고령자 급성 췌장염의 임상적 고찰

Abstract

Background/Airns: Inflammatory diseasas of the pancreas are not uncommon. The advanced age is one of the significant factors in assessing the severity of acute pancreatitis. It has been shown that the biliary tract disease is a more frequent cause of acute pancreatitis in the elderly than in the young. With the increased life span, the elderly are comprising a large proportion of the population. As a result, physicians are more often being faced with acute pancreatitis in the elderly. The purpose af this study was to evaluate clinical features of acute panereatitis in the elderly. Methods: A total of 188 patients with acute pancreatitis were reviewed. We investigated the differences of clinical characteristics between the elderly patients aged over 60 and the young patients aged under 60. Results: The sex distribution showed male preponderance in the young patients (M:F=2.4:1), but was nearly equal in the elderly patients (M:F=1.1:1). The most common cause of acute pancreatitis in the elderly was biliary tract disease (52.5%), while alcohol abuse was the most common cause in the young patients (38.8%), Local complications of acute pancreatitis, such as psuedocyst, necrosis, abscesses were not differently shown between the elderly (16.9%) and the young (20.2%) patients. Systemic complications including acute puhnonary failure occurred more frequently in the elderly patients than the young patients. The mortality rate of the elderly patients (5.1%) was not significantly different from that of the young patients (3.1%). Conclusions: To detect correctable underlying bihary tract diseases the elderly patients with acute pancreatitis should be completely investigated using endoscopic retrograde cholangiopancreatography (ERCP). In addition, the patient should be closely monitored for the development of the systemic complications during the disease process.