Clinical features of patients with painless acute pancreatitis / 中华胰腺病杂志

ABSTRACT

ObjectiveTo investigate the clinical features of patients with painless acute pancreatitis ( AP),and to improve the diagnosis accuracy of painless AP.MethodsThe clinical data of 12 patients with painless AP were retrospectively collected from January 2007 to January 2011.Results The mean age of patients with painless AP was 52 years old.Seven (58.3％) patients complained of abdominal distension and discomfort,4 (33.3％) patients complained of nausea and vomiting,abdominal tenderness occurred in 7(58.3％ ) patients.Serum levels of lipase and amylase was increased in 11 (91.7％) and 8 (66.7％)patients,respectively.The diagnostic accuracy of abdominal ultrasound and CT for AP was 58.3％ and 91.7％,respectively.Five (41.7％) patients were diagnosed to have AP upon admission,and 4 patients were misdiagnosed to have non-digestive diseases.There were 7 severe AP patients among the 12 painless AP patients,and the percentage was significantly higher than that in AP patients with pain (65/327,x2 =7.30,P ＜ 0.05).Painless AP patients needed longer hospital stay when compared with that of AP patients with pain [ ( 20.4 ± 9.1 ) d vs.( 12.9 ± 6.2) d,t =2.296,P ＜ 0.05 ) ].ConclusionsThe misdiagnosis rate of painless AP is high and patients with painless AP are in critical situation,and early measurement of serum levels of lipase and amylase,as well as CT scan is important for correct diagnosis.