Harmless Acute Pancreatitis Score

Introduction: Acute Pancreatitis is a common disease in our region. It can range from mild to severe disease with high mortality rate. It is critical to identify patients who are at high risk for a severe disease course, since they require close monitoring and immediate aggressive treatment. Aims: To compare the effectiveness of Harmless Acute Pancreatitis Score with Ranson’s scoring system in predicting the severity of Acute Pancreatitis. Methods: A prospective cross sectional study was done among 45 patients who were admitted in surgery department over a period of one year with diagnosis of acute pancreatitis. If haematocrit was less than39% in female and less than43% in male, serum creatinine less than two miligram /deciliter and no sign of peritonitis, it was assigned as Harmless Acute Pancreatitis Score Zero. If at least one parameter was abnormal it was assigned as Harmless Acute Pancreatitis Score +. Severe pancreatitis (poor prognosis) was considered in those who required Intensive Care Unit care, who had in hospital mortality and who had hospitalization of more than five days. Patients with on admission Ranson’s score of more than three were suspected to have severe Pancreatitis. Results: There were total 45 patients, 18 females and 27 males. Twenty four patients were assigned as Harmless Acute Pancreatitis Score zero and 21 patients were assigned as Harmless Acute Pancreatitis Score +. Harmless Acute Pancreatitis Score was able to predict correctly in 18 out of 26 patients who fulfilled the criteria of poor prognosis (p<0.001). Conclusion: Harmless Acute Pancreatitis Score proved to be a better screening tool compared to on admission Ranson’s scoring system to predict the severity of Acute Pancreatitis, which may help predict the prognosis of the patient.

Study to Assess the Severity of Pancreatitis Based on Ranson’s Scoring and Modified CT Severity Index

Background: Acute pancreatitis is an emergency condition requiring intensive care and 20% of patients fall under the severe category with severe complications and requires early assessment. Objectives: To assess the severity of pancreatitis based on Modified CT severity index and Ransons’s score in a tertiary health care centre. Materials and Methods: This is prospective study done on 80 patients diagnosed of acute pancreatitis, ranson's criteria was calculated within 48 hours and Modified CT severity index was measured in all the patients with CECT to identify the severity and prognosis of the disease. Results: Out of the 80 patients 61 were males and 19 were females and alcohol was the commonest etiology of acute pancreatitis. Ranson's criteria showed 31 patients with mild and 49 with severe pancreatitis. MCTSI score showed 18 patients of severe pancreatitis and all were under the severe category of Ranson's criteria. Conclusion: Ranson's score and Modified CT severity index helps in identifying severity in early stage and provide better treatment for the early prognosis of the patients.

Early enteral nutrition in acute pancreatitis - how beneficial is it?

Background: Acute pancreatitis is an inflammatory disease of pancreas and is one of the leading cause of acute abdomen requiring hospital admission. Nutritional support plays a crucial role in this hypercatabolic state in not only providing calories but also in preventing complications and decreasing recovery time.Methods: This prospective study was done among 120 patients with acute moderate and severe pancreatitis who got admitted in department of general surgery at Saveetha Medical College and Hospital, Chennai, Tamil Nadu, India between 2018 and 2019.Results: 67 (55.8%) patients were in early enteral and 53 (44.2%) were in parenteral/delayed enteral group. Maximum number of patients were in 30-40 years age group. The mean of patient age was 40.33. Mean duration of hospital stay in enteral group was 7.06 and in parenteral/delayed enteral group it was 14.09 (p<0.001). Mean pain score in enteral group was 2.69 and in parenteral group it was 6.51 (p<0.001).Conclusions: There was significant (p<0.001) decrease in hospital stay duration and pain score in early enteral group compared to parenteral/delayed enteral group. Infections related to feeding route was found high in parenteral group. No significant difference found in complications of acute pancreatitis. Hence early enteral feeding is more beneficial in terms of shortened hospital stay, decreased pain score leading to reduction in usage of analgesics and reducing the recovery time and less nutrition related complications in management of acute moderate and severe pancreatitis.