Prevalence and characterization of acute biliary pancreatitis-associated upper gastrointestinal mucosal lesions

Yıl 2012, Cilt: 20 Sayı: 2, 44 - 47, 01.08.2012

Elmas Kasap () Müjdat Zeybel () Elif Tu¤ba Tuncel Selim Serter () Semin Ayhan () Hakan Yüceyar ()

https://doi.org/10.17940/endoskopi.74830

Öz

Background and Aims:Acute pancreatitis can be associated with various up-per gastrointestinal mucosal lesions. However, their pathogenesis and clinical significance have been discussed rarely. The aim of this study was to retros-pectively investigate upper gastrointestinal mucosal lesions in relation to the prevalence of Helicobacter pylori infection in acute biliary pancreatitis.Met-hods: This study was carried out in 94 patients with acute biliary pancreati-tis and 179 control dyspeptic patients with or without gallstone disease. In all research subjects, upper gastrointestinal endoscopy was performed, and two biopsy specimens were taken from the antrum and gastric body for histologi-cal examination and Helicobacter pylori detection. Results: 71% of patients with acute biliary pancreatitis had evidence of upper gastrointestinal mucosal abnormalities. Esophagitis and peptic ulceration were more prevalent compa-red to the control groups (p

Anahtar Kelimeler

Biliary pancreatitis, peptic ulcer disease, Helicobacter pylori

Akut biliyer pankreatit'te üst gastrointestinal mukoza lezyonlarının yaygınlığı ve karakterizasyonu

Öz

Giriş ve Amaç:Akut pankreatit'li olgularda akut pankreatite bağlı çeşitli üst gastrointestinal mukoza lezyonları görülebildiği ve akut pankreatitle ilişkili olduğu belirtilsede, bu ilişkinin patogenezi ve klinik önemi tam olarak araştırılmamış ve ortaya çıkarılmamıştır. Bu çalışmamızın amacı kliniğimizde akut biliyer pankreatit tanısı ile yatan olgularda üst gastrointestinal mukozal lezyonları saptamak ve bu lezyonlarda Helikobakter pilori prevalansını retrospektif olarak belirlemektir. Gereç ve Yöntem: Çalışmaya retrospektif ola-rak 94 akut biliyer pankreatitli ve toplam 179 safra taşı birlikteliği olan ve olmayan dispeptik olgu kontrol grubu olarak şdahil edilmiştir. Çalışmaya dahil edilen tüm vakalardan antrum ve korpustan hem Helikobakter pilori hemde mukozanın histolojik yapısını belirlemek için ikişer adet biyopsi alın-mıştı.Bulgular: Akut biliyer pankreatitli olguların %71'inde üst gastrointes-tinal mukozal lezyon saptandı. Özofajit ve peptik ülser akut biliyer pankre-atitli olgularda kontrol grubuna göre anlamlı olarak yüksek çıktı (p

Anahtar Kelimeler

Biliyer pankreatit, peptik ülser, Helikobakter pilori

Kaynakça

• DeFrances CJ, Lucas CA, Buie VC, Golosinskiy A. 2006 National hospi- tal discharge survey. National Health Statistics Reports 2008.
• Tinto A, Lloyd DA, Kang JY, et al. Acute and chronic pancreatitis-disea- ses on the rise: a study of hospital admissions in England 1989/90- 1999/2000. Aliment Pharmacol Ther 2002;16:2097-105.
• Spanier BW, Dijkgraaf MG, Bruno MJ. Epidemiology, etiology and out- come of acute and chronic pancreatitis: an update. Best Pract Res Clin Gastroenterol 2008;22:45-63.
• Chen TA, Lo GH, Lin CK, et al. Acute pancreatitis-associated acute gas- trointestinal mucosal lesions: incidence, characteristics, and clinical sig- nificance. J Clin Gastroenterol 2007;41:630-4.
• Lin CK, Wang ZS, Lai KH, et al. Gastrointestinal mucosal lesions in pa- tients with acute pancreatitis. Chin Med J (Taipei) 2002;65:275-8.
• Lee KM, Paik CN, Chung WC, Yang JM. Association between acute pan- creatitis and peptic ulcer disease. World J Gastroenterol 2011;17:1058- 62.
• Chan FK, Leung WK. Peptic-ulcer disease. Lancet 2002;360:933-41.
• Bresalier RS. The clinical significance and pathophysiology of stress-re- lated gastric mucosal hemorrhage. J Clin Gastroenterol 1991;13:35-43.
• Balthazar EJ, Robinson DL, Megibow AJ, Ranson JH. Acute pancreatitis: value of CT in establishing prognosis. Radiology 1990;174:331–6.
• Ranson JH, Rifkind KM, Roses DF, et al. Prognostic signs and the role of operative management in acute pancreatitis. Surg Gynecol Obstet 1974;139:69-81.
• Hori K, Matsumoto T, Miwa H. Analysis of the gastrointestinal symp- toms of uninvestigated dyspepsia and irritable bowel syndrome. Gut 2009;3:192-6.
• Armstrong D, Bennett JR, Blum AL, et al. The endoscopic assessment of esophagitis: a progress report on observer agreement. Gastroenterology 1996;111:85-92.
• Chebli JM, de Souza AF, Gaburri PD, et al. Prevalence and pathogenesis of duodenal ulcer in chronic alcoholic pancreatitis. J Clin Gastroenterol 2002;35:71-4.
• Khan J, Pelli H, Lappalainen-Lehto R, et al. Helicobacter pylori in alco- hol induced acute pancreatitis. Scand J Surg 2009;98:221-4.
• Manes G, Balzano A, Vaira D. Helicobacter pylori and pancreatic disea- se. JOP J Pancreas 2003;4:111-6.
• Metz DC. Preventing the gastrointestinal consequences of stress related mucosal disease. Curr Med Res Opin 2005;21:11-8.
• Navab F, Steingrub J. Stress AGML: is routine prophylaxis necessary? Am J Gastroenterol 1995;90:708-12.
• Amaral MC, Favas C, Alves JD, Riso N. Stress-related mucosal disease: incidence of bleeding and the role of omeprazole in its prophylaxis. Eur J Intern Med 2010;21:386-8.