Clinicopathological characteristics of pancreatitis in Far North Queensland

Pancreatitis is a common cause for unscheduled admissions in General or Gastrointestinal Surgery units throughout the world. This is particularly perceived to be the case in northern Australia, where alcohol and certain socio-demographic factors may be prominent in influencing the incidence and course of the disease. Over the years, much has been written about various aspects of pathogenesis, prognostication and management. However in the average clinical setting, many useful questions go unasked and unanswered. Because patients rarely require formal surgical intervention or even high-dependency management, there is rarely any active enquiry into the issues surrounding acute pancreatitis admissions. The chronic aspects of what is superficially considered to be an isolated acute process are also often overlooked. This body of work evolved out of the desire to foster a better standard of care for such patients and ultimately to reduce the frequency of acute hospital admissions, particularly recurrent admissions for the same patient. In order to effect any improvement in the management of a disease, it is first necessary to quantify and characterize it in relation to the target population. To this end, a retrospective audit was undertaken of acute pancreatitis admissions to the three major referral hospitals of Northern Queensland over the calendar year of 1997. Any inferences from this study were limited by the quality of the data recorded by a variety of clinicians. However, from what was available, it was evident that many patients admitted to hospital with a diagnosis of acute pancreatitis appeared to exhibit the characteristics of a chronic disease process. Indeed almost half of those who fulfilled the diagnostic criteria for acute pancreatitis appeared to be harbouring underlying chronic pancreatitis, based on clinical specifications. To better characterize the clinicopathological features of hospitalizations for pancreatitis in Northern Queensland, it was therefore necessary to acquire case data in a robust ...