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Chronic pancreatitis with Numerous Exacerbations - Surprising Final

100%

Łaski D., Hać S., Smoczyński M.

Polish Journal of Surgery

2010

vol. 82

issue 6

362-366

The authors presented a case of 62-year old caucasian race male patient that was repeatedly admitted to hospitals, in 3 last years, with exacerbations of the chronic pancreatitis. During two last hospitalisations, according to the ERCP examination and high level of CEA and Ca 19.9 in pancreatic juice, a hypothesis of IPMN was put. Patient underwent a distal pancreatectomy with splenectomy. Postoperative specimen examination revealed dilated Wirsung duct in distal part of the pancreas. Small cysts and multiple papillas in the lumen of MPD were found. Microscopy reveal Intraductal Papillary Mucinous Neoplasm with medium grade dysplasia without cancer.When we confronted the reported case with available literature, we found that IPMN is not a frequent cause of recurrent pancreatitis, but those patiets require separate treatment strategy to other chronic pancreatitis patients.

Epidemiological Characteristic of Acute Pancreatitis in Trzebnica District

88%

Bogdan J., Elsaftawy A., Kaczmarzyk J., Jabłecki J.

Polish Journal of Surgery

2012

vol. 84

issue 2

70-75

Acute pancreatitis is one of the most common surgical disease, and thus cause of hospitalization. Incidence and etiology of this condition demonstrates large regional differences. This situation is a substantial financial burden forhospital district, and changes in organization structure and funding medical service should be taken under consideration.The aim of the study was to record the epidemiology with etiology, diagnosis and treatment of acute pancreatitis in large district (77 000 inhabitants).Material and methods. A meta-analysis study of all 298 patients admitted to Hospital St Hedwig in Trzebnica, in the six-year period from 2005 to 2010, with acute pancreatitis was performed.Results. Acute pancreatitis was diagnosed in 298 patients in the six - year period, giving an estimated incidence of 64.4 per 100 000. Among the group of 441 admissions for acute pancreatitis in 298 patients was confirmed. Severe acute pancreatitis developed in 22.5% (67/298) of patients, more often in males 56/208 (27%) than in females 11/90 (12%). Gallstones were found as an etiological factor in 27% (80/298), and alcohol intake in 49% of patients. 211/298 (70%) patients had only one attack, whereas 29% (87/298) were readmitted with 230 relapses. The risk of recurrent pancreatitis was 48% in alcohol induced and 6,25% in gallstone induced pancreatitis. 53/298 patients (17%) were operated, ERCP procedures were performed in 24.Performed operations: necrosectomy in 25/53 (47%), elective cholecystectomy in 16/53 (30%), open drainage of abdominal abscess in 5/53 (9%), open drainage of cysts in 5/53 (9%), Jurasz's operation in 2/53 (3%). Majority surgical treatment was carried out in 68% cases with severe acute pancreatitis. Mortality due to acute pancreatitis was 3% (10/298); 15% in severe pancreatitis.Conclusions. 1. Acute pancreatitis continues to be an important clinical problem. 2. Severe, necrotic acute pancreatitis is associated with high mortality rates. 3. The ethanol-intake-related episodes of acute pancreatitits are much more prevalent than the gall-stone-related ones. 4. After the exclusion of ethanol- and gall-stones-related etiologies, the subsequent diagnostic process should aim at excluding neoplastic process of the head of pancreas.

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2 Polish Journal of Surgery

1 2012

1 2010

1 Bogdan J.

1 Elsaftawy A.

1 Hać S.

1 Jabłecki J.

1 Kaczmarzyk J.

1 Smoczyński M.

1 Łaski D.

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Chronic pancreatitis with Numerous Exacerbations - Surprising Final

Epidemiological Characteristic of Acute Pancreatitis in Trzebnica District