is the number one cause of acute pancreatitis and the mortality rate is 15.3%. Very important for prognosis of disease optimal choice of treatment tactics, detection of infectious evidence of necrotizing pancreatitis. Therefore, based on the above, there is an urgent need to conduct research to address important issues and to improve the diagnosis and treatment of acute alcohol-induced pancreatic necrosis.@*Goal@#Determine the importance of early diagnostic assessment of alcohol induced severe acute necrotizing pancreatitis.@*Materials and Methods@#Research model and research method. We conducted our research using an observational research model and a factual research method.Sampling of research materials will be carried out by targeted sampling. From November 1, 2008 to January 1, 2020, 122 patients who were hospitalized with alcohol-inducedAP were selected and archival documents or medical histories were selected. Statistical analysis was performed using averages and regression analysis methods to calculate the laboratory parameters in the analysis related to the new evaluation system.@*Results@#The minimum age of patients with ANP was 25 and the maximum was 71, with the majority (87.4%) aged 26 to 60 years. When the Person Correlation method calculates the relationship between alcohol consumption and mortality, it is assumed that the weaker the correlation, the higher the amount of alcohol consumed, the lower the cure and the higher the mortality. Of the 31 deaths reported in the study, 24 (77.4%) were hospitalized more than 72 hours after the onset of the disease. Late hospitalization and late treatment of patients with acute necrotizing pancreatitis (ANP) disease have been shown to adversely affect the prognosis of the disease. In our study, all parameters were significant, but procalcitonin, serum amylase, serum lipase, serum LDG8 C-reactive protein, serum glucose was found to be higher than the value specified in the evaluation system for the variable (in determining pancreatic necrosis). АNOVA analysis test showed that white blood cells, procalcitonin, serum amilza, serum lipaza, serumglucose, serum LDG, C-reactive protein were higher than those specified in the evaluation system, and that the level of significance for the variable (indicating a severe pancreatitis or poor prognosis) was higher than other test results (P <0.01). According to the new evaluation system, 12 out of 122 patients were classified as A class or 0-3, 69 (56.5%) patients were class B or 4-6, and 41 (33.6%) patients were class C or >7 points. Of the total cases, 90.1% were rated as severe form of ANP and pancreatic necrosis by the classification system we developed. When we assessed the prognosis with the new assessment system, we found that 100 percent of patients in category A were cured, 89.8 percent of patients in category B were cured, and 41.5 percent of patients in category C were cured and 58.5 percent died. Statistical calculations using the correlation analysis method for the correlation between the score and the cure of the evaluation system shows negative correlation (P <0.01) other words, the higher the score of the evaluation system, the lower the cure rate and the higher the mortality rate.@*Conclusion@#In Mongolia, relatively young men suffer from alcohol-induced pancreatitis.Factors contributing to the development of necrosis in acute pancreatitis include alcohol abuse, prolonged alcohol use, delayed hospitalization, and delayed treatment.In our study, following clinical signs and laboratory findings are effective in distinguishing severe forms of acute necrotizing pancreatitis, early diagnosis, assessment of prognosis. Laboratorytests include: increase in white blood cells, procalcitonin, serum amylase, serum LDH, serum lipase, C-reactive protein and a decrease in hematocrit, serum calcium.
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Introduction: Etiology of Pancreatitis continues to stir up controversy. The incidence of acute pancreatitis has been reported to vary around the world in different studies. The etiological profile of pancreatitis may be different in different parts of the world and it is therefore important that experiences from different parts of the country be recorded. Alcohol was once thought to be most common etiology. Recent studies in western countries show that non-alcoholic causes include more than 50% of causes of pancreatitis. Aim: The aim this study was to know the etiological factors of pancreatitis and to compare the serum amylase, lipase levels in alcoholic and non- alcoholic patients. Materials and methods: This was a prospective observational study conducted in Gandhi Medical College and Hospital, Secunderabad from December 2012 to November 2014 with duration of 2 years. 75 patients were included in this study according to inclusion and exclusion criteria. Detailed history along with physical examination and laboratory investigations for confirmation of diagnosis and etiology were done. Results: In the present study, out of 75 cases, 40 had significant history of alcohol consumption, while 35 were found to be non-alcoholics. The age group of patients in our study was from 18yrs to 62 years. 20 out of 45 alcoholics were less than 40 years old while 21 out of 35 non alcoholics were less than 40 years old. Out of the 75 cases, 51 were males while 24 were females. In our study alcohol causes pancreatitis in 60% of the cases while non-alcoholic causes of pancreatitis included 40% of cases. Mean amylase, mean lipase and amylase: lipase ratio values were raised more in alcoholics than non-alcoholics. Recurrent pancreatitis was also observed in alcoholics than non-alcoholics. N L Varunmai, Mudumala Issac Abhilash, M Uma Devi, P Shravan Kumar. Incidence and etiology of pancreatitis among alcoholic and non-alcoholic patients. IAIM, 2017; 4(5): 117-121. Page 118 Conclusion: Within limitations of this study, concluded that alcohol remains to be most common cause of pancreatitis in south India (Telangana), incidence of recurrent pancreatitis was significantly high in alcoholics and Serum lipase: amylase ratio more in alcoholics than non-alcoholics.
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Introducción: La cetoacidosis diabética (CAD) es una complicación metabòlica aguda que afecta a los pacientes diabéticos. Las anormalidades metabólicas propias de la CAD favorecen el incremento de los niveles de lipasa y amilasa, así como la formación de cuerpos cetónicos, lo que empeora el estado de acidosis y el desequilibrio hídroelectrolítico. Estas alteraciones, aunadas a las manifestaciones clínicas asociadas a la CAD, son fuente de interpretación errónea con cuadros de abdomen agudo. Aunque no se conoce un significado clínico claro, los niveles de hiperlipasemia parecen variar en función de la severidad de la CAD, por lo que en el presente estudio exploramos esta posible correlación. Material y métodos: Estudio observacional con diseño transversal analítico y comparativo, que incluyó a pacientes de medicina interna en los hospitales generales de Xoco, Balbuena y Ticomán, de la Secretaría de Salud del Distrito Federal, con diagnóstico de CAD, distintos niveles de lipasa y en ausencia de pancreatitis aguda, patología gástrica o de glándula parótida. El grado de severidad de CAD se determinó con base en la información del expediente clínico. Se consideró hiperlipasemia con un valor de lipasa > 38 Ul/l). Resultados: Se incluyó a 45 pacientes con CAD, de los que se excluyó a 4. Los 41 pacientes estudiados, se dividieron en 3 grupos de acuerdo a la severidad de la CAD. La prevalencia general de hiperlipasemia fue de 51.2%, con una distribución de 42.8, 33.3 y 23.9%, entre la población con CAD leve, moderada y severa, respectivamente. Se encontró que los niveles de lipasa de los grupos de CAD leve y severa eran distintos, pero no hubo diferencia al considerar únicamente la población que mostró hiperlipasemia. Se encontró una correlación inversa, aunque baja, entre la severidad de CAD y los niveles de lipasa sérica (r = -0.37, IC del 95%, -0.07 a -0.6; p = 0.01), así como una relación de la lipasa con el pH (r = 0.3), el HCO3 (r = 0.3) y la brecha aniónica (r = -0.23), de acuerdo al análisis de regresión múltiple. Este estudio sugiere que la presencia de hiperlipasemia carece de valor como marcador de severidad de la CAD. Conclusión: Existe una tendencia a la relación inversa entre los niveles lipasa y la severidad de la CAD, que a la luz del conocimiento actual no se puede dar un valor significativo para la interpretación clínica.
Introduction: Diabetic ketoacidosis (DKA) is an acute metabolic complication which affects diabetic patients. DKA metabolic abnormalities promote the increase of lipase and amylase serum levels, as well as the overproduction of ketone bodies, worsening the acidosis state and hydroelectrolytic balance. These abnormalities, together with the clinical features associated with DKA are potential sources for misinterpreting the symptoms as acute abdomen. Although the clinical meaning is unclear, hyperlipasemia levels seem to vary according to the severity of DKA; hence, this likely correlation is assessed in this study. Material and methods: Observational cross-sectional analytic comparative study, including internal medicine patients from the following general hospitals: Xoco, Balbuena and Ticomán (SSDF). The patients were diagnosed with DKA, showing different lipase levels with no acute pancreatitis, gastric and/or parotid gland pathology. The severity of DKA was assessed based on the clinical record. Hyperlipasemia was considered as a lipase serum level of >38 UI/L. Results: Forty-five patients with DKA were included and 4 were excluded. The 41 patients studied were divided in 3 groups according to their DKA severity. The general prevalence of hyperlipasemia was 51.2%, with a distribution of 42.8%, 33.3% and 23.9% among patients with mild, moderate and severe DKA, respectively. Lipase levels between the groups with mild and severe DKA were different; however, no difference was found when comparing only patients showing hyperlipasemia. Furthermore, a low inverse correlation was found between DKA severity and serum lipase levels (r=0.37), HCO3 (r=0.3) and anion gap (r=0.23), according to multiple regression analysis. This study suggests that the presence of hyperlipasemia is not a good marker to indicate the severity of DKA. Conclusion: Lipase levels and DKA severity show an inverse correlation, which, according to current knowledge, should have no significant value for clinical interpretation.
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Critically ill children are often complicated with multiple organ damage. When the pancreas was involved, kinds of pancreatic enzymes would elevate, which suggested the high risk complication of pancreatic damage was really existed. The changes of pancreatic enzymes under different critical conditions such as shock, surgery, injury, etc. were reviewed, as well as the clinical significance of different pancreatic enzymes, so as to provide evidence for acknowledge the early biological signs in early phase of critically ill children with pancreatic damage,to decrease the mortality of complications and to improve the prognosis of critically ill children.