COMPARTMENT-SYNDROME AS A PREDICTOR OF THE ACUTE PANCREATITIS SEVERITY COURSE

Abstract

Summary. A directly proportional relationship between the level of intra-abdominal pressure (IAP) and the clinical and morphological form and severity of acute pancreatitis (AP) was established in the course of the study. Namely: intra-abdominal hypertension (IAH) severity degree I–II was stated in 22.5 % of patients with edematous interstitial pancreatitis and in 43.5 % with necrotic pancreatitis. Compartment syndrome was diagnosed in 56.5 % of patients with necrotic pancreatic necrosis, accompanied by signs of persistent multiple organ failure (MOF) and purulent complications

The aim of the study – to establish a connection between the development of abdominal compartment syndrome and the severity of acute pancreatitis

Materials and Methods. 112 patients with acute pancreatitis, which was established on the basis of clinical and anamnestic data, the center of treatment of acute destructive pancreatitis of Rivne Regional Clinical Hospital. 79.5 % of patients with interstitial edematous pancreatitis (n = 89) and 20.5 % (n = 23) – necrotic pancreatitis were identified as a result of the analysis of clinical, laboratory and instrumental research methods. Patients were divided into three groups in terms of determining the degree of IAH indirect method: group 1 – 61.6 % (n = 69) was the examined who had intra-abdominal pressure within normal limits (5–7 mm Hg). Group 2 – 26.8 % (n = 30) – patients with IOP 12–20 mm Hg and group 3 – 11.6 % (n = 13) – with ICP> 20 mm Hg.

Results. Etiological factors were: alcohol 54.5 %, alimentary – 24.1 %, biliary – 17 %, and other causes – 4.5 %. The share of concomitant pathology was 33.9 %, with a predominance of hypertension. The study of IAP was performed in terms of severity of AP and clinical and morphological form. Among all examined 61.6 % of patients mainly with a mild course (except for (n = 4 - moderate) edematous pancreatitis ICP was within normal limits. IAH degree I–II was determined in 30 patients, including 17.8 % – edematous pancreatitis, mild and 43.5 % – necrotic pancreatic necrosis, moderate and severe disease. Compartment syndrome was diagnosed in 56.5 % (n ​​= 23) patients, as the severity of the disease progressed, the appearance of persistent MOF and purulent complications.

Conclusions. A direct strong correlation was found between the level of ICP, clinical and morphological form and severity of the disease (r = 0.7853).