Acute pancreatitis-associated acute gastrointestinal mucosal lesions: incidence, characteristics, and clinical significance.
OBJECTIVE
Dyspeptic symptoms are associated with acute pancreatitis, but some of them may be related to acute gastrointestinal mucosal lesions (AGML) and need acid-suppressive therapy. The aim of this prospective study was to investigate the incidence, characteristics, and clinical significance of acute pancreatitis-associated AGML.


METHODS
From January to December 2005, a total of 197 patients with acute pancreatitis were included. All patients underwent computed tomography to evaluate the severity of acute pancreatitis. They also underwent upper gastrointestinal endoscopy to detect any AGML in upper gastrointestinal tract. The clinical and laboratory data from patients with or without AGML were compared.


RESULTS
Of the 197 patients, 128 patients (65%) were found having AGML by endoscopy. The locations of AGML included esophagus (9), stomach (50), duodenum (33), combined esophagus and stomach (10), and combined stomach and duodenum (26). The incidence of AGML was more frequent in patients with male gender (P<0.01). There was no statistical significance in relationship between AGML presence and age, etiologies of pancreatitis, severity of pancreatitis according to computed tomography grading or Ranson's score, serum total bilirubin level, duration of stay, or mortality. There was also no statistical significance in relationship between AGML location and etiologies of pancreatitis.


CONCLUSIONS
Sixty-five percent of patients with acute pancreatitis complicate with AGML and may benefit by acid-suppressive therapy. The occurrence of AGML is significantly increased in male patients and is not an early predictor of severity in acute pancreatitis.
Chen
Tai-An
TA
Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
Lo
Gin-Ho
GH
Lin
Chiun-Ku
CK
Lai
Kwok-Hung
KH
Wong
Hsin-Yung
HY
Yu
Hsien-Chung
HC
Hsu
Ping-I
PI
Chen
Hoi-Hung
HH
Tsai
Wei-Lun
WL
Chen
Wen-Chi
WC
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001663:Bilirubin / Q000097:blood; D004386:Duodenum / Q000473:pathology; D016099:Endoscopy, Gastrointestinal; D004947:Esophagus / Q000473:pathology; D005260:Female; D042882:Gallstones / Q000150:complications; D005753:Gastric Mucosa / Q000473:pathology*; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000473:pathology; D010195:Pancreatitis / Q000150:complications* / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology; D010437:Peptic Ulcer / Q000209:etiology* / Q000523:psychology; D011446:Prospective Studies; D012720:Severity of Illness Index; D012737:Sex Factors; D013315:Stress, Psychological; D014057:Tomography, X-Ray Computed
D001663:Bilirubin