Profile and Pathway of Patients Hospitalized for Acute Pancreatitis in the Hepatogastroenterology Department of the CHU of Libreville

Abstract

Introduction: Acute pancreatitis is a diagnostic and therapeutic emergency with well-defined management guidelines. The objective was to define the care pathway for patients presenting with acute pancreatitis. Patients and methods: Through a retrospective and descriptive study, we collected all cases of acute pancreatitis hospitalized in the hepatogastroenterology department of the Libreville University Hospital between January 1, 2019, and December 31, 2023, based on the Atlanta criteria. Sociodemographic data, patient care pathway, severity of the flare-up, etiology, and outcome were recorded. Results: We collected 95 cases of acute pancreatitis with a mean age of 41.9 years (±15.6) and a male-to-female ratio of 1.15. It was moderately severe in 78.94% of cases. The etiology was gallstones (43.16%), alcohol (30.53%), and mixed (12.63%). The mean time to emergency department visit was 4.79 days (±1.41 days). The prehospital pathway revealed that 16.84% went directly to the emergency department, 36.84% self-medicated, 35.79% consulted a traditional healer, and 10.53% visited places of worship. The hospital pathway revealed that 11.43% were admitted to the intensive care unit. Mortality was 12.63% with associated factors including CRP above 150 mg/L (OR = 2.11 [1.18 - 3.74]; p = 0.043) and CTSI above 7 (OR = 1.6 [1.31 - 2.89]; p = 0.038). Conclusion: Socio-cultural constraints are responsible for the delay in access to care, which seems to be aggravated by the absence of an intensive digestive care unit.