Shrestha SK, Jha IK, Vaidya Anira


INTRODUCTION: Acute pancreatitis is common disease presenting in emergency department. Biliary calculus and alcohol consumption are most common etiologies. Detection of biliary etiology is important because the endoscopic retrograde cholangiopancreatography associated with endoscopic sphincterotomy can prevent further complications in patients with severe biliary pancreatitisand also in order to provide definite management in form of cholecystectomy to prevent further attacks. The majority of patients experience a mild course of the disease, with no need for immediate invasive intervention.In order to aim for early endoscopic decompression early detection of gallstones and determination of the severity of acute pancreatitis is essential. Differences in biochemical investigations of acute biliary and non-biliary pancreatitis have been observed and have been used to project the etilogy of pancreatitis.

OBJECTIVES: To find out and compare biochemical parameters in acute biliary and non-biliary pancreatitis and to correlate the parameters with the biliary etiology

METHODS: It is a prospective study carried out in Bir Hospital for 1 year and 3 months period. All admitted cases of AP were included in the study. Data analysis was done using SPSS 20.Fifty nine patients admitted with diagnosis of acute pancreatitis from October 2013 to December 2014 were included in the study. The relation between etiology with age, sex, admission serum amylase and total bilirubin. direct bilirubin, AST, ALT, ALP, LDH, serum amylase  were evaluated.

RESULTS: Out of 59 patients 38(64.4%) and 21(35.6%) had biliary and non-biliary etiology respectively. Biliary pancreatitis was distributed  more in females but not significant (16 vs 22). Distribution of severity was comparable between both groups. Biliary pancreatitis group had significantly higher amylase level(2032 IU vs 855IU, p 0.002) whereas values of liver function test were higher in biliary pancreatitis though not statistically significant.

CONCLUSIONS: A simple and approximate prediction of biliary etiology of acute pancreatitis can be obtained from biochemical parameters especially serum amylase.


biliary, amylase, acute pancreatitis,severity

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