RESUMO
INTRODUCTION: Acute pancreatitis is a local inflammatory process that could be generalized by producing mild to severe gastroenteral manifestations, like multiple organ dysfunction and death. OBJECTIVE: To describe epidemiological, clinical, therapeutical characteristics and evolution of patients with AP of our unit and to compare with other studies of Peru and other countries. MATERIALS AND METHODS: We realized a review of all cases with AP treated in ICU-INCU of Victor Lazarte Echegaray Hospital over 1 degrees January of 2004 to April, 30 of 2007. RESULTS: At the time of this study were admitted 40 patients with AP, just 36 clinics records were recovered, 24 of these were Severe Acute Pancreatitis (SAP) and 12 were Mild Acute Pancreatitis (MAP). Age mean was 55+/-16.7 years old (range 27-84 y.o.), male and female had equal predominance 18 (503). Biliar compliances were the most frequent etiology with 26 cases (72.2%). All patients (100%) had abdominal pain, 34 de 36 cases (94.4%) had nauseas and/or vomits. Seric amylase mean was 2580+/-1507.1 UA/L (range 380-6883 UA/L). Ranson score was 2.92+/-1.97 points (range 0-6 points) and APACHE II score was 11.86+/-8.27 points (range 0-31 points). Computed Tomography was realized in 22 patients with Tomography Severity Index mean was 4.41 +/- 2.79 points (range 0-10 points). Four patients with SAP (16.6%) developed pancreatic pseudocyst. Respiratory dysfunction was the systemic complication most frequent with 36.1% patients of all (13/36 cases), eight patients had multiple organ dysfunction. No patients with MAP dead. Eleven of 36 patients (30.6%) received prophylactic antibiotics. Length of stay in hospital and ICU-INCU were 7.7+/-5.3 days (range 1-26 days) y 14.8+/-9.7 days (range 1-53 days). Two patients with SAP were performed to surgery after AP was detected: one case was cholecystectomized for perfored pyocholecist and other one was cholecystectomized and drain of choledoco; no one of these dead. CONCLUSION: Epidemiological, clinical, therapeutical characteristics and evolution of the patients with AP were similar to the majority of national and international reports.
Assuntos
Pancreatite , Doença Aguda , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Hospitais , Humanos , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Pancreatite/diagnóstico , Pancreatite/epidemiologia , Pancreatite/terapia , PeruRESUMO
INTRODUCCIÓN. La pancreatitis aguda (PA) es un proceso inflamatorio localizado que puede generalizarse produciendo disfunción multiorgánica y fallecimiento del paciente. OBJETIVO. Describir las características epidemiológicas, clínicas, terapéuticas y evolución de los pacientes con PA de nuestra unidad y compararlos con los descritos en la literatura nacional e internacional. MATERIAL Y MÉTODOS. Se realizó una revisión de los casos de PA manejados en la UCI-UCIN del Hospital Víctor Lazarte Echegaray Hule durante el periodo 1° de Enero del 2004 al 30 de Abril del 2007. RESULTADOS. Se hospitalizaron 40 pacientes con PA, recuperando 36 historias clínicas, 24 tuvieron PA Grave (PAG) y 12 tuvieron PA Leve (PAL). La edad promedio de los pacientes fue 55 ± 16,7 años (27-84 años), siendo similar el número de pacientes varones y mujeres (18o). La etiología predominante fue biliar con 26 casos (72,2%). El 100% de los pacientes tuvo dolor abdominal estando en 94,4% (34/36 casos) asociado a nauseas y vómitos. El valor promedio de la amilasa sérica fue de 2580 ± 1507,1 UA/L (380-6883 UA/L). El score de Ranson promedio fue 2,92 ± 1,71 puntos (0-6 puntos) y el score APACHE II fue 11,86 ±8,27 puntos (0-31 puntos). La Tomografía contrastada fue realizada a 22 pacientes, el Índice de Severidad Tomográfica promedio fue 4,41 ± 2,79 puntos (0-10 puntos). Se identificó pseudoquiste pancreático en 4 pacientes con PAG (11,1 por ciento). La disfunción respiratoria fue la complicación sistémica más frecuentemente encontrada en 36,1% (13/36 casos). La disfunción multiorgánica (DMO) se encontró en 8 pacientes (22,2%), todos con PAG. La mortalidad fue de 4 casos (11,1%) de los 36 revisados; los 4 ingresaron con DMO de 4 a más órganos. CONCLUSIÓN. Las características epidemiológicas, clínicas, terapéuticas y evolución de los pacientes con PA fueron semejantes a los descritos en la mayoría de los reportes nacionales e internacionales.
INTRODUCTION. Acute pancreatitis is a local inflammatory process that could be generalizedby producing mild to severe gastroenteral manifestations, like multiple organ dysfunction anddeath. OBJECTIVE. To describe epidemiological, clinical, therapeutical characteristics and evolution ofpatients with AP of our unit and to compare with other studies of Peru and other countries. MATERIALS AND METHODS. We realized a review of all cases with AP treated in ICU-INCU ofVictor Lazarte Echegaray Hospital over 1° January of 2004 to April, 30 of 2007.RESULTS. At the time of this study were admitted 40 patients with AP, just 36 clinics records were recovered, 24 of these were Severe Acute Pancreatitis (SAP) and 12 were Mild AcutePancreatitis (MAP). Age mean was 55 ± 16,7 years old (range 27-84 y.o.), male and female had equal predominance 18 (503). Biliar compliances were the most frequent etiology with 26 cases(72,2%). All patients (100%) had abdominal pain, 34 de 36 cases (94,4%) had nauseas and/orvomits. Seric amylase mean was 2580 ± 1507,1 UA/L (range 380-6883 UA/L). . Two patients with SAP were performed to surgery after AP was detected: one casewas cholecystectomized for perfored pyocholecist and other one was cholecystectomizedand drain of choledoco; no one of these dead.CONCLUSIÓN. Epidemiological, clinical, therapeutical characteristics and evolution of thepatients with AP were similar to the majority of national and international reports.