INTRODUCTION:
Acute pancreatitis is an inflammatory disease ranging from mild self- limiting course to a fulminant phase with multiple organ failure and mortality. It occur in two forms, 80% of patients develops edematous pancreatitis and 20% manifest as acute necrotising pancreatitis. The average mortality rate for edematous type is < 1% and necrotising type ranges from 10-20%. Patients with mild type managed with aggressive fluid resuscitation and supportive care. Severe AP may require maximal non operative care and nutritional support. Severe AP is divided into two-phase systemic disease. In the early phase (Within initial 2 weeks) development of pancreatic inflammation and necrosis, followed by systemic inflammatory response syndrome (SIRS) ultimately leading to multiple organ dysfunction syndromes (MODS). Mortality is high due to MODS. If the early phase is not corrected by therapeutic intervention, then late phase occurs after the second week of onset, and includes the formation of infected pancreatic necrosis or fluid collection with possible progression to overt sepsis, MODS and death. Organ failure is present in only half of the patients with pancreatic necrosis. The mortality rate for MODS ranges from 30 to 100%. Respiratory failure is the most common type of organ failure in AP. Increasing knowledge of the importance of proinflammatory and anti-inflammatory cytokine helps in development of anti-inflammatory therapy which is beneficial.
AIMS OF THE STUDY:
1. To correlate and analyse the various clinical presentations of acute pancreatitis.
2. To predict the severity of acute pancreatitis with available clinico biochemical parameters.
3. To assess the severity in relation to serum C REACTIVE PROTEIN.
4. To prognosticate and assess the severity of the disease.
5. To predict the outcome of acute pancreatitis with regard to serum CRP.
MATERIALS & METHODS:
54 patients are included in this study who presented with acute pancreatitis in the department of surgical emergency, Thanjavur medical college during the period of October 2015- August 2016.
STUDY DESIGN:
Prospective study from October 2015- August 2016.
INCLUSION CRITERIA:
Patients diagnosed as acute pancreatitis irrespective of sex and age over 25 years.
EXCLUSION CRITERIA:
1. Patient age < 25 years.
2. Patient diagnosed as chronic pancreatitis.
3. Withdrawl / refusal to consent.
CONCLUSION:
1. Serum CRP is the important single prognostic marker of predicting the severe pancreatitis with the cut off value of 150mg/L.
2. CRP levels increase significantly in early stages of pancreatic necrosis.
3. CRP plays a critical role in initial process of diagnosis, as an early predictive indicator of severity of the disease and helps in detecting the mortality in this study.
4. Serum CRP plays a major role in stratifying the patients for early aggressive intervention of acute pancreatitis to reduce morbidity and mortality
