Acute pancreatitis after major spine surgery: a case report and literature review

Investigation of factors affecting COVID-19 pancreatic injury: a single-center, retrospective study

Pancreatic injury is considered an organ-related complication in patients with coronavirus disease 2019 (COVID-19). However, it is unclear whether COVID-19 status affects pancreatic injury. This retrospective study aimed to determine whether COVID-19 affects the occurrence of pancreatic injuries. Consecutive patients diagnosed with sepsis admitted to the ICU between March 2020 and September 2021 were included. The primary endpoint was a pancreatic injury, which was defined as amylase or lipase levels > 3 times the upper limit of the normal range. Among the 177 patients included in the analysis, 40 (23%) were COVID-19 patients, and 54 (31%) had pancreatic injuries. Of these three patients, acute pancreatitis was diagnosed based on computed tomography. The pancreatic injury was significantly more common among COVID-19 patients (75 vs. 18%, p < 0.001). Multivariate analysis showed that COVID-19 and steroid use were independent risk factors for pancreatic injury (Odds Ratio (OR) 4.79 [95% confidence interval (CI) 1.48-15.5], p = 0.009; OR 4.02 [95% CI 1.42-11.4], p = 0.009). This study revealed that the proportion of pancreatic injury in septic patients with COVID-19 was significantly higher than in those without COVID-19. It may be difficult to diagnose pancreatitis based on amylase and lipase levels in COVID-19 patients.

Clinical characteristics and outcomes of acute pancreatitis following spinal surgery: a systematic review

Objective

This study reviewed the current evidence on the clinical characteristics and outcome of acute pancreatitis (AP) following spinal surgery.

Methods

A systematic search was performed to identify English articles published through May 2020 in PubMed, Scopus, EMBASE, Latin American & Caribbean Health Sciences Literature, and Cochrane Library. Data on clinical characteristics, risk factors, and outcomes were analyzed.

Results

Eleven papers (including six case reports) were included, with 306 patients (incidence, 23.0%) developing AP after spinal surgery (mean age, 14.2 years). Of the studies that specified symptoms (55 patients), abdominal pain (43.6%), nausea and vomiting (32.7%), and abdominal distension (7.27%) were most prevalent. The mean duration from surgery to symptom onset was 6.15 days (range, 1–7). The most common complications of AP were glucose intolerance (25%), peritonitis (2%), pseudocyst formation (2%), and fluid collection (2%) were most prevalent. Prolonged fasting time (13.6%), intraoperative blood loss (9.09%), gastroesophageal reflux disease (9.1%), age >14 years (9.1%), and low BMI (9.1%) were most commonly associated with AP. Two deaths (0.6%) were reported.

Conclusion

AP remains an important complication of spinal surgery because of its morbidity and mortality. Avoiding major risk factors can reduce the incidence of AP following spinal surgery.

Assessment of changes in blood pancreatic lipase activities using FDC-v-LIP in dogs that underwent various surgical procedures

OBJECTIVE

To describe the perioperative changes in blood pancreatic lipase activity and explore the contributing clinical factors associated with these changes.

DESIGN

Prospective observational study.

SETTING

University teaching hospital.

ANIMALS

One hundred and four dogs underwent various surgical procedures under general anesthesia.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

Blood pancreatic lipase activities, which were measured using FUJI DRI-CHEM v-Lip-P (FDC-v-Lip), significantly increased postoperatively compared to preoperative measurements (premedian 58.5 U/L [range, 23-157] vs. postmedian 80 U/L [range, 22-1000], P < 0.0001). The patient with a postoperative increase in FDC-v-Lip over the normal range (35 dogs [33.6%]) had significantly higher preoperative FDC-v-Lip values.

CONCLUSIONS

In this study, dogs had significantly increased pancreas-specific lipase activities after surgical procedures under general anesthesia. Direct contributors to the increase and its relevance to clinical and histological pancreatitis should be determined in the future.