Etiology, clinical profile and outcome of acute pancreatitis in a tertiary care teaching hospital in rural South India: a ten year retrospective study

Abstract

Background: Acute pancreatitis is a complex condition with diverse local and systemic complications, dealt by the surgeons all over the world. There were no previous detailed studies regarding the etiology, clinical profile and outcome of acute pancreatitis in rural Kerala.Methods: This is a hospital based study by retrospective chart analysis of all acute pancreatitis cases from the past 10 years in this tertiary care centre which have clinical/ laboratory/ radiological findings suggestive of acute pancreatitis.Results: Among 436 cases studied 318 (72.9%) were males and 118 (27.1%) were females. Epigastric pain without radiation to the back (51.6%) was the most common clinical presentation. Alcohol was the most common etiological factor seen in 42.4% followed by idiopathic pancreatitis (IP) (36.9% cases) and then by gallstone/biliary pancreatitis (14.5%). Acute fluid collection was the most common local complication seen in 29.1% cases and respiratory system involvement was the most common organ involvement seen in 16.5% of cases.Conclusions: Epigastric pain without radiation to the back was the most common clinical presentation. Incidence of alcoholic pancreatitis (42.4%) and idiopathic pancreatitis (36.9%) was slightly higher in our study, which should prompt us to look with further studies for identifiable new aetiologies in the idiopathic group. This work provides the first known regional description of the etiology, clinical profile and outcome of acute pancreatitis. Due to institutional and population similarities, this may represent the status of developing countries in general. This will help in formulating a hospital policy which would be beneficial.