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- Title
Objective Early Identification of Severe Acute Pancreatitis.
- Authors
Ranson, John H. C.; Rifkind, Kenneth M.; Roses, Daniel F.; Fink, Simon D.; Eng, Kenneth; Localio, S. Arthur
- Abstract
One hundred consecutive patients with acute pancreatitis have been evaluated. Fifteen patients died and 16 were seriously ill requiring over one week of intensive care. Pancreatitis was associated with alcoholism in 74, biliary tract disease in 14 and other etiologies in 12 patients. Statistical analysis of 43 early objective findings identified 11 that were of significant prognostic value. Death or serious illness correlated with: on admission: age, over 55 years; blood glucose, over 200 mg.%; white blood cell count, over 16,000/cu. mm.; LDH, over 700 IU% and SGOT, over 250 Sigma Frankel u.%; or during initial 48 hours of therapy: hematocrit decrease. over 10 percentage points; serum calcium, below 8 mg.%; base deficit, over 4 mEq./l.; blood urea nitrogen, increase over 5 mg.%; fluid sequestration, over 6 1. and arterial PO2 below 60 ml. of mercury. Plain admission roentgenograms of the chest and abdomen were evaluated in 73 of these patients and the incidence of nine radiographic signs assessed. These were gastrocolic separation, gastric greater curvature distortion, duodenal ileus, segmental small bowel ileus, colonic dilatation, obscured psoas margins, increased epigastric soft tissue density, pleural effusion and pancreatic calcification. Radiographic signs were present in 79% of patients and although they may provide valuable diagnostic information, correlation with prognosis is poor.
- Publication
American Journal of Gastroenterology (Springer Nature), 1974, Vol 61, Issue 6, p443
- ISSN
0002-9270
- Publication type
Academic Journal