Which of the following types of pancreatitis has the best prognosis
Correct Answer: Gall stone pancreatitis
Description: .Ranson's prognostic criteria On admission:--* Old age >55 years * Blood sugar >200 mg% * TC >16,000/mm3 * Serum LDH > 350 IU/L * Serum SGOT > 250 IU/L In 48 hrs: * Base deficit > 4 mEq/L * Serum calcium < 8 mEq/L * Haematocrit : altered by 10% * Aerial O2 (PO2) < 60 mm Hg * Extravascular space fluid loss: > 6 * Blood urea (BUN) altered > 5 mg% of the normal Total score is 11 Scores up to 5 -- better prognosis 5-7 -- equivocal--but dangerous >7 -- is highly dangerous Glasgow criteria-* Age > 55 years * PO2 < 8 KPa * Total count >15000 cells/mm3 * Serum calcium < 2 mmoles/L * Blood urea > 16 mmol/L * Blood glucose > 10 mmols/L (200 mg%, no H/O diabetes) * SGPT > 200 IU/L * LDH > 600 U/L * Serum albumin < 3.2 gm/dl Note: * Decrease serum calcium level is worst prognostic indicator of pancreatitis. * These scoring systems differ for non gall stone pancreatitis and gall stone pancreatitis. * Other scoring systems which are often used are APACHE II (Acute Physiology And Chronic Health Evaluation II) and SAP (simplified acute physiology) scoring systems. Twelve variables are used to assess in APACHE II scoring. ref:SRB&;S manual of surgery,ed 3,pg no 620
Category:
Surgery
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