The management of acute necrotizing pancreatitis:Retrospective study at the General Surgery Service of the Hospital Military Avicenna Marrakech

M Lahkim[1a], M Ramraoui[1] , J Fassi Fihri[1] ,A Elguazzar[1] , A Elkhader[1], A Mejdane[1] , R El Barni[1] , A Achour[1]
Page No. 19-23

Our study is a retrospective analysis of the clinical data, prognosis, therapeutic aspects and
outcomes in acute necrotizing pancreatitis through a series of 39 cases diagnosed and treated at the
department of general surgery of Avicenne military hospital, Marrakesh, from December 2006 to
December 2014. There were 23 female and 16 male patients, with a mean age of 52.5 years.
Abdominal pain was the most common symptom (100%), 23% of our patients had dyspnea and
12,8% had shock at the admission. Abdominal computed tomography was performed for all
patients, pancreatitis grade E was the most predominant (59%). Ranson score was up to 3 in (69,
2%) of cases .35 patients (89, 7 %) were managed conservatively and 4 patients (10,3%) underwent
surgery. The mortality rate was 25,6%. The outcome was favorable in 35,8% of cases. However 64,
2% of patients developed complications. Organ failure was the most predominant complication
(51%). it was associated to infection necrosis in 30, 7% of cases. There fore clinical and
paraclinical supervision is needed to detect and treat this complication early.
Keywords : Acute pancreatitis-pancreatic necrosis-Medical management-Necrosectomy