Mariam Malik, Mazhar Iqbal, Abdul Malik Magsi, Sughra Perveen.
Mortality of Acute Necrotizing Pancreatitis.
J Surg Pak Jan ;22(3):97-100.

Objective: To find out the mortality in patients with acute sterile necrotizing pancreatitis with conservative management and acute septic necrotizing pancreatitis with surgical necrosectomy. Study design: Descriptive case series. Place & Duration of study: Surgical Unit 1 Ward 3 Jinnah Postgraduate Medical Center (JPMC) Karachi, from January 2015 to December 2016. Methodology: All patients diagnosed as acute necrotizing pancreatitis based upon serum amylase level more than three times the normal and CT scan abdomen with contrast findings, were included in the study. Group A patients belonged to acute sterile pancreatitis where aspirate did not reveal microorganisms growth. When microorganisms were found on culture and sensitivity report then the patients were kept in group B and labeled as having acute septic necrotizing pancreatitis. Group A patients were treated conservatively and mortality was recorded. In group B patients surgical necrosectomy was done and mortality recorded. Result was analyzed by SPSS Version 22. Results: A total of 190 patients of acute pancreatitis were evaluated for necrosis of pancreas. CT scan with contrast showed that 65/190 (34.21%) had acute necrotizing pancreatitis. Out of these 65 patients, no growth of microorganisms on aspiration was found in fifty (76.92%) cases. After conservative treatment of group A patients, only two expired with mortality rate of 4%. In group B fifteen patients had microorganisms growth on culture. These were treated surgically and necrosectomy was done. Four patients out of fifteen expired after surgery with mortality of 26.67%. All patients who expired had more than 50% necrosis of pancreas. Conclusion: Mortality in acute sterile necrotizing pancreatitis was low with conservative treatment (4%) and high (26.67%) in acute septic necrotizing pancreatitis even with surgical intervention.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com