Changing pattern of incidence, aetiology and mortality from acute pancreatitis at Kalafong Hospital, Pretoria, South Africa, 1988-2007: A retrospective evaluation

Abstract

Background: Literature reports from Western countries suggest an increasing incidence of acute pancreatitis (AP) and changing pattern over the past two decades. The aim of this study was to document the incidence, aetiology and mortality from AP over two decades and to examine any emerging trends.

Methods: A retrospective study of all confirmed cases of AP admitted over a 20-year period to the surgical department was performed. Patients’ demographics, year of admission, number of attacks, aetiology, management and outcome were entered on a special study proforma.

Results: Altogether 707 attacks of AP (M: F, 5.7: 1) were recorded. The proportion of gallstone AP increased (3.1% to 12.7%) and that of alcohol-related AP decreased (84% to 67.6%). Alcohol was the main aetiological factor for AP. Drugs, hyperlipidaemia, human immunodeficiency virus (HIV) and endoscopic pancreatography-related AP increased in the second decade. The in-hospital mortality rate during the respective periods was 6.5% and 3.1%.

Conclusion: Gallstone AP increased during second decade from more Caucasian admissions and increased gallstones among Blacks. The reduced mortality was attributed to changing trends in the nature and aetiology of AP recorded, heightened awareness of the condition and improved management.