Abstract
Four practice criteria of severity were assessed on admission in 87 patients with acute pancreatitis. The value of hypotension and hypocalcaemia was limited by their lack of sensitivity (14-32%). Hypoxaemia and a positive peritoneal tap had greater sensitivity (47-55%) without losing diagnostic accuracy (83-84%). The presence of one or more positive criteria discriminated between a 'severe' group of patients with a mortality of 43% and a 'mild' group with a majority of 3% (p less than 0.001). Twenty-three patients with predicted 'severe' disease were randomised to receive peritoneal lavage for 72 h (9) or no lavage (14), but no statistically significant benefit has yet been shown from this treatment.
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Selected References
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