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￭ S-113 ￭
Diabetes mellitus is associated with mortality in acute pancreatitis
1Division of Gastroenterology and Hepatology, 2Divison of Endocrinology, Department of Internal Medicine,Yonsei University Wonju College of Medicine, Wonju, Korea
*Hosung Jeon1, JiHye Huh2, Jae Woo Kim1, KyongJoo Lee1
Background/Aims: Predicting severe pancreatitis is important for early aggressive management of patients with acute pancreatitis. This study was de- signed to investigate the risk factors of mortality in acute pancreatitis. Methods: Patients diagnosed with first attack of acute pancreatitis were enrolled from January 2013 to December 2014. We evaluated the relationship between smoking, obesity, hypertension, liver cirrhosis, diabetes mellitus, several predictive scoring systems, and mortality. Results: A total of 161 patients (62.1% male, mean age 59.3 ± 18.7 years) with acute pancreatitis were included. Etiologies included gallstone (49.7%), alcohol (38.5%), hypertriglyceridemia (1.9%) and idiopathic (9.9%). Body mass index, Ranson score, Bedside Index of Severity in Acute Pancreatitis (BISAP), number of ICU admission, and mortality were higher in group consisting of acute pancreatitis with diabetes compared to those without. In univariate analysis, diabetes mellitus, CT score index (CTSI) and BISAP were associated with mortality in acute pancreatitis. In multivariate analysis, diabetes mellitus (Odds ratio 4.72, 95% CI 1.23-18.12, p＝0.023) and BISAP (Odds ratio 10.96, 95% CI 2.61-45.94, p＝0.001) were independently associated with mortality. Discussions: Diabetes mellitus with higher level of BISAP score is associated with mortality in acute pancreatitis. Keywords: Acute pancreatitis; Diabetes mellitus; Mortality
￭ S-114 ￭
Neuroendocrine tumor mimicking accessory spleen
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea Univ College of Medicine, Seoul, Korea
*HK Oh, JJ Hyun
Neuroendocrine tumor within the tail of pancreas is commonly mistaken by imaging studies for intrapancreatic accessory spleen. Herein, we report a case of neuroendocrine tumor that mimicked accessory spleen on imaging studies, but eventually confirmed as neuroendocrine carcinoma after laparo- scopic distal pancreatectomy. A 70-year-old Korean man was admitted for a lung mass in the right lower lobe. During evaluation, however, a mass le- sion was incidentally found in pancreatic tail on abdominal CT scan. This 2.6 cm sized pancreatic tail mass showed T2 high signal intensity and T1 low signal intensity, along with T2 bright high signal intensity indicating the presence of cystic portion. Radiologic impression was neuroendocrine tumor or accessory spleen rather than metastasis from lung cancer. Therefore, he underwent concurrent operation of right lower lobe wedge resection and laparo- scopic distal pancreatectomy. The result of the immunohistochemistry for pancreatic mass was as follows: synaptophysin (＋), CD56 (＋), chromogra- nin A (＋), Ki-67 index (3-4%). Based on these findings, the patient was diagnosed with well-differentiated endocrine carcinoma of the pancreas.
