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Clinical features of patients with painless acute pancreatitis

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Author:
No author available
Journal Title:
Chinese Journal of Pancreatology
Issue:
4
DOI:
10.3760/cma.j.issn.1674-1935.2012.04.002
Key Word:
胰腺炎;诊断;症状和体征;无痛;Pancreatitis;Diagnosis;Symptoms and signs;Painless

Abstract: Objective To investigate the clinical features of patients with painless acute pancreatitis ( AP),and to improve the diagnosis accuracy of painless AP.Methods The clinical data of 12 patients with painless AP were retrospectively collected from January 2007 to January 2011.Results The mean age of patients with painless AP was 52 years old.Seven (58.3%) patients complained of abdominal distension and discomfort,4 (33.3%) patients complained of nausea and vomiting,abdominal tenderness occurred in 7(58.3% ) patients.Serum levels of lipase and amylase was increased in 11 (91.7%) and 8 (66.7%)patients,respectively.The diagnostic accuracy of abdominal ultrasound and CT for AP was 58.3% and 91.7%,respectively.Five (41.7%) patients were diagnosed to have AP upon admission,and 4 patients were misdiagnosed to have non-digestive diseases.There were 7 severe AP patients among the 12 painless AP patients,and the percentage was significantly higher than that in AP patients with pain (65/327,x2 =7.30,P < 0.05).Painless AP patients needed longer hospital stay when compared with that of AP patients with pain [ ( 20.4 ± 9.1 ) d vs.( 12.9 ± 6.2) d,t =2.296,P < 0.05 ) ].Conclusions The misdiagnosis rate of painless AP is high and patients with painless AP are in critical situation,and early measurement of serum levels of lipase and amylase,as well as CT scan is important for correct diagnosis.

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