Prevalencia y complicaciones de pancreatitis aguda en pacientes entre 20 y 60 años en el Hospital Liborio Panchana Sotomayor período 2016 - 2017
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2018
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Carrera de Medicina
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INTRODUCCIÓN: La pancreatitis aguda (PA) es una enfermedad inflamatoria, originada por la activación, liberación intersticial y autodigestión de la glándula por sus propias enzimas. Aunque es una enfermedad que puede presentarse en cualquier persona existen factores de riesgo como la edad entre 40 a 60 años, consumo de alcohol en el sexo masculino y patología de vías biliares que afecta con mayor frecuencia al sexo femenino. Entre las complicaciones tenemos las sistémicas que se presentan de forma temprana y producen falla multiorgánica y las complicaciones locales que son tardías como la necrosis, absceso o pseudoquistes pancreáticos. MATERIALES Y MÉTODOS: Se realizó un estudio descriptivo, retrospectivo y transversal. Las variables analizadas fueron, número de pacientes-prevalencia, sexo, edad, factores de riesgo, complicaciones y escalas pronosticas en pacientes de 20 a 40 años. Se tomó como población 402 historias clínicas de pacientes diagnosticados de pancreatitis aguda ingresados en el Servicio de Medicina Interna del Hospital Liborio Panchana Sotomayor en el período 2016-2017. RESULTADOS: La prevalencia en el periodo de estudio fue de 39.1 por cada 10000 egresos. Con respecto al sexo la PA se presentó en un 72% en las mujeres y, con una diferencia muy significativa, en un 28% en los varones. Con respecto a la edad se presentó con mayor frecuencia entre los 51 a 60 años con un 34%. El 89% no presento antecedentes patológicos de relevancia. De los factores de riesgo el que con mayor frecuencia se presenta es la litiasis Biliar con un 7%. La etiología más frecuente fue la Litiasis Biliar con un 90%, seguido de la alcohólica en un 6%. El síntoma más frecuente fue el dolor abdominal con un 98%, el segundo lugar náuseas y vómitos con un 79% y el tercer lugar la distención abdominal con un 51%. El 99100% presentaron elevación de enzimas pancreáticas a las 24 horas de ingreso. De acuerdo a los días de hospitalización el 77% se internaron más de 7 días. La complicación local más frecuente el absceso 28%. La complicación sistémica más frecuente fue la insuficiencia respiratoria en un 10%. Las escalas pronosticas tuvieron una sensibilidad de entre 77-87% y especificidad entre 91-100%. CONCLUSIÓN: La pancreatitis aguda es una enfermedad con prevalencia en aumento, diagnosticada por clínica, imágenes y laboratorio, el diagnóstico oportuno evita complicaciones graves.
INTRODUCTION: Acute pancreatitis (AP) is an inflammatory disease, caused by the activation, interstitial release and self-digestion of the gland by its own enzymes. Although it is a disease that can occur in any person there are risk factors such as age between 40 to 60 years, alcohol consumption in males and pathology of bile ducts that most often affects the female sex. Among the complications we have the systemic ones that occur early and produce multi-organ failure and local complications that are late such as necrosis, abscess or pancreatic pseudocysts. MATERIALS AND METHODS: A descriptive, retrospective and transversal study was carried out. The variables analyzed were: number of patients-prevalence, sex, age, risk factors, complications and prognostic scales in patients aged 20 to 40 years. A total of 402 clinical histories were taken from patients diagnosed with acute pancreatitis admitted to the Internal Medicine Service of the Liborio Panchana Sotomayor Hospital during the 2016-2017 period. RESULTS: The prevalence in the study period was 39.1 per 10000 discharges. With regard to sex, BP was present in 72% of women and, with a very significant difference, in 28% in men. With regard to age, it occurred more frequently between 51 to 60 years with 34%. 89% did not present relevant pathological antecedents. Of the risk factors, the one that most frequently occurs is Biliary lithiasis with 7%. The most frequent etiology was Biliary Lithiasis with 90%, followed by the alcoholic one in 6%. The most frequent symptom was abdominal pain with 98%, second place nausea and vomiting with 79% and third place abdominal distention with 51%. 99-100% had elevated pancreatic enzymes 24 hours after admission. According to the days of hospitalization 77% were admitted for more than 7 days. The most frequent local complication abscess 28%. The most frequent systemic complication was respiratory failure in 10%. The prognostic scales had a sensitivity between 77-87% and specificity between 91-100%. CONCLUSION: Acute pancreatitis is a disease with increasing prevalence, diagnosed by clinical, imaging and laboratory, timely diagnosis avoids serious complications.
INTRODUCTION: Acute pancreatitis (AP) is an inflammatory disease, caused by the activation, interstitial release and self-digestion of the gland by its own enzymes. Although it is a disease that can occur in any person there are risk factors such as age between 40 to 60 years, alcohol consumption in males and pathology of bile ducts that most often affects the female sex. Among the complications we have the systemic ones that occur early and produce multi-organ failure and local complications that are late such as necrosis, abscess or pancreatic pseudocysts. MATERIALS AND METHODS: A descriptive, retrospective and transversal study was carried out. The variables analyzed were: number of patients-prevalence, sex, age, risk factors, complications and prognostic scales in patients aged 20 to 40 years. A total of 402 clinical histories were taken from patients diagnosed with acute pancreatitis admitted to the Internal Medicine Service of the Liborio Panchana Sotomayor Hospital during the 2016-2017 period. RESULTS: The prevalence in the study period was 39.1 per 10000 discharges. With regard to sex, BP was present in 72% of women and, with a very significant difference, in 28% in men. With regard to age, it occurred more frequently between 51 to 60 years with 34%. 89% did not present relevant pathological antecedents. Of the risk factors, the one that most frequently occurs is Biliary lithiasis with 7%. The most frequent etiology was Biliary Lithiasis with 90%, followed by the alcoholic one in 6%. The most frequent symptom was abdominal pain with 98%, second place nausea and vomiting with 79% and third place abdominal distention with 51%. 99-100% had elevated pancreatic enzymes 24 hours after admission. According to the days of hospitalization 77% were admitted for more than 7 days. The most frequent local complication abscess 28%. The most frequent systemic complication was respiratory failure in 10%. The prognostic scales had a sensitivity between 77-87% and specificity between 91-100%. CONCLUSION: Acute pancreatitis is a disease with increasing prevalence, diagnosed by clinical, imaging and laboratory, timely diagnosis avoids serious complications.
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Pancreatitis, Estudios retrospectivos, Epidemiología descriptiva, Hospital General Dr. Liborio Panchana Sotomayor, Cantón Santa Elena, Ecuador, Prevalencia, Complicaciones