Aspectos clinicos e morfologicos da pancreatite cronica em uma serie de 320 pacientes

AUTOR(ES)
DATA DE PUBLICAÇÃO

1995

RESUMO

With the purpose to describe clinical aspects, complications, morphological alterations and associations with others disease, were investigated a series ofthe 320 patients with diagnosis of chronic pancreatitis between 1978 and 1994. Of them, 294 (91,9%) were males and 26 (8,1 %) females, with mean age at diagnosis of 40.9 :t 9.7 years. Criteria for diagnosis of chronic pancreatitis included at least one of the following: (a) pancreatic calcifications, (b) abnormalities in the pancreatic duct by endoscopic retrograde pancreatography and (c) histological findings of chronic pancreatitis. Of the 320 cases, 295 (92.2%) were attributed to alcohol, 19 (6.0%) were idiopathic, 2 (0.6%) hyperlipidemia, 2 (0.6%) cystic fibrosis and 2 (0.6%) trauma. Ofthe 295 patients presenting with alcoholism, alcQholic consumption was characterized by: a) mean age of onset of drinking was 18. O :t 4.4 years; b) mean age of the appearance of clinical symptoms was 37,7 years; c) mean value daily intake of alcohol was 208.7 :t 82,3 gld of ethanol; d) mean value of the duration of alcoholism was 19.6:t 7.5 years, and d) alcoholic beverage more commonly consumed was a kind of liquor, the cane-spirit alcohol. The principal clinical features observed were represented by: abdominal pain 280 (87.5%), weight loss 279 (87.2%), steatorrhea 106 (33,1%) and diabetes 122 (38,1%). Abdominal pain was the most frequent presenting symptom, being the chief complaint in 225 (70,3%) af our patients. The clinical complications ocurred in 175 (54.6%) patients.The main complications observed were represented by: pancreatic cysts 129 (40.3%), jaundice 66 (20.6%), ascites and/or pleural effusion 19 (5.9%), hemorrhage due to pancreatic origin 16 (5.0%), splenic vein thrombosis 14 (4.4%) and duodenal obstruction 6 (1.8%). I Calcifications detected by ultrasonography were observed in 200 ofthe 320 cases (62.5%). I There was a positive association between pancreatic calcification and pancretic insuficiency. Of the 167 patients that were performed endoscopic retrograde pancreatography, in 10 (5.9%) was found pancreas divisum and marked radiological alterations were found in 130 (78.0%). Endoscopic retrograde colangiography was performed in 142 patient and was observed common bile duct stenosis in 65 (45.7%). Associations of chronic pancreatitis with other diseases also were investigated: peptic ulcers 44 of 260 (16.7%) patients that was performed upper digestive endoscopy, cholelithiasis 41 (12.8%), liver cirrhosis 3 of the 54 (5.0%) patients that was performed liver biopsy, renal stone 10 (3.1%) and tuberculosis 24 (7.5%). Neoplasia ofpancreas ocurred in 1 (0.3%) of . . Ipatients and extra pancreatic malignancy in 9 (2.8%). 153 patients were submited to the surgi cal procedures. The most common indication was intractable pain

ASSUNTO(S)

pancreatite alcoolismo doenças cronicas

ACESSO AO ARTIGO

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