It is the purpose to define more accuratory the clinical course of an acute pancreatitis from the onset of an attack to the recovery.
Fourteen patients complained sever pain in the upper abdomen, but two groups of patients were noticed for the duration of abdominal pain. In 8 patients it stopped within 5 days but in 6 it continued over three weeks. Abdominal masses due to swelling of the pancreas were palpated in 7 (50%) patients and its positive durations were correlated with that of abdominal pain.
The average of laboratory data of 14 patients were examined from the onset to the recovery on successive days. Elevated serum amylase (1833±1034 S.U.) or urine amylase (12672±7554 S.U.) decreased rapidly to normal levels within 5-7 days, but fever, tachycardia and leucocytosis continued for about three weeks. For blood pressure, erythrocyte, hemoglobin, electrolyte and liver function no remarkable changes were recoginized.
By the abdominal radiograph sentinel loop and dilated colon were noticed in 7 (88%) of 8 patients. By intravenous cholangiography the gallbladder was not demonstrated in 7 of 14 patients. In these patients the association of cholecysitis or cholelithiasis were suggested. Intraoperative cholangiography was perfomed in 3 patients and common channels were recoginized in all three patients. The radiographic evaluation of upper gastrointestinal tracts and computerlized tomography were also useful for the diagnosis of acute panctreatitis.
Laparotomies were perfomed in 8 (57%) of 14 patients (cholecystectomy 3, cholecystostomy 1, drainage 4), and the severity of the abdominal inflammation for example the degree of abdminal exsudate was in inverse proportion to the duration from the onset of an attack to the operation.
The fistula of transverse colon was the only complication and one patient was died.
Results of our study suggest the importance to consider the duration from the onset of an attack when the patients of acute pancreatitis were examined or laboratory data were discussed.
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