CT FINDINGS OF ACUTE PANCREATITIS IN MAHARAJ NAKORN CHIANG MAI HOSPITAL
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Date
2007-11-30
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Chiang Mai Medical Journal
Abstract
Purpose: To retrospectively review etiologies, CT findings, complications and correlation between the CT severity index (CTSI) and length of hospital stay (LOS) in the patients with acute pancreatitis in Maharaj Nakorn Chiang Mai Hospital.
Materials and methods: Ninety one patients with a diagnosis of acute pancreatitis were recruited from the Maharaj Nakorn Chiang Mai Hospital database from October 2003 to June 2005. The etiologies of acute pancreatitis were collected from medical records. Fifty patients underwent CT scans in the hospital. The CT findings were analyzed. All patients were grouped into mild, moderate and severe pancreatitis using the currently accepted CTSI, developed by Bathazar et al. Correlation between CTSI and LOS was calculated by ANOVA and Sheffe methods using the SPSS program.
Result: The most common etiology of acute pancreatitis was alcohol ingestion, which presented in 30 patients (60%). By using the currently accepted CTSI, we graded the severity of acute pancreatitis as mild in 30 (60%), moderate in 16 (32%) and severe in 4 (8%) of the 50 patients. The most common extrapancreatic abnormality was pleural effusion; which accounted for 29 (58%) of the 50 patients. Complications of pancreatitis were as follows; pancreatic abscess in 6 patients (12%), infected pancreatic necrosis in 2 (4%), pancreatic pseudocyst in 4 (8%), venous thrombosis in 8 (16%) and splenic infarction in 1 patient (2%). When comparing LOS between groups, there was a significant difference in LOS between the mild and moderate pancreatitis groups (p=0.04) and between the mild and severe pancreatitis groups (p=0.001), but there was no significant difference in LOS between the moderate and severe pancreatitis groups (p=0.078).
Conclusion: The most common etiology of acute pancreatitis in Maharaj Nakorn Chiang Mai Hospital is alcohol ingestion. Most of the patients with acute ancreatitis are in the mild group. The most common complication is venous thrombosis. The grading of pancreatitis could be graded in mild and severe acute pancreatitis groups, which correlated well with patient outcome.
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Chiang Mai Medical Journal; Vol.46 No.2 June 2007 (pages 45 - 91); 45 - 53