Trends of Lipase and General Features in Organophosphates Induced Acute Pancreatitis
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(Cho Nam-Hyub) - Yonsei University Wonju College of Medicine Department of Emergency Medicine
񊀔(Kim Hyun) - Yonsei University Wonju College of Medicine Department of Emergency Medicine
Á¤¿ìÁø(Jung Woo-Jin) - Yonsei University Wonju College of Medicine Department of Emergency Medicine
±è¿ë¿ø(Kim Yong-Won) - Yonsei University Wonju College of Medicine Department of Emergency Medicine
±èÅÂÈÆ(Kim Tae-Hoon) - Yonsei University Wonju College of Medicine Department of Emergency Medicine
±è¿ÀÇö(Kim Oh-Hyun) - Yonsei University Wonju College of Medicine Department of Emergency Medicine
Â÷°æö(Cha Kyoung-Chul) - Yonsei University Wonju College of Medicine Department of Emergency Medicine
ÀÌ°Çö(Lee Kang-Hyun) - Yonsei University Wonju College of Medicine Department of Emergency Medicine
Ȳ¼º¿À(Hwang Sung-Oh) - Yonsei University Wonju College of Medicine Department of Emergency Medicine
Â÷¿ë¼º(Cha Yong-Sung) - Yonsei University Wonju College of Medicine Department of Emergency Medicine
Abstract
Purpose: There have been few case reports and studies on acute pancreatitis associated with organophosphate (OP) poisoning. We investigated prevalence, general characteristics, trends of lipase levels, and findings of computed tomography (CT) in acute pancreatitis associated with OP poisoning.
Methods: A retrospective review was conducted of 84 consecutive cases of organophosphate insecticide poisoning that were diagnosed and treated at the Emergency Department of the Wonju Severance Christian Hospital from January 2008 to April 2012.
Results: Acute pancreatitis was seen in 14 patients (16.7%). In pancreatitis patients, diagnosis was made at ED presentation in eight patients (57.1%) and after hospital day(HD) #2 in six patients (42.9%). In the subgroup of patients with an elevated lipase level, after OP poisoning time of peak lipase level and time to normalization were 3.6 (IQR 2.2-5.6) h and 50.6 (IQR 26.7-86.1) h, respectively. CTs were all grade A according to Balthazar classification. Significant differences were observed between the pancreatitis vs. non-pancreatitis groups in terms of ingested amounts [300 (IQR 125-450) mL vs. 100 (IQR 30-200) mL, p=0.007], pH [7.26 (IQR 7.11-7.36) vs. 7.35 (IQR 7.27- 7.40), p=0.048], and serum lactate [5.85 (IQR 3.53-9.53) mmol/L vs. 3.39 (IQR 2.31-5.99) mmol/L, p=0.037], respectively. No statistical differences in terms of respiratory failure requiring ventilator care, shock, pneumonia, and AKI were observed between the pancreatitis vs. non-pancreatitis groups. No statistical differences in terms of total admission length, ICU admission length, and mortality were observed between the pancreatitis vs. non-pancreatitis groups.
Conclusion: The prevalence of acute pancreatitis in OP poisoning was 16.7%. After OP poisoning time of peak lipase level and time to normalization were 3.6 (IQR 2.2-5.6) h and 50.6 (IQR 26.7-86.1) h, respectively. In the acute pancreatitis group, ingested amounts, serum lactate were higher and serum pH was less than in the non-pancreatitis group.
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Pancreatitis, Lipase, Organophosphates
KMID :
0385920140250030277
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