Acute pancreatitis, severity scores, and management according to the new recommendations: A series of 356 cases in Morocco
Zerhouni, Ahmed
Acute pancreatitis, severity scores, and management according to the new recommendations: A series of 356 cases in Morocco - 2024.
5
Acute pancreatitis (AP) is an acute inflammatory process involving the pancreas, the incidence of which is increasing, and the management of which requires multidisciplinary intervention. We performed a prospective analysis of 356 cases of AP documented in the emergency and intensive care departments of the Hassan II teaching hospital in Fes over a 2-year period, from April 2017 to May 2019. The aim of this study was to analyze the epidemiological aspects of AP and to verify the reliability and feasibility of the new “systemic inflammatory response syndrome” (SIRS) score in assessing the severity of AP in our clinical setting. The diagnosis of AP was made on the basis of a clinical picture associated with lipase levels three times greater than normal in 91.5% of cases. Abdominal CT scans revealed a predominance of stage E AP (37.5%), according to the Balthazar criteria, followed by stage C (32.5%). Biliary etiology was predominant in 78.4% of cases. SIRS on admission was present in 48% of cases and was persistent beyond 48 hours in 18% of cases. All patients who developed a complication during AP were SIRS-positive at admission. The superinfection of the necrosis flows was present in 75.8% of patients SIRS persisting beyond 48 hours. Complications were mainly dominated by superinfection of necrosis flows, found in 15% of cases. According to the Atlanta classification, we found that medical treatment was initiated in all patients, while endoscopic and surgical treatment were much less common. In light of our study, it was concluded that the SIRS score is a simple, precise, and specific tool for predicting and evaluating the severity of acute pancreatitis, considering the drawbacks of other multifactorial scores.
Acute pancreatitis, severity scores, and management according to the new recommendations: A series of 356 cases in Morocco - 2024.
5
Acute pancreatitis (AP) is an acute inflammatory process involving the pancreas, the incidence of which is increasing, and the management of which requires multidisciplinary intervention. We performed a prospective analysis of 356 cases of AP documented in the emergency and intensive care departments of the Hassan II teaching hospital in Fes over a 2-year period, from April 2017 to May 2019. The aim of this study was to analyze the epidemiological aspects of AP and to verify the reliability and feasibility of the new “systemic inflammatory response syndrome” (SIRS) score in assessing the severity of AP in our clinical setting. The diagnosis of AP was made on the basis of a clinical picture associated with lipase levels three times greater than normal in 91.5% of cases. Abdominal CT scans revealed a predominance of stage E AP (37.5%), according to the Balthazar criteria, followed by stage C (32.5%). Biliary etiology was predominant in 78.4% of cases. SIRS on admission was present in 48% of cases and was persistent beyond 48 hours in 18% of cases. All patients who developed a complication during AP were SIRS-positive at admission. The superinfection of the necrosis flows was present in 75.8% of patients SIRS persisting beyond 48 hours. Complications were mainly dominated by superinfection of necrosis flows, found in 15% of cases. According to the Atlanta classification, we found that medical treatment was initiated in all patients, while endoscopic and surgical treatment were much less common. In light of our study, it was concluded that the SIRS score is a simple, precise, and specific tool for predicting and evaluating the severity of acute pancreatitis, considering the drawbacks of other multifactorial scores.
Réseaux sociaux