ASSESSMENT OF SPECTRUM OF PULMONARY DYSFUNCTION IN ACUTE PANCREATITIS
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Keywords
Acute Pancreatitis, Pulmonary dysfunction, Spectrum, Etiology
Abstract
Background: Acute pancreatitis (AP) has long been considered as the cause of pulmonary dysfunction and multi-organ failure, which contribute to 20% cases with increasing rate of mortality.
Objective: The objective of the current study was to assess the spectrum of pulmonary dysfunction in acute pancreatitis patients.
Methodology: This prospective study was carried out on 72 patients admitted for acute pancreatitis in the General Surgical unit in collaboration of Medicine and Gastroenterology Department of Mardan Medical Complex Mardan, kpk,Pakistan from January 2021 to December 2021. Individual diagnosed of acute pancreatitis based on elevated serum amylase level, clinical findings, and computed tomography (CT) were enrolled. Pancreatitis severity was evaluated based on computed tomography severe index (CTSI). All the patients underwent Chest X-rays and Arterial blood gas analysis. SPSS version 27 was used for data analysis.
Results: The overall mean age was 38.96±16.4 years with an age range 16-70 years. The CSTI mean value (mean ± SD) was 8.20±2.29. There were 56 (77.8%) male and 16 (22.2%) female. Gallstones was the most prevalent etiology of AP found in 48 (66.7%) followed by trauma 10 (13.9%), infections 6 (8.3%), metabolic disorders 5 (6.9%), and idiopathic 3 (4.2%). The incidence of mild (PaO2 between 60 and 75 mmHg), moderate (PaO2 between 40 and 60 mmHg), and severe (<40 mmHg) hypoxemia during presentation at hospital was 32 (44.4%), 10 (13.9%), and 7 (9.7%) respectively. Pleural effusion was the most prevalent respiratory complication found in 38 (52.8%) followed by acute respiratory distress syndrome (ARDS) 17 (23.6%), atelectasis 11 (15.3%), and pulmonary infiltrates 6 (8.3%). The prevalence of >50% necrosis, 30-50% necrosis, <30% necrosis, and no necrosis was 35 (48.6%), 5 (6.9%), 17 (23.6%), and 15 (20.8%) respectively.
Conclusion: Hypoxemia at initial presentation is associated with cardio-renal dysfunction throughout disease progression and is a poor prognostic indicator. Gallstones was the most prevalent etiology of AP. Individuals with over 50% necrosis experienced delicate pulmonary dysfunction and required ventilator support.
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Muhammad Ismail
Consultant surgery Department BKMC, Mardan, Kpk
Aurangzeb Khan
Assistant professor of surgery Unit B Bacha Khan Medical College Mti Mardan Medical Complex Mardan
Abbas Ali raza
Senior registrar surgery Department BKMC, Mardan, Kpk
Muhammad Kashif
Associate Professor GKMC/BKMC, Swabi, Kpk