P2119 - Challenges of Management of Acute Pancreatitis in Limited Resource Setting: A Single Center Study in Bangladesh

Md. S. Hossain, MBBS, MD
Rangpur Medical College, Rangpur, Rangpur, Bangladesh

Introduction: Acute pancreatitis is a common and dangerous medical emergency in the practice of gastroenterology all over the world. Management of acute pancreatitis needs multidisciplinary approach with support starting from emergency to ICU. So, there is a chance of mismanagement in every steps facing the physicians a challenge, especially in low resource settings. Other factors such as patient’s financial condition, education, social custom, transport facility, referral system from periphery may also challenge the current guidelines for management.

Methods: This study was intended to determine the clinicopathological profile, severity assessment and challenges of management of acute pancreatitis in a government laid medical college hospital to image the real scenario of management in a low resource place. A total of 100 patients who were admitted and diagnosed as acute pancreatitis were included in this prospective study, held in Department of Gastroenterology, Rangpur medical college hospital from July 2017 to July 2018. We assessed the severity of acute pancreatitis by Ranson,s criteria, BISAP score and Revised Atlanta criteria. We managed all patients according to ACG guidelines for management of Acute pancreatitis; 2013.

Results: Among 100 patients of acute pancreatitis, 85 of the patients were mild whereas 13 were moderately severe and 02 had severe acute pancreatitis. The most common aetiology of acute pancreatitis in our study was gall stone (15%) and biliary sludge (15%), whereas 54% were idiopathic acute pancreatitis. The most common challenges we faced were delay in hospital admission (59%) and delay in hospital diagnosis (20%). Other challenges are non-adherence of patient party and lack of investigation facility, physician’s poor knowledge about current guidelines. We were able to give early aggressive fluid to only 18% patients as per current guideline.

Discussion: Management of acute pancreatitis as per guideline is challenging when optimum facility is lacking. So, a modified guideline for the assessment and management of acute pancreatitis should be prepared for limited resource setting.



Disclosures:


Md. S. Hossain, MBBS, MD. P2119 - Challenges of Management of Acute Pancreatitis in Limited Resource Setting: A Single Center Study in Bangladesh, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.