Comparison of intraabdominal pressure with Ranson’s criteria in prognosis of acute pancreatitis

Abstract

Intraabdominal hypertension (IAH) and abdominal compartment syndrome has described in patients with severe acute pancreatitis, but its clinical impact remains unclear. The aim of the study was to assess whether increased intraabdominal pressure affects clinical course in patients with acute pancreatitis and compare intra abdominal pressure with Ranson's criteria in the prognosis of acute pancreatitis. The present study was conducted in Department of General Surgery at Himalayan Institute of Medical Sciences over a period of 12 months. All patients admitted in hospital with confirmed diagnosis of Acute Pancreatitis were included in study and were followed up by measurement of intraabdominal pressure (IAP) by intravesicular method at time of admission and daily monitoring of IAP for one week. The incidence of IAH (defi-ned as intraabdominal pressure >12 mmHg), occurrence of organ dysfunction and outcome of disease was studied and compared with Ranson’s score. The analysis included 65 patients, all patients were subjected Ranson’s score and IAP monitoring. The comparison of both groups showed statically P value in pulmonary failure of 0.557, CVS failure of 0.634, renal failure of 0.504, pancreatic necrosis of 0.641, ınfected pancreatic necrosis of 0.799 and patient undergoing surgical management of 0.778. Statically values of ICU stay and mortality in the patients with IAH was similar as in Ranson’s score. It was observed that there was a positive correlation between IAP and Ranson’s score i.e. 0.92. The IAP monitoring is useful, inexpensive, easy method and can be considered an independent prognostic marker for the evolution and complications of acute pancreatitis especially in developing countries.

Keywords

• Abdominal compartment syndrome
• acute pancreatitis
• Ranson
• prognosis