During 10 year period from 1964 to 1973, about 550 patients had been recorded as acute pancreatitis at Yonsei University Medical Center. Of these, 363 cases fulfilled our diagnostic criteria for acute pancreatitis.
The results of the analysis of the 363 cases are as follows:
1. Over one half of these was between 30 and 50 years of age, and sex ratio of male to female was equal.
2. The associated etiologic factors were unknown in 40% of the cases and biliary tract diseases in 26%, gluttony, in 14%, alcohol in 8%, helminthes in 5% and trauma in 4%
3. In the majority of the cases, the diagnosis was made on the basis of history, physical examination and various labaratory data. In only 23% of the cases, diagnosis was confirmed by the exploratory laparotomy.
4. Among various forms of acute pancreatitis, necrotizing pancreatitis was estimated about 9.4% and pancreatic abscess was about 3.5%.
5. Necrotizing form was progressed to abscess in about 20%.
6. The edematous pancreatitis predominated in all age group. The hemorrhagic necrotizing form predominated in the elderly group, while the pseudocyst predominated in the younger group.
7. Acute edematous pancreatitis could be successfully treated by non-operative supportive therapy with recurrent rate of about 30%.
8. Majority of necrotizing or suppurative. pancreatitis, traumatic pancreatitis and edematous
pancreatitis with biliary tract diseases were treated with surgical intervention.
9. Complications were pulmonary insufficiency, shock, gastrointestinal bleeding and septicemia.
10. Chief causes of death were pulmonary insufficiency, shock, septicemia, gastrointestinal bleeding and renal failure.
11. The over-all mortality rate was about 4.6%. That of the non-operated group was about 4%, while that of the operated group was as high as 7%.
12. Over-all mortality rate of hemorrhagic-necrotizing pancreatitis was about 35% and that of the pancreatic abscess arising from necrotizing pancreatitis was as high as 45%. Mortality of the necrotizing pancreatitis and abscess which had undergone operation was as low as 22%.
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