Profile of acute pancreatitis in Jizan, Saudi Arabia

OBJECTIVE: The epidemiology of acute pancreatitis in the Kingdom of Saudi Arabia (KSA) may be different from the West. The present study describes the profile of acute pancreatitis in Jizan, KSA.

METHODS: Patients diagnosed as acute pancreatitis in the King Fahd Central Hospital (KFCH), Jizan, KSA over a period of 12 years (1411-1422 Hijra year) were retrospectively analyzed with particular reference to the clinical features, disease severity, and result on management.

RESULTS: There were 71 episodes in 62 patients (26 males and 36 females; 53 Saudis, whose ages ranged from 13-82 years (mean age: 42.6 years.). Of these patients, 5 had 2 episodes each one had 5 recurrent episodes. The etiology included gallstone disease in 26 (42%) cases; endoscopic retrograde cholangiopancreatography (ERCP) in 11 (18%) cases. No cause could be identified in 16 (26%). Patients. with ERCP - related pancreatitis were asymptomatic. In the symptomatic group (60 episodes), abdominal pain (100%), vomiting (78%) and fever (20%) were the most frequent features. Overall the clinical course was mild in 61 (86%) episodes and severe in 10 (14%). Ranson's scoring accurately identified 60 of the 61 mild episodes and only 6 of the severe illness. Complications in the latter sub-group of cases, included pseudocyst (4 cases) and pancreatic abscess in 2 cases. Three of the patients died, giving overall mortality of 4.2%. Two deaths were directly related to the severe pancreatitis and one was due to massive vomiting and aspiration.

CONCLUSION: It is concluded that 1. Cholelithiasis is the most frequent cause of acute pancreatitis; 2. Biliary pancreatitis occurred more frequently in elderly females and was associated with higher mean levels of lactic dehydrogenase and aspartate transaminase as compared to patients with non-biliary causes. In Jizan, acute pancreatitis presents in a mild form with low morbidity and mortality, irrespective of the cause.