Published: 2019-09-26

Etiology, clinical profile and outcome of acute pancreatitis in a tertiary care teaching hospital in rural South India: a ten year retrospective study

Ramu R., Vergis Paul, Devipriya S., Nevil C. Philip


Background: Acute pancreatitis is a complex condition with diverse local and systemic complications, dealt by the surgeons all over the world. There were no previous detailed studies regarding the etiology, clinical profile and outcome of acute pancreatitis in rural Kerala.

Methods: This is a hospital based study by retrospective chart analysis of all acute pancreatitis cases from the past 10 years in this tertiary care centre which have clinical/ laboratory/ radiological findings suggestive of acute pancreatitis.

Results: Among 436 cases studied 318 (72.9%) were males and 118 (27.1%) were females. Epigastric pain without radiation to the back (51.6%) was the most common clinical presentation. Alcohol was the most common etiological factor seen in 42.4% followed by idiopathic pancreatitis (IP) (36.9% cases) and then by gallstone/biliary pancreatitis (14.5%). Acute fluid collection was the most common local complication seen in 29.1% cases and respiratory system involvement was the most common organ involvement seen in 16.5% of cases.

Conclusions: Epigastric pain without radiation to the back was the most common clinical presentation. Incidence of alcoholic pancreatitis (42.4%) and idiopathic pancreatitis (36.9%) was slightly higher in our study, which should prompt us to look with further studies for identifiable new aetiologies in the idiopathic group. This work provides the first known regional description of the etiology, clinical profile and outcome of acute pancreatitis. Due to institutional and population similarities, this may represent the status of developing countries in general. This will help in formulating a hospital policy which would be beneficial.


Acute pancreatitis, Etiology, Clinical profile, Outcome

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Beger HG, Rau BM. Severe acute pancreatitis: Clinical course and management. World J Gastroenterol. 2007;13(38):5043-51.

Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD, Sarr MG, et al. Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus. Gut BMJ. 2013;62:102-11.

Reid GP, Williams EW, Francis DK, Lee MG. Acute pancreatitis: A 7 year retrospective cohort study of the epidemiology, aetiology and outcome from a tertiary hospital in Jamaica. Ann Med Surg (Lond). 2017;20:103–8.

Vengadakrishnan K, Koushik AK. A study of the clinical profile of acute pancreatitis and its correlation with severity indices. Int J Health Sci (Qassim). 2015;9(4):410–7.

Beger HG, Büchler MW. Decision-making in surgical treatment of acute pancreatitis: operative or consecutive management of necrotizin pancreatitis. Theor Surg. 1986;1:61.

Beger HG, Krautzberger W, Bittner R, Block S. Results of surgical treatment of necrotizing pancreatitis. World J Surg. 1985;9:972-9.

Peery AF, Dellon ES, Lund J, Crockett SD, McGowan CE, Bulsiewicz WJ. Burden of gastrointestinal disease in the united states: 2012 update. Gastroenterology. 2012;143:1179-87.

Lee MG, Chung A, Miles A, Terry SI, Royes CA. Chronic pancreatitis in Jamaica. West Indian Med J. 1992;41:61-3.

Casas JD, Díaz R, Valderas G, Mariscal A, Cuadras P. Prognostic value of CT in the early assessment of patients with acute pancreatitis. Am J Roentgenol. 2004;182(3):569–74.

Barreto SG, Tiong L, Williams R. Drug-induced acute pancreatitis in a cohort of 328 patients. A single-centre experience from Australia. JOP J Pancreas. 2011;12(6):581-5.

Cappell MS. Acute Pancreatitis: Etiology, Clinical Presentation, Diagnosis, and Therapy. Med Clin N Am. 2008;92:889–923.

Raghuwanshi S, Gupta R, Vyas MM, Sharma R. CT Evaluation of Acute Pancreatitis and its Prognostic Correlation with CT Severity Index. J Clin Diagnos Res. 2016;10(6):TC06-11.

Banday IA, Gattoo I, Khan AM, Javeed J, Gupta G, Latief M. Modified computed tomography severity index for evaluation of acute pancreatitis and its correlation with clinical outcome: a tertiary care hospital based observational study. J Clin Diagnos Res. 2015;9(8):TC01.

Ahlawat V, Godara R. Clinical Study of Demographic Profile, Etiology, Severity and Outcome of Acute Pancreatitis in a Tertiary Care Teaching Hospital in Northern India. J Gastrointest Dig Syst. 2018;8:575.