Summary
Conclusion
In African blacks, acute pancreatitis requiring hospital adminission is a severe disease associated with a high mortality and significant long-term morbidity in surviving patients.
Background
It has been suggested that acute pancreatitis has a benign course in Africans in contrast to Western populations. The aim of the present study was to ascertain the incidence of acute pancreatitis at Baragwanath Hospital for a 1-yr period and to test the validity of the above hypothesis.
Methods
One hundred thirty-six patients with acute pancreatitis were retrospectively assessed. Fifty patients were available for a prospective follow-up examination and underwent sonographic and biochemical investigations. Acute pancreatitis was diagnosed if the patient presented with the typical clinical picture and a raised serum amylase level >800 U/L.
Results
The study consisted of 108 male and 28 female patients. Alcohol was identified as the predominant etiologic factor in 83.1%, biliary disease in 7.4%, and idiopathic causes in 6.6%. Substantial morbidity was encountered in 32.3% and was caused mainly by pancreatic complications, metabolic derangements, alcohol-related symptoms, and respiratory impairment. A portion (10.3%) of the patients developed further pancreatic pathology, such as pseudocysts, necroses, or an abscess. The overall mortality rate was 8.1%. Patients who died had a higher mean serum amylase, and most deaths occurred within 2 d of admission. Prospective follow-up after an average of 9.3 mo revealed serious morbidity in two-thirds of patients. Fifty-two percent suffered from severe abdominal pain, 36% complained of weight loss, and 18% were shown to have a sonographically abnormal pancreas. Fecal chymotrypsin levels indicated exocrine pancreatic impairment in 30.6%
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John, K., Segal, I., Hassan, H. et al. Acute pancreatitis in sowetan africans. Int J Pancreatol 21, 149–155 (1997). https://doi.org/10.1007/BF02822386
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DOI: https://doi.org/10.1007/BF02822386