rganophosphate insecticides are used all over the world and are household items in the
rural area o the Korea. Because of their easy accessability, their ingestion either accidentally
or for a suicidal purpose is common in the Koea. Acute pancreatitis occuring as a
complication of an anticholinesterase insecticide intoxication ws first reported by Dressel et al
(1979) and has since been reported by other investigators. Among them, pancreatitis with
unresponsiveness followed by pseudocyst, or painless hemorrhagic pancreatitis only menifested
by ileus and abdominal distension was founded after intoxication. We had serial serum
amylase determination and clinical evaluation on 31 patients of organophosphate intoxication.
The results were as follows. In the 31 patients of poisonous organophosphate insecticide,
serum amylase was elevated in the 17 patients and was assumed to show pancreatic
involvement. But, abdominal pain or ileus was absent. In 5 of 17 patients, serum amylase
level was more than 500 U/dl and suggested to evoke acute pancreatitis. All of the 5
patients received upper abdominal ultrasonography. In one patient, there was an edematous
change in the body and tail of the pancreas and normalized in the following study. Others
were normal. Severely affected patients who needed respiratory assistance and had mental
change, mean serum amylase value was the hightest. In our study, fortunately, all the
patients discharged with out complication of acute pancreatitis. Therefore, in the ptients of
organophosphate inseticide intoxication, if ileus or suspicious peritonitis is present, we must
consider the development of acute pancreatitis.
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