Searching the Best Prognostic Factor in Out Come Evaluation in Patients With Acute Pancreatitis Admitted at Assiut University Hospitals
Searching the Best Prognostic Factor in Out Come Evaluation in Patients With Acute Pancreatitis Admitted at Assiut University Hospitals
Acute pancreatitis (AP) is rapid-onset inflammation of the pancreas that varies in severity
 from a self-limiting mild illness to rapidly progressive multiple organ failure. Statistics
 suggest that 10-20% of patients with AP develop severe AP (SAP),1 which usually has an
 unfavourable disease progression and is associated with a poor prognosis.

 The two most common and important causes of acute pancreatitis are gallstones (40-70%) and
 alcohol (25-35%) Gallstone pancreatitis is usually due to an obstructing stone in the
 pancreatic duct near the sphincter of Oddi . In alcohol-related pancreatitis, it is believed
 that the acinar cells of the pancreas are susceptible to damage by ethanol and underlie the
 etiology of the disease . Another common cause, iatrogenic pancreatitis, may occur after
 endoscopic retrograde cholangiopancreatography (ERCP) in up to 5% of patients. Other
 etiologies of acute pancreatitis include medications, infections, trauma, hereditary,
 hypertriglyceridemia and autoimmune disease.
Acute pancreatitis (AP) is rapid-onset inflammation of the pancreas that varies in severity
 from a self-limiting mild illness to rapidly progressive multiple organ failure. Statistics
 suggest that 10-20% of patients with AP develop severe AP (SAP),1 which usually has an
 unfavourable disease progression and is associated with a poor prognosis. (Banks PA,
 Bollen,et al.).

 The two most common and important causes of acute pancreatitis are gallstones (40-70%) and
 alcohol (25-35%) (Tenner S et al., 2014) Gallstone pancreatitis is usually due to an
 obstructing stone in the pancreatic duct near the sphincter of Oddi ( Bhatia M et al .,2005).
 In alcohol-related pancreatitis, it is believed that the acinar cells of the pancreas are
 susceptible to damage by ethanol and underlie the etiology of the disease ( Tonsi AF et al .,
 2009). Another common cause, iatrogenic pancreatitis, may occur after endoscopic retrograde
 cholangiopancreatography (ERCP) in up to 5% of patients. Other etiologies of acute
 pancreatitis include medications, infections, trauma, hereditary, hypertriglyceridemia and
 autoimmune disease.

 According to the American College of Gastroenterology, a patient must have two of the
 following three features present to make a diagnosis of acute pancreatitis The diagnostic
 criteria used for acute pancreatitis includes:

 1. Clinical criteria - history of pain in abdomen radiating to the back and relieved on
 bending forward associated with tenderness/guarding in the upper abdomen.

 2. Radiographic evidence - Computed Tomography findings suggestive of acute pancreatitis
 such as pancreatic edema, pancreatic necrosis, peripancreatic fluid collections

 3. Biochemical - Serum amylase concentration greater than 180 Somogyii units (by the
 Somogyii method).
Inclusion Criteria:

 -  100 patients with acute pancreatitis admitted at Assiut university hospital and the
 diagnosis of acute pancreatitis is confirmed if at least two of the following three
 features present:

 1. abdominal pain characteristic of acute pancreatitis.

 2. serum amylase and/or lipase greater than 3 times the upper limit of normal .

 3. radiographically demonstrated acute pancreatitis on CT scan or abdominal
 ultrasound.

 Exclusion Criteria:

 1. Patients are excluded from the study if they do not meet the criteria for acute
 pancreatitis

 2. Patients who are under the age of 16.

 3. Patients with chronic pancreatitis.

 4. Patients with recurrent acute pancreatitis