Acute pancreatitis: a clinical study in some toxicity with helical computed tomography

ABSTRACT

This study was conducted on 15, 48, 23 patients exposed to scorption sting, anticholinesterase insecticide, and methanol intoxication respectively with total number of 86 patients admitted to Poison Control Centre, Ain Shams University Hospitals, Cairo Egypt. On admission, and on discharge, serum amylase, and serum lipase, in addition to pseudo-cholinesterase [butyryl cholinesterase Bu-ChE], blood pH, and blood bicarbonate were determined and compared with those of normal control subjects. Abdominal ultrasonography and helical computed tomography [CT] were performed for cases with increased serum amylase and lipase. Acute pancreatitis was diagnosed in 6, 20, and 8 patients exposed to scorpion sting, anticholinesterase insecticide, and methanol intoxication respectively. All those patients demonstrated significantly elevated serum amylase, and lipase levels when compared with control group and other patients. Helical Computed Tomography [CT] showed findings suggestive of acute pancreatitis in 31 patients [91%]. There was a significant correlation between developing acute pancreatitis and severity of toxicity. Pancreatic necrosis, estimated on early, contrast-enhanced CT and seen only in patients with severe manifestations, was a specific predictor of morbidity. The present study showed that acute pancreatic injury might be more common than was previously thought. So, it is suggested that diagnosis of acute pancreatic injury should be considered in such cases to avoid deterioration and improve prognosis