Obesity as a risk factor for severe acute pancreatitis patients.

BACKGROUND: Obesity plays an important role in increasing the risks of cardiovascular diseases, metabolic diseases, and death. Controversy persists concerning the degrees to which obesity influences mortality and morbidity in severe acute pancreatitis. MATERIALS AND METHODS: Between 2008 and 2012, the findings of 384 consecutive acute pancreatitis patients were analyzed in a prospective trial. Ranson's scores, Acute Physiology And Chronic Evaluation II scores, and computed tomography severity indexes were calculated. Patients were categorized by body mass index (BMI) and waist circumference for the analysis. The aim of this study was to investigate the influence of obesity on local and systemic complications as well as on mortality in severe acute pancreatitis patients. RESULTS: Severe acute pancreatitis was confirmed in 91 (23.7 %) patients. Local and systemic complications were recorded in 64 (16.7 %) and 51 (13.3 %) patients, respectively. Obesity calculated by BMI was identified as a significant risk factor for local and systemic complications (p < 0.02 and p < 0.03, respectively). Moreover, in this study, obesity was also categorized by waist circumference and was confirmed as a risk factor (p < 0.01). The overall mortality rate was 2.4 %, i.e., nine patients died. This study indicates that obesity can have a statistically significant influence on the mortality of severe acute pancreatitis patients. CONCLUSIONS: The presence of obesity has a negative impact on the survival rate of severe acute pancreatitis patients. Obese patients have higher incidence of local and systemic complications. Obesity seems to be a negative prognostic factor in severe acute pancreatitis patients.

Intrapancreatic accessory spleen. A case report and review of literature.

CONTEXT: Accessory spleen is a congenital focus of healthy splenic tissue that is separated from the main body of spleen. Although an accessory spleen usually appears as an isolated asymptomatic abnormality, it may have clinical significance in some situations. CASE REPORT: We report the case of 53-year-old woman with a 2-year history of upper abdominal discomfort after meals and weight loss. The pathologic lesion was diagnosed by the abdominal sonography and the magnetic resonance tomography in the pancreatic tail. The patient was operated with suspicion of a solid pseudopapillary neoplasm or a nonfunctioning islet cell tumor. Histopathological examination found an intrapancreatic accessory spleen, which is a congenital abnormality consisting of normal splenic tissue in ectopic sites. CONCLUSION: We present possibilities of differential diagnosis of this entity.

Perioperative and follow-up results in chronic pancreatitis patients after pancreatic resection.

BACKGROUND/AIM: Surgical therapy for chronic pancreatitis is reserved for patients with intractable abdominal pain, complications of the disease, or suspected underlying carcinoma. Pancreatic resection can be performed safety with good postoperative results. METHODS: Between January 1996 and December 2009, the findings for 90 consecutive patients suffering from chronic pancreatitis were analyzed in prospective trial. Short-term results - postoperative complications were investigated 30 days after surgery. Long-term follow-up results, including quality of life (QoL) assessment using visual analog scale of pain (VAS), Karnofsky performance scale (KPS), and EORTC Quality of Life Questionnaire (QoL-C30) were carried out. The influence of postoperative complications on long-term quality of life was documented. RESULTS: The overall mortality rate and morbidity rate were 3.3% (3 patients) and 27.7% (25 patients), respectively. Surgically related morbidity rate was 21.1% (19 patients). Long-term follow-up was investigated in 65 patients (72%). The median pain score decreased using VAS from 8 to 1 and using KPS increased from 50 to 100 (p < 0.0001). During the follow-up, the median global QoL improved by 100%. Apart from the cognitive functioning, the physical status, working ability, and emotional and social functioning all improved significantly (p < 0.0001). The presence of postoperative complications had no significant influence on long-term quality of life. CONCLUSION: Surgery for patients with chronic pancreatitis can be performed safely with minimal morbidity and very good long-term results.