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Trends in the incidence and significance of presentations to the emergency department due to acute pancreatitis.
Eur J Emerg Med. 2006 Aug; 13(4):209-13.EJ

Abstract

INTRODUCTION

Acute pancreatitis is an important cause of abdominal pain that may be associated with significant morbidity for the patient and considerable workload for the hospital. Our impression has been that it is becoming increasingly common, perhaps in tandem with increased rates of other alcohol-related disease.

METHODS

The medical records of all patients attending our emergency department with acute pancreatitis by Hospital Inpatient Enquiry coding over a 9-year period were examined to determine its incidence, aetiology and significance (Imrie severity of pancreatitis scoring, length of hospital stay and interventional workload).

RESULTS

The incidence of acute pancreatitis (n=97, 40 male patients) increased approximately threefold over the study period (especially in the lattermost triennial period with 75 patients) in a fashion disproportionate to changes in our locality's population. Gallstone-related disease continues to be most prevalent although alcohol-related disease also became more common. Disease severity (length of hospital stay and Imrie score) was similar throughout with a mean length of hospital stay exceeding that of the majority of accident and emergency admissions. Seven acute complications of acute pancreatitis were noted while 34 chronic sequelae developed. Requirement for invasive intervention doubled (n=19 in first triennial period in the study vs 39 in the latter triennial period), although the relative need for endoscopic retrograde cholangiopancreaticography diminished with increased availability of magnetic resonance cholangiography imaging. Nine patients with gallstone-related acute pancreatitis suffered recurrent attacks while awaiting cholecystectomy.

CONCLUSION

Acute pancreatitis is an increasingly frequent cause of hospital admission while the clinical significance of each incident remains high. The presentation of acute pancreatitis to the emergency department as an early declaration of symptomatic cholelithiasis is especially worrisome as it suggests a failing of recognition and/or effective referral of premonitory biliary complaints.

Authors+Show Affiliations

Department of Surgery, Waterford Regional Hospital, Waterford, Ireland.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16816584

Citation

Shaddique, Shahid, et al. "Trends in the Incidence and Significance of Presentations to the Emergency Department Due to Acute Pancreatitis." European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine, vol. 13, no. 4, 2006, pp. 209-13.
Shaddique S, Cahill RA, Watson RG, et al. Trends in the incidence and significance of presentations to the emergency department due to acute pancreatitis. Eur J Emerg Med. 2006;13(4):209-13.
Shaddique, S., Cahill, R. A., Watson, R. G., & O'Connor, J. (2006). Trends in the incidence and significance of presentations to the emergency department due to acute pancreatitis. European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine, 13(4), 209-13.
Shaddique S, et al. Trends in the Incidence and Significance of Presentations to the Emergency Department Due to Acute Pancreatitis. Eur J Emerg Med. 2006;13(4):209-13. PubMed PMID: 16816584.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Trends in the incidence and significance of presentations to the emergency department due to acute pancreatitis. AU - Shaddique,Shahid, AU - Cahill,Ronan A, AU - Watson,R Gordon, AU - O'Connor,Joe, PY - 2006/7/4/pubmed PY - 2006/12/13/medline PY - 2006/7/4/entrez SP - 209 EP - 13 JF - European journal of emergency medicine : official journal of the European Society for Emergency Medicine JO - Eur J Emerg Med VL - 13 IS - 4 N2 - INTRODUCTION: Acute pancreatitis is an important cause of abdominal pain that may be associated with significant morbidity for the patient and considerable workload for the hospital. Our impression has been that it is becoming increasingly common, perhaps in tandem with increased rates of other alcohol-related disease. METHODS: The medical records of all patients attending our emergency department with acute pancreatitis by Hospital Inpatient Enquiry coding over a 9-year period were examined to determine its incidence, aetiology and significance (Imrie severity of pancreatitis scoring, length of hospital stay and interventional workload). RESULTS: The incidence of acute pancreatitis (n=97, 40 male patients) increased approximately threefold over the study period (especially in the lattermost triennial period with 75 patients) in a fashion disproportionate to changes in our locality's population. Gallstone-related disease continues to be most prevalent although alcohol-related disease also became more common. Disease severity (length of hospital stay and Imrie score) was similar throughout with a mean length of hospital stay exceeding that of the majority of accident and emergency admissions. Seven acute complications of acute pancreatitis were noted while 34 chronic sequelae developed. Requirement for invasive intervention doubled (n=19 in first triennial period in the study vs 39 in the latter triennial period), although the relative need for endoscopic retrograde cholangiopancreaticography diminished with increased availability of magnetic resonance cholangiography imaging. Nine patients with gallstone-related acute pancreatitis suffered recurrent attacks while awaiting cholecystectomy. CONCLUSION: Acute pancreatitis is an increasingly frequent cause of hospital admission while the clinical significance of each incident remains high. The presentation of acute pancreatitis to the emergency department as an early declaration of symptomatic cholelithiasis is especially worrisome as it suggests a failing of recognition and/or effective referral of premonitory biliary complaints. SN - 0969-9546 UR - https://www.unboundmedicine.com/medline/citation/16816584/Trends_in_the_incidence_and_significance_of_presentations_to_the_emergency_department_due_to_acute_pancreatitis_ L2 - https://doi.org/10.1097/01.mej.0000209062.90826.e7 DB - PRIME DP - Unbound Medicine ER -