| Endotoxemia predicts outcome in acute pancreatitis. | |
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MedLine Citation:
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PMID: 9563923 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The incidence of complications of acute pancreatitis is high in patients with endotoxemia, and so we determined the endotoxin levels in the blood and peritoneal fluid of patients with acute severe pancreatitis to correlate the levels with any sequelae. Fourteen patients with acute severe pancreatitis were examined with regard to clinical features, biochemical tests, and laparotomy (n = 9). In all coagulation profiles, blood gas analysis, chest and abdominal x-rays, ultrasound, and abdominal computed tomography scan (n = 10) were performed. Qualitative estimation of endotoxin levels was done in peripheral blood and peritoneal and peripancreatic fluid. Ten (71.42%) of 14 patients had endotoxin in the blood, and 9 (64.28%) had it in the peritoneal fluid. Twelve (85.7%) had pulmonary involvement, with hypoxia being the most common (85.7%); among them endotoxin was found in the blood of 10 (83.32%) and in the peritoneal fluid of 8 (66.66%) patients. Renal dysfunction was found in 4 (28.57%) patients; endotoxin was present in the blood of all 4 patients and in the peritoneal fluid of 3 (75%) patients. Cardiovascular abnormality was detected in 8 (57.14%) patients, and endotoxin was present in the blood and peritoneal fluid of all patients. Metabolic abnormality was present in 8 (57.14%) patients; endotoxin was present in the blood of all 8 patients and in the peritoneal fluid of 7 (87.6%) patients. Eight (88.88%) of the 9 patients who required surgery had endotoxemia. Three (30%) patients with endotoxemia survived, whereas all 4 patients without endotoxemia survived. Mean hospital stay was 61.2 days and 46.7 days for endotoxin-positive and endotoxin-negative patients, respectively. We conclude that the presence of endotoxin in blood and peritoneal fluid correlates with the severity, systemic complications, and mortality rates of acute pancreatitis. Endotoxin estimation can identify patients at risk in the early stages of acute pancreatitis. |
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Authors:
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J D Wig; R Kochhar; J D Ray; D V Krishna Rao; N M Gupta; N K Ganguly |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Journal of clinical gastroenterology Volume: 26 ISSN: 0192-0790 ISO Abbreviation: J. Clin. Gastroenterol. Publication Date: 1998 Mar |
Date Detail:
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Created Date: 1998-06-09 Completed Date: 1998-06-09 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 7910017 Medline TA: J Clin Gastroenterol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 121-4 Citation Subset: IM |
Affiliation:
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Department of Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Adult Ascitic Fluid / metabolism Biological Markers / blood Endotoxemia / complications, diagnosis*, metabolism Endotoxins / metabolism* Female Follow-Up Studies Humans Length of Stay Male Middle Aged Pancreatitis / diagnosis*, etiology, metabolism Tomography, X-Ray Computed Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; 0/Endotoxins |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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