Management Modalities and their Outcome in Patients of Acute Pancreatitis: A Cross Sectional Study
Keywords:acute pancreatitis, enteral feeding, necrotizing pancreatitis
Background: Acute pancreatitis is a potentially serious condition with wide variation in severity ranging
from mild and self-limiting to a rapidly progressive illness leading to multi-organ failure.
Aim and Objective: To study early enteral feeding and their outcome in patients of acute pancreatitis.
Methodology: Present study was a prospective study carried out in 60 patients out of 50 were male (83.3
%) and 10 female (16.6 %) admitted as acute pancreatitis in the department of surgery, Shalinitai Meghe
hospital and Research centre, Datta Meghe Medical College, Nagpur. A thorough history was taken and
detailed clinical examination was conducted of all the patients on admission. All the patients were subjected
to biochemical and Radiological investigations. Radiological investigations like X-Ray chest abdomen and
Ultrasonography were carried out initially in all the patients. CT Abdomen performed as per requirement.
Severity of disease was accessed on admission on the basis of BISAP scoring system. Conservative
management was instituted with early enteral feeding for all patients. All patients who recovered were
discharged and followed up on outpatient basis. Data was analyzed with appropriate statistical tests.
Results: All the patients were initially managed conservatively with early enteral feeding. Type of feeding
was according to the severity of the illness. Oral in mild / moderate pancreatitis and nasogastric feeding
in severe pancreatitis. Mild and moderate variety tolerated enteral feeding well thus need for intravenous
infusion was obviated. Out of these, 1 patient (1.7 %) required interventional management due to acute
necrotizing pancreatitis. This patient later required intravenous infusion and TPN in view of progressive
clinical deterioration due to necrotizing pancreatitis. The management of complications was essentially
conservative. Acute necrotizing pancreatitis has a mortality of 100 % even with aggressive management.
The overall mortality rate in our study was 1.7% .
Conclusion: Conservative management is the mainstay of treatment in acute pancreatitis. Early enteral
feeding obviates the need for intravenous infusion in mild and moderate pancreatitis and in selected cases
of severe acute pancreatitis. Early enteral feeding has advantages over Parenteral nutrition and reduces
mortality, infectious complications, preventing malnutrition, reduction in length of hospital stay. Early
detection and aggressive management of in acute severe pancreatitis can prevent its progression to acute
necrotizing pancreatitis and its complications.
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