Estudo clínico-epidemiológico das pancreatites em um hospital de referência terciária entre 2013 e 2014

Donavan de Souza Lúcio; Ronaldo Antonio Borghesi

doi:10.5327/z1984-4840201625381

Authors

Donavan de Souza Lúcio Pontifícia Universidade Católica de São Paulo. Faculdade de Ciências Médicas e da Saúde – Sorocaba (SP), Brasil
Ronaldo Antonio Borghesi Pontifícia Universidade Católica de São Paulo. Faculdade de Ciências Médicas e da Saúde – Sorocaba (SP), Brasil

DOI:

https://doi.org/10.5327/z1984-4840201625381

Keywords:

pancreatitis, epidemiology, epidemiologic studies, tertiary care centers

Abstract

Introduction: Clinical manifestations of pancreatitis are so varied that if the physician only bear the classic symptoms, he will diagnose just part of the cases. Method: This is a descriptive study of patients diagnosed with acute or chronic pancreatitis in the Conjunto Hospitalar de Sorocaba, São Paulo, Brazil. We reviewed 39 medical records, which covered all cases of pancreatitis from June 2013 to June 2014. Results: We found 26 cases of acute pancreatitis and 4 of chronic pancreatatis. Biliary etiology accounted for 50,0% of cases, followed by alcoholic (26.7%) and idiopathic (13.3%). The classic upper abdominal pain was found in 11 patients, and in 3 of them it irradiates to the back. Several other painful manifestations have been reported. The duration of the pain ranged from 6 hours to 5 months. The etiologies found showed different distribution between genders. The duration of pain was higher among cases of chronic pancreatitis (median 70.5 versus 2 days; p=0.02), and the values of amylase were higher in acute pancreatitis (median 929 versus 52.5 U/L; p=0.00). Conclusions: Acute pancreatitis and chronic acutized pancreatitis, when properly diagnosed, have a benign curse, solving in a few days. The characterization of pain and other clinical manifestations are little scrutinized in medical records, perhaps because of the relative ease of classic cases diagnosis and the availability of laboratory tests. de avaliação laboratorial.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Author Biographies

Donavan de Souza Lúcio, Pontifícia Universidade Católica de São Paulo. Faculdade de Ciências Médicas e da Saúde – Sorocaba (SP), Brasil

Graduando em Medicina pela Faculdade de Ciências Médicas e da Saúde, da Pontifícia Universidade Católica de São Paulo, como bolsista do Programa Universidade para Todos. Durante a graduação desenvolveu projetos de pesquisa pelo Programa de Educação pelo Trabalho para a Saúde, do Ministério da Saúde, e como bolsista de iniciação científica pelo Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq).

Ronaldo Antonio Borghesi, Pontifícia Universidade Católica de São Paulo. Faculdade de Ciências Médicas e da Saúde – Sorocaba (SP), Brasil

Possui graduação em Medicina pela Pontifícia Universidade Católica de São Paulo (1976), mestrado em Medicina (Gastroenterologia) pelo Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia (1982) e doutorado em Ciências da Cirurgia pela Universidade Estadual de Campinas (1995). Atualmente é pesquisador da Pontifícia Universidade Católica de São Paulo e professor titular da Pontifícia Universidade Católica de São Paulo. Tem experiência na área de Medicina, com ênfase em Cirurgia Gastroenterologia, atuando principalmente nos seguintes temas: gastro, coloproctologia, cirurgia e aparelho digestivo.

References

Greenberger NJ, Toskes PP. Acute and chronic pancreatitis. In: Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson J, Loscalzo J, editores. Harrison’s Principles of Internal Medicine. 18th ed. New York: McGraw-Hill; 2012.

Vege SS. Etiology of acute pancreatitis. UpToDate. Waltham: UpToDate; 2014.

Forsmark CE, Baillie J. AGA Institute technical review on acute pancreatitis. Gastroenterology. 2007;132(5):2022-44.

Riela A, Zinsmeister A, Melton L, DiMagno E. Etiology, incidence, and survival of acute pancreatitis in Olmsted County, Minnesota. Gastroenterology. 1991;100:A296.

Moreau JA, Zinsmeister AR, Melton LJ, DiMagno EP. Gallstone pancreatitis and the effect of cholecystectomy: a population-based cohort study. Mayo Clin Proc. 1988;63(5):466-73.

Tenner S, Dubner H, Steinberg W. Predicting gallstone pancreatitis with laboratory parameters: a meta- analysis. Am J Gastroenterol. 1994;89(10):1863-6.

Yang AL, Vadhavkar S, Singh G, Omary MB. Epidemiology of alcohol-related liver and pancreatic disease in the United States. Arch Intern Med. 2008;168(6):649-56.

Coté GA, Yadav D, Slivka A, Hawes RH, Anderson MA, Burton FR, et al. Alcohol and smoking as risk factors in an epidemiology study of patients with chronic pancreatitis. Clin Gastroenterol Hepatol. 2011;9(3):266-73.

Berglund L, Brunzell JD, Goldberg AC, Goldberg IJ, Sacks F, Murad MH, et al. Evaluation and treatment of hypertriglyceridemia: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2012;97(9):2969-89.

Fortson MR, Freedman SN, Webster PD. Clinical assessment of hyperlipidemic pancreatitis. Am J Gastroenterol. 1995;90(12):2134-9.

Chang CC, Hsieh YY, Tsai HD, Yang TC, Yeh LS, Hsu TY. Acute pancreatitis in pregnancy. Zhonghua Yi Xue Za Zhi (Taipei). 1998;61(2):85-92.

Jouppila P, Mokka R, Larmi TK. Acute pancreatitis in pregnancy. Surg Gynecol Obstet. 1974;139(6):879-82.

Gold MS, Aronson MD. Alcohol use disorder: epidemiology, pathogenesis, clinical manifestations, adverse consequences, and diagnosis. Waltham: UpToDate; 2014.

Ammann RW, Muellhaupt B. The natural history of pain in alcoholic chronic pancreatitis. Gastroenterology. 1999;116(5):1132-40.

Vege SS. Clinical manifestations and diagnosis of acute pancreatitis. Waltham: UpToDate; 2014.

Banks PA, Freeman ML, Practice Parameters Committee of the American College of Gastroenterology. Practice guidelines in acute pancreatitis. Am J Gastroenterol. 2006;101(10):2379-400.

Freedman SD. Clinical manifestations and diagnosis of chronic pancreatitis in adults. Waltham: UpToDate; 2014.

Yadav D, Agarwal N, Pitchumoni CS. A critical evaluation of laboratory tests in acute pancreatitis. Am J Gastroenterol. 2002;97(6):1309-18.

Mutinga M, Rosenbluth A, Tenner SM, Odze RR, Sica GT, Banks PA. Does mortality occur early or late in acute pancreatitis? Int J Pancreatol. 2000;28(2):91-5.

Freedman SD. Complications of chronic pancreatitis. Waltham: UpToDate; 2014.