Comparison of BISAP score with Ranson's score in determining the severity of acute pancreatitis

To determine the accuracy of BISAP score in finding out the frequency of severity and mortality in patients with acute pancreatitis by comparing it with Ranson's score. Crosse-sectional study. Department of Surgery, Pakistan Institute of Medical Sciences, Islamabad, from April to December 2010. A total of 80 patients who presented in emergency with acute pancreatitis were included by consecutive non probability sampling technique. Cases of acute pancreatitis were classified as mild or severe based on the organ failure criteria and/or local complications according to the Atlanta Symposium. All patients were scored according to both Ranson's score and BISAPscore. Out of 80 patients, 35 [44%] were males and 45 [56%] were females. The mean age was 46.89 +/- 15.75 years. Twenty five patients [31.25%] were classified as severe acute pancreatitis and 3 patients [3.75%] had evidence of pancreatic necrosis on CT scan. The duration of hospital stay was 1 - 54 days with a mean of 13.12 +/- 12.83 days and mortality rate was 5%. The number of patients with a BISAPscore of >/=3 was 15 and Ranson's score >/=3 was 25. The observed incidence of severe disease stratified by the BISAP score has [p < 0.001] and by Ranson's score has [p < 0.001]. In regards to mortality, patients having BISAPscore >/=3 has p=0.003, while patients having Ranson's score >/=3 has p=0.002, both are statistically significant. The newly proposed BISAP score is a simple and accurate tool for severity stratification and is equally effective in finding out frequency of severity and in turns mortality in patients with acute pancreatitis as Ranson's score

Mesenteric lipoma leading to small gut strangulation and short gut syndrome

A rare case of mesenteric lipoma was presented to us as acute abdomen. His abdominal x-ray showed dilated small gut. Ultrasonography of abdomen revealed dilated small gut loops and minimal amount of free fluid in the peritoneal cavity. On exploration, most of the small gut was gangrenous and tightly twisted twice around its mesentery that contained a lump which was confirmed as lipoma on histopathology