Prevalence and Epidemiological Profile of Acute Pancreatitis in King Faisal Hospital: Retrospective descriptive study from 2014--2024

Prevalence and Epidemiological Profile of Acute Pancreatitis in King Faisal Hospital: Retrospective descriptive study from 2014--2024 | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Prevalence and Epidemiological Profile of Acute Pancreatitis in King Faisal Hospital: Retrospective descriptive study from 2014--2024 Osama Mokhtar, Ahmed Hashim, Shikama Felicien This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6917772/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: Acute pancreatitis is one of the most important acute gastrointestinal conditions worldwide, although its prevalence and etiology vary across countries and regions. This study investigated regional and national patterns in the prevalence and etiology of acute pancreatitis, demographic patterns in prevalence, and trends over time in prevalence in Kigali, Rwanda. Objective: To determine the prevalence of acute pancreatitis (AP) in Kigali, Rwanda, KFH. -To identify the most common causes of AP in Kigali, Rwanda, and KFH. -To characterize the clinical presentation of AP in Kigali, Rwanda, KFH. Methods: This retrospective study analyzed patients from medical wards between 2014 and 2024. The study excluded patients with a history of chronic pancreatitis or incomplete files. Additionally, a structured review was conducted to examine the prevalence and etiology of acute pancreatitis in hospitalized patients. Results: A study of 65 acute pancreatitis patients revealed that most were male, aged 25--35 years, with an average age of 37 years. Common causes included alcohol (75.4%) and gallstones (27.7%). The symptoms were mainly abdominal pain, nausea, and vomiting. Most cases were mild to moderate, with 9.5% very severe. Diagnostic imaging frequently includes CT scans and ultrasounds. Most patients were hospitalized for under 5 days, received conservative treatment, and improved. Necrosis was a notablecomplication in 9.2% of the patients. Conclusion : This study reveals important patterns in the demographics, clinical features, and management of acute pancreatitis patients. Although the findings are consistent with global trends, significant regional variations in causes, severity, and socioeconomic factors highlight the necessity for localized prevention and treatment strategies. More research into these regional differences is crucial for refining acute pancreatitis care approaches. Acute pancreatitis Etiology Alcohol Gallstones Rwanda Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 1 Introduction 1.1. Background Acute pancreatitis (AP), an inflammatory condition affecting the pancreas, poses a significant global health challenge because of its potential for severe complications, high morbidity, and mortality ([^1^] Banks & Freeman 2006 ). Understanding the prevalence and epidemiological profile of acute pancreatitis is essential for effective public health planning, resource allocation, and the development of targeted preventive strategies. This research aims to contribute to this understanding by investigating the prevalence and key epidemiological factors associated with acute pancreatitis. The incidence of AP has shown notable variations across regions and populations, reflecting the complex interplay of genetic, environmental, and lifestyle factors ([^2^] Yadav & Lowenfels 2013 ). Variations in healthcare access and diagnostic practices further contribute to the diversity of reported prevalence rates. According to the Global Burden of Disease Study 2019, millions of new cases of AP have been reported, along with substantial mortality and disability-adjusted life years (DALYs) attributable to the condition. The study also highlighted significant regional differences, emphasizing the need for a nuanced understanding of the epidemiological landscape specific to each locality ([^3^] GBD 2019 ). Alcohol use, gallstones, and differences between populations are well-known factors linked to the development of acute pancreatitis ([^4^] Forsmark et al. 2016 ) ([^5^] Lankisch et al. 2013 ). Yet, despite these common causes, there's still a lack of detailed data from regions like ours. With this study, we aim to explore the patterns of acute pancreatitis in our setting to help fill that gap. By sharing findings that reflect local realities, we hope to support more tailored prevention efforts, better patient care, and policies that reflect the needs of similar communities.Acute pancreatitis is a disease that attacks the pancreas, one of the visceral organs located behind the stomach. The pancreas produces digestive enzymes and hormones, including insulin. AP occurs when digestive enzymes affect the pancreas and cause inflammation ([^9^] NIDDK 2019). There are two types of pancreatitis: acute and chronic pancreatitis, both of which are serious and can lead to complications ([^10^] Nesvaderani et al. 2015 ). Acute pancreatitis is a medical emergency, with symptoms ranging from a mild form, which resolves with effective treatment within days, to a severe form that can lead to organ failure and even death ([^11^] Banks PA et al. 2013). AP can be classified into mild AP, where systemic complications and organ failure are absent; moderate AP, where organ failure occurs but can be resolved with effective treatment; and severe AP, where one or multiple organ failures become persistent ([^11^] Banks PA et al. 2013). Globally, AP occurs annually in approximately 30 per 100,000 people ([^12^] Lankisch et al. 2015 ). Certain individuals, particularly males and those with a personal or family history of gallstones or a positive family history of pancreatitis, are at greater risk of being affected by acute or chronic pancreatitis ([^9^] NIDDK 2019). The signs and symptoms of AP vary and may include pain in the right upper quadrant radiating to the back, nausea, and vomiting that worsens with eating. Fever may occur, and jaundice may appear when the gallbladder is affected by gallstones ([^9^] NIDDK 2019). Bile duct obstruction by gallstones and heavy alcohol use are the two most common causes of AP, accounting for approximately 80% of cases ([^13^] Parenti DM et al. 1996). Other causes include direct trauma, certain medications (e.g., statins, ACE inhibitors, oral contraceptive/hormone replacement therapy (HRT), diuretics, antiretroviral therapy, and oral hypoglycemic agents), infections (bacterial, viral, parasitic, and fungal), smoking, and tumors ([^14^] Rawla P et al. 2017 ). Autoimmune diseases such as cystic fibrosis, high blood fat levels, obesity, and recent procedures such as endoscopic retrograde cholangiopancreatography (ERCP) can also contribute to AP ([^9^] NIDDK 2019). Additionally, type 2 diabetes mellitus is associated with a 2.8-fold greater risk of AP ([^15^] Noel RA et al. 2009). Unclear (idiopathic) causes have become more common, and although the disease is rare in children, the number of pediatric cases has rapidly increased ([^16^] Janisch N et al. 2015). 1.2 Problem statement Despite its global significance as a gastrointestinal ailment, acute pancreatitis has not been extensively researched within the population served by King Faisal Hospital (KFH). This lack of detailed knowledge about the incidence, distribution, and risk factors for acute pancreatitis in this particular healthcare setting hinders the development of effective interventions, diagnostic strategies, and management protocols. A comprehensive understanding of the epidemiological landscape of acute pancreatitis in KFH is crucial for optimizing patient care, informing healthcare policies, and contributing to the broader body of knowledge on this condition in the Rwandan healthcare context. Consequently, there is a pressing need for a thorough investigation to outline the prevalence and epidemiological characteristics of acute pancreatitis in KFH. This research will not only benefit the local patient population but also enhance the global understanding of acute pancreatitis within the context of King Faisal Hospital and similar healthcare settings. 1.3 Justification This study aimed to understand the prevalence and characteristics of acute pancreatitis in Kigali. By uncovering the extent and specific factors contributing to its occurrence, this research provides valuable insights into the local burden and unique patterns of the condition. The findings will guide improved healthcare planning and targeted interventions for people in Kigali. Additionally, contributing to global knowledge, this research facilitates comparisons and advancements in patient care strategies, ultimately enhancing healthcare effectiveness tailored to the specific needs of the population in Kigali. 1.4 Research question What is the prevalence and epidemiological profile of AP in Kigali, Rwanda? 1.5 Research Hypothesis Null Hypothesis: There is no significant difference in the prevalence and epidemiological profile of acute pancreatitis at King Faisal Hospital from 2014–2023 compared with previous years or other populations. Alternative Hypothesis: There is a significant difference in the prevalence and epidemiological profile of acute pancreatitis at King Faisal Hospital from 2017–2023 compared with previous years or other populations. 1.6 Research objectives General Objective To determine the prevalence and epidemiological profile of acute pancreatitis (AP) in Kigali, Rwanda. Specific Objectives -To determine the prevalence of acute pancreatitis (AP) in Kigali, Rwanda, and KFH. -To identify the most common causes of AP in Kigali, Rwanda, and KFH. -To characterize the clinical presentation of AP in Kigali, Rwanda, KFH. 1.7 Literature Review AGE/GENDER Demographic considerations play a pivotal role in shaping the epidemiological landscape of acute pancreatitis. Studies have reported age-specific patterns, indicating an increased incidence in middle-aged and older populations ([^3^] GBD 2019 ) ([^1^] Banks & Freeman 2006 ). Gender differences have also been noted, with some regions reporting higher incidence rates in men than in women. ([^3^] GBD 2019 ) Pancreatitis associated with alcohol consumption tends to be more prevalent in men, although gender distinctions diminish when alcohol intake levels are comparable. Further research is essential to explore whether genetic factors contribute to an increased risk in men. In women, pancreatitis is often linked to factors such as gallstones, ERCP, and autoimmune diseases, or it may be idiopathic. The variations in the distributions of age and sex across different geographic regions are likely attributed to variations in the underlying causes of pancreatitis. ([^2^] Yadav & Lowenfels 2013 ) Etiology AP has numerous identifiable causes, with approximately 75%-85% of patients having easily identifiable triggers. In developed nations, the predominant causes of acute pancreatitis are obstruction of the common bile duct by stones (38%) and alcohol abuse (36%). Gallstone-induced pancreatitis occurs when gallstones migrate and cause obstruction in the bile duct, pancreatic duct, or both. This obstruction leads to increased duct pressure, subsequently triggering unregulated activation of digestive enzymes and promoting pancreatitis ([^7^] Wang et al. 2009 ). AP can potentially be triggered by endoscopic retrograde cholangiopancreatography (ERCP). Following the procedure, 35%-70% of patients may experience asymptomatic hyperamylasemia. The risk of inducing acute pancreatitis is greater with ERCP when it is performed to treat Oddi sphincter dysfunction than when it is used for gallstone removal from the bile duct. ([^3^] GBD 2019 ) The etiology of acute pancreatitis is notably diverse, with gallstone-related causes and alcohol consumption standing out prominently ([^4^] Forsmark et al. 2016 ) ([^5^] Lankisch et al. 2013 ). Gallstone-induced pancreatitis often results from the migration of gallstones, leading to ductal obstruction and subsequent pancreatic inflammation. Alcohol, on the other hand, is recognized as a significant risk factor, contributing to a substantial proportion of cases ([^4^] Forsmark et al. 2016 ) Gallstone disease is the leading cause of acute pancreatitis worldwide and is responsible for 20–70% of cases in Western countries. Its prevalence increases with age, contributing to the increasing incidence of acute pancreatitis. The obstruction of the sphincter of Oddi by gallstones was the first confirmed cause of acute necrotizing pancreatitis. Women are more affected by the higher prevalence of gallstones. While gallstones can cause acute pancreatitis in children, this is less common than in drug-induced cases. Transabdominal ultrasound (TUS) is recommended for initial evaluation to detect gallbladder stones and biliary ductal dilatation, which may indicate cholangitis. ([^23^] Wang et al. 2023 ) Socioeconomic factors Socioeconomic factors play crucial roles in shaping the prevalence and outcomes of acute pancreatitis. Studies have explored the influence of socioeconomic status on disease incidence, access to healthcare, and treatment outcomes ([^6^] Petrov & Yadav 2019 ). Addressing these disparities is essential for achieving equitable healthcare. Definitions AP is defined by the presence of 2 of the 3 criteria4: 1. Abdominal pain characteristic of AP; 2. Serum amylase and/or lipase 3 times the upper limit of normal; and 3. Characteristic findings of AP on computed tomography (CT) scan. In 1992, the Atlanta International Symposium classified AP into mild AP (edematous/interstitial pancreatitis), which has a mortality rate of 1%, and severe AP. (necrotizing pancreatitis), which constitutes approximately 20–30% of AP cases, with a mortality rate of approximately 20–30%. ([^8^] Muniraj et al. 2012) Similar studies A study conducted in Japan in 2011 estimated that the total number of patients with acute pancreatitis (AP) was 63,080, with a 95% confidence interval of 57,678–68,484. This resulted in a prevalence rate of 49.4 per 100,000 individuals. The male‒female ratio was 1.9, with an average age of 58.5 years for males and 65.3 years for females. Alcoholic AP was more common among men, whereas gallstone AP was more prevalent in women. The overall mortality rate for AP patients was 2.6%, increasing to 10.1% for severe cases. ([^22^] Kobayashi et al. 2014 ) A study conducted in Japan in 2007 estimated that 57,560 patients were treated for acute pancreatitis (AP), with a 95% confidence interval of 48,571–66,549, leading to a prevalence rate of 45.1 per 100,000 individuals. The male‒female ratio was 2.0, with a mean age of 56.6 years for men and 64.6 years for women. Alcohol-induced AP was more common in men, whereas gallstone-induced AP was more prevalent in women. The overall mortality rate for AP patients was 1.9%, increasing to 8.0% in severe cases. ([^21^] Kobayashi et al. 2011 ) A study conducted by Peter Szatmary, Tassos Grammatikopoulos, Wenhao Cai, Wei Huang, Rajarshi Mukherjee, Chris Halloran, Georg Beyer, and Robert Sutton provides valuable insights into the risk factors and prevalence of acute pancreatitis. According to their research, various etiological factors contribute to the onset of this condition, with a significant focus on the role of alcohol consumption. Heavy alcohol consumption is a well-established cause of acute pancreatitis, and its incidence varies significantly by region. In North America and Europe, alcohol is frequently cited as the second most common cause of acute pancreatitis, accounting for up to one-third of cases. In Eastern Europe, it is the leading cause. The incidence of acute alcoholic pancreatitis ranges from as low as 2% in Latin America and less than 10% in China to as high as 46% in Japan and 70% in Finland. ([^20^] Wang et al. 2022) A study conducted by Stephen E. Roberts, Sian Morrison-Rees, Ann John, John G. Williams, Tim H. Brown, and David G. Samuel reported the prevalence of acute pancreatitis across 17 European countries, with rates ranging from 4.6–100 per 100,000 people. The highest prevalence was typically observed in Eastern or Northern Europe, although these rates varied on the basis of the criteria used for case ascertainment. Among 20 studies examining prevalence trends, all but three indicated percentage increases over time, with an overall median increase of 3.4% per year and a range from − 0.4–73%. Southern Europe, including Greece, Turkey, Italy, and Croatia, presented the highest ratios of gallstones to alcohol-related causes, whereas the lowest ratios were primarily found in Eastern Europe, including Latvia, Finland, Romania, Hungary, Russia, and Lithuania. ([^17^] Roberts et al. 2017 ) A study conducted by Xiao et al. and Shen et al. investigated the various etiologies of acute pancreatitis (AP) and revealed that these causes are significantly influenced by geographical and demographic factors. Their research revealed that biliary etiology was the predominant cause of AP, accounting for 67.1% of cases. This finding aligns with the global trend where gallstones are identified as the leading cause of AP, particularly prevalent in developed nations. The prominence of biliary pancreatitis is particularly evident among female patients and older patients, reinforcing observations from previous studies. These findings underscore the critical role of biliary factors in the development of AP and highlight the need for targeted prevention and treatment strategies, considering the demographic and regional variations in disease etiology. ([^18^] Aydın Şeref Köksal et al. 2024) A study conducted in Dubai in February 2024 investigated 19 patients admitted with acute pancreatitis, with only 2 of these patients requiring admission to the intensive care unit (ICU). The patient cohort included 10 males (52%) and 9 females (47%), with ages ranging from 5–66 years and an average age of 41 years. The mean age for males was 42 years, whereas for females, it was 40 years. Hospital stays varied from 1 to 11 days, with a mean duration of 3 days. Patients were grouped into three age categories: 1–29 years, 30–59 years, and 60 years and older. The majority, 15 patients, fell into the 30–59 years age group. At admission, abdominal pain was universally reported (100%), with other symptoms, including vomiting in 10 patients (52.63%), fever in 2 patients (10.53%), and weight loss in 2 patients (10.53%). In terms of etiology, idiopathic pancreatitis emerged as the most common cause, affecting 11 patients (52.63%), followed by biliary pancreatitis in 21.05% of the patients. Other causes included alcohol-related pancreatitis, malignancy, and COVID-19-related pancreatitis, each contributing to 5.26% of the cases. ([^19^] Alkabbani et al.2024) 2 Results 2.1 Sociodemographic data: Among the 65 patients included in this study, the majority were males {72.3%}, and most of the patients were aged 25–35 years {44.6%}, with a mean age of 37 years. Furthermore, most of the patients were married {61.5%} and not employed {46.2%}, but {38.5%} had their own business. Table 2.1 Sociodemographic data of the patients (N = 65) Socio-Demographic Data Count Valid N % Gender Female 18 27.7% Male 47 72.3% Age Less than 25 Year Old 9 13.8% 25–35 Year Old 29 44.6% 36–45 Year Old 16 24.6% 46 --55 Year Old 4 6.2% More than 55 Year Old 7 10.8% Status Married 40 61.5% Single 25 38.5% Occupation Engineer 3 4.6% Privet Business 25 38.5% Manager 3 4.6% Governmental employee 4 6.2% Not employed 30 46.2% 2.2 Prevalence of Acute Pancreatitis: This study revealed that {28 patients (43.1%)} had previous episodes of acute pancreatitis, whereas {56.9%} had not experienced any prior episodes. 2.3 Medical history Few portion of the patients in this study had a chronic condition {33.8%}, and only {12.3%} had a family history of chronic conditions. Moreover, the majority of the patients were alcoholic {75.4%}, but {20%} were smokers. DM and HTN are the most common chronic conditions {10.8}. Table 2.2 The medical history of the patients (N = 65) Medical History Count Valid N % Any Chronic condition? No 43 66.2% Yes 22 33.8% Family History of chronic conditions No 57 87.7% Yes 8 12.3% History of Alcohol No 16 24.6% Yes 49 75.4% History of smoking No 52 80.0% Yes 13 20.0% Chronic conditions : 2.4 Etiology: Alcohol and gallstones were the most common causes of acute pancreatitis among patients {78.5%} and {27.7%, respectively. 2.5 Symptoms: In terms of symptoms of acute pancreatitis, abdominal pain, nausea and vomiting were the most common symptoms among the patients {100%}, {81.5%} and {81.5%}, respectively. 2.6: Severity: In this study, most of the cases were a little or to some extent severe {23.8%} and {22.2%}, whereas only {9.5%} were very severe cases. Table 2.3: Severity of acute pancreatitis among the patients (N = 65) Count Valid N % Severity Not severe 5 7.9% A little 15 23.8% To some extend 14 22.2% Severe 23 36.5% Very severe 6 9.5% 2.7 Investigations: Only {26.2%} of the patients had a serum amylase > 3 times the upper limit of the normal range (ULN), and {23.1%} had a serum lipase > 3 times the ULN. Table 2.4 shows the results of the serum enzyme investigations among the patients (N = 65). Serum enzymes Count Valid N % Serum amylase 3 times ULN 17 26.2% Serum Lipase 3 times ULN 15 23.1% Imaging : This study revealed that the most frequent imaging methods for acute pancreatitis were CT and U/S {76.9%} and {43%, respectively. 2.8 Hospital Management and Outcomes: In this study, most of the patients admitted for less than 5 days {53.8%} underwent conservative treatment {84.6%} and improved {66.2%}, whereas {4.6%} were unresolved. Necrosis was the most prevalent complication {9.2%}. Finally, most of the patients required more 3-week follow-up {63.1%}. Table 2.5: Hospital management and outcomes of the patients (N = 65) Hospital Management and Outcome Count Valid N % Duration of admission Less than 5 days 35 53.8% 5 -- 10 days 26 40.0% More than 10 days 4 6.2% Treatment Conservative 55 84.6% Conservative, interventional 9 13.8% Interventional 1 1.5% Outcome Improved 43 66.2% Recovered 19 29.2% Unresolved 3 4.6% Complications ARDS 2 3.1% Necrosis 6 9.2% None 52 80.0% Paralytic ileus 1 1.5% Post ERCP 1 1.5% Pseudocyst 3 4.6% Follow up duration Less than 1 week 5 7.7% 1 -- 2 weeks 16 24.6% >2 -- 3 weeks 3 4.6% > 3 -- 4 weeks 41 63.1% 3 Methods 3.1 Study Design The study is a retrospective, descriptive facility-based study. 3.2 Study Setting/Area The study will take place at King Faisal Hospital, Kigali, Rwanda. A multispecialty quaternary hospital was established in 1991 with the help of the Saudi Funds for Development (SCP). Data will be obtained from the health records of patients who have been diagnosed with acute pancreatitis . 3.3 Study population Records of patients who were diagnosed with acute pancreatitis at King Faisal Hospital within the specified study period. The inclusion criterion was patients who were diagnosed with acute pancreatitis at King Faisal Hospital from February 2014 to June 2024. The exclusion criteria were patients with incomplete or missing health records and patients who were diagnosed outside the specified study period. 3.4 Sampling 3.4.1 Sample size The total number of patients diagnosed with acute pancreatitis meeting the inclusion criteria and satisfying the exclusion criteria between February 2014 and June 2024 were included in the study. This totaled 65 patients. 3.4.2 Sample technique All case files of patients who were diagnosed with acute pancreatitis from February 2014 to June 2024 were obtained via the total coverage nonrandom sampling technique . 3.5 Data collection techniques used for the different study populations The data collection process took a range of 1 month. During this process, a list of eligible acute pancreatitis patients was compiled from the patients' register records after the required ethical approval and data collection agreement were obtained. The medical records of eligible patients were obtained from the medical records archive. The required data were collected via a checklist that covers the research objectives. Independent variables: 1. Smoking status 2. History of hyperlipidemia 3. History of hypertension 4. History of diabetes 5. History of alcohol consumption 6. Age 7. Gender 8. Previous history of AP Dependent variable: Presence or absence of APs 3.6 Data management and analysis plan The collected data retrieved from the collection sheet (from the medical records) were exported into Microsoft Excel and then imported into the Statistical Package for Social Sciences (SPSS) version 25. The descriptive percentage was calculated as (frequency * 100/sample size) and is presented in the tables and figures. The chi-square test was used to assess significant associations. The P value was considered significant when it was < 0.05. Amylase 3 times ULN (Upper Limit Normal range) = 330 IU/L Lipase 3 times ULN = 480 IU/L 4 Discussion 4.1 Sociodemographic data Our study revealed that acute pancreatitis is more common in males (72.3%) than in females and mainly occurs in those aged 25--35 years, with a mean age of 37 years. This male predominance concurs with other studies reporting that acute pancreatitis is common in males, especially those with alcohol-related etiologies ([^3^] GBD 2019) ([^20^] Wang et al. 2022)). In contrast to our study, in which the average age is 37 years, the literature mostly includes an older age group, with an average age of 56--65 years ([^21^] Kobayashi et al. 2011)) ([^22^] Kobayashi et al. 2014). This difference may thus be due to regional variations in the demographic profile of acute pancreatitis patients. Marital status: 61.5% of our patients were married, while 46.2% were not employed, among whom 38.5% were engaged in private business. These socioeconomic factors may affect the prevalence of the disease and various strategies for the management of patients. The relatively high unemployment rate and business proprietorship rate in our retrospective descriptive study might indicate some socioeconomic conditions unique to our study population. 4.2 Prevalence of Acute Pancreatitis A past history of acute pancreatitis in 43.1% of patients indicates a significant recurrence rate and therefore is a chronic, relapsing condition. This rate is similar to that reported in some global studies that emphasize recurrence in acute pancreatitis patients, while it is slightly higher than that reported in studies where the recurrence rate is low. ([^19^] Alkabbani et al.2024) ([^10^] Nesvaderani et al. 2015) ([^8^] Muniraj et al. 2012)) 4.3 Medical history Our study revealed that 75.4% of the patients had a history of alcohol use, which is much greater than the global average in which alcohol is the leading cause of acute pancreatitis ([^20^] Wang et al. 2022). The high prevalence of alcohol use in our retrospective study underscores its critical role in the etiology of acute pancreatitis in our region. Additionally, 33.8% of the patients had chronic conditions, and 12.3% of them had a positive family history of chronic diseases, which was consistent with other studies indicating the commonality of chronic conditions, such as diabetes and hypertension, in acute pancreatitis patients. In this study, a lower prevalence of smoking (20%) than that reported in other studies seemed to reflect regional differences in habits related to smoking and their association with pancreatitis. ([^18^] Aydın Şeref Köksal et al. 2024) 4.4 Etiology In this study, alcohol (78.5%) and gallstones (27.7%) were identified as the most common causes of acute pancreatitis. This concurs with the literature, which usually quotes these two factors as predominant causes in different regions ([^4^] Forsmark et al. 2016) ([^5^] Lankisch et al. 2013). The high prevalence of alcohol-induced pancreatitis in our study concurs with data from regions with high alcohol consumption rates, such as Eastern Europe and Finland ([20] Wang et al. 2022). Gallstone-induced pancreatitis, although less common in our cohort, is well documented in the literature as another significant etiology, particularly in developed nations ([^4^] Forsmark et al. 2016) ([^23^] Wang et al. 2023). 4.5 Symptoms Among all patients, 100% experienced abdominal pain, while nausea and vomiting were observed in 81.5% of the patients. These symptoms are typical manifestations of acute pancreatitis, as abdominal pain, nausea, and vomiting are common modes of presentation ([^4] Forsmark et al. 2016), ([^7^] Wang et al. 2009). The fact that abdominal pain is a universal complaint confirms its status as a core diagnostic symptom of acute pancreatitis, as confirmed by robust clinical literature ([^4^] Forsmark et al. 2016), ([^18^] Aydın Şeref Köksal et al. 2024). 4.6 Severity With respect to severity, most cases in our study were mild to moderate, with 46% classified as either "a little" or "to some extent." Only 9.5% of the cases were very severe. Indeed, such a distribution suggests that our cases are generally less severe than some studies that have a greater proportion of severe cases, thus showing a somewhat favorable severity profile. The lower prevalence of very severe cases in our study might be related to differences in patient management or to variations in disease presentation. ([^10^] Nesvaderani et al. 2015) ([^2^] Yadav & Lowenfels 2013) 4.7 Investigations The laboratory results revealed that only 26.2% of the patients had a serum amylase level higher than three times the ULN, and elevated serum lipase was detected in only 23.1% of the patients. These percentages are much lower than would be predicted by using classic diagnostic criteria for acute pancreatitis, which commonly include an elevated enzyme level as part of the definition ([^7^] Wang et al. 2009), ([^8^] Muniraj et al. 2012). Differences in the assay used or the time of enzyme measurement might explain these findings. 4.8 Imaging CT was the most commonly used imaging modality (76.9%), whereas ultrasound was the most commonly used imaging modality (43%). This preference for CT is understandable, given the high sensitivity and diagnostic accuracy for acute pancreatitis cited in the literature. Ultrasound is often used for an initial assessment, more specifically for identifying gallstones, and would thus support this role in the diagnostic process. ([^18^] Aydın Şeref Köksal et al. 2024) 4.9 Hospital Management and Outcomes Among the patients, 53.8% were admitted for less than 5 days, whereas 84.6% received conservative treatment. The findings therefore explicitly agree with the standard management practice in acute pancreatitis, in which the mainstay of treatment is conservation ([^23^] Wang et al. 2023). High rates of improved outcomes (66.2%) and complications such as necrosis (9.2%) mirror typical disease progress and management outcomes. This is further supported by the fact that 63.1% of patients required follow-up for more than three weeks, thus necessitating continued monitoring and care in the management of acute pancreatitis. ([^21^] Kobayashi et al. 2011) Limitations & recommendation This study has certain limitations. As a retrospective, single-center analysis, it is subject to inherent biases associated with secondary data use, including incomplete or missing clinical information and potential misclassification. The findings may not be generalizable beyond the population served by King Faisal Hospital due to regional variations in healthcare access, referral patterns, and patient demographics. Moreover, the descriptive design precludes causal inference. Several important variables—such as alcohol intake, smoking status, nutritional history, and socioeconomic indicators—were unavailable, limiting comprehensive analysis of risk factors. Additionally, the extended 10-year study period may have introduced temporal variations due to evolving diagnostic criteria, clinical practices, or record-keeping standards. 5 Conclusion 5.1 Conclusion This study describes the demographic, clinical, and etiological profile of acute pancreatitis in a tertiary care center in Rwanda. Alcohol was identified as the predominant cause, especially among young male patients. While the findings are consistent with global literature, they underscore the importance of local risk factor assessment. Given the limitations of the retrospective, single-center design, further prospective multicenter studies are recommended to support evidence-based regional strategies. 5.2 Recommendation: On the basis of the observations derived from this study and their comparison with the literature available on the subject, the following recommendations are proposed for the management of acute pancreatitis to improve the understanding of the disease process: 1. Enhanced Public Awareness and Prevention Heavy alcohol consumption, therefore, should be stressed through public health campaigns. An effective educational program to link heavy drinking to pancreatitis can lead to a long way toward prevention. Lifestyle modifications: Awareness campaigns should include lifestyle modifications such as dietary changes and smoking cessation because they are also linked with acute pancreatitis. 2. Best Practices in Diagnosis and Monitoring Early Diagnosis: Due to the variability of enzyme levels and imaging findings, a multimodal approach for diagnosis might be the best, combining clinical presentation, serum enzyme levels, and imaging studies to achieve an early and accurate diagnosis. Standardization of Enzyme Measurement: In view of the low levels of enzymes noted in our study, standardization of measurement techniques for serum amylase and lipase and uniformity at the time of sample collection may yield better results in diagnosis. Regular monitoring: As acute pancreatitis is a chronic process with a significant recurrence rate, patients with a previous history should be regularly followed up and monitored for early recognition of relapses and management of complications. 3. Individualized Management Algorithms Regional Variations: Management strategies should focus on regional epidemiological profiles. For example, in areas where there is a high consumption of alcohol, specifically designed interventions could aim to reduce the amount of alcohol use, and in areas with a large prevalence of gallstones, more attention might need to be given to gallstone-related complications. Grading of severity and severity-based treatment: The need to grade the severity of the condition and treat it accordingly is realized. More aggressive modes of management with close monitoring are associated with better outcomes in patients with severe acute pancreatitis. 4. Comprehensive Research and Data Collection Longitudinal studies: Longitudinal studies on acute pancreatitis need to be conducted to understand the long-term outcomes and recurrence rates of the disease process. This would lead to a better understanding of the chronic management of the disease process and the outcomes of different modes of treatment. Regional Epidemiological Research: More regional epidemiological research on acute pancreatitis must be conducted to determine regional variations in etiology and prevalence. This would facilitate an understanding of the differences that might lead to more focused prevention and treatment strategies. Etiological factors: Elucidate how other potential etiological factors and their interactions contribute to acute pancreatitis. Examples include the role of genetic predisposition, dietary factors, and environmental factors in causing a disease. 5. Healthcare Policy and Training Policy development: Designing and implementing healthcare policies for acute pancreatitis prevention and management Such policies need to include primary prevention, such as a reduction in alcohol consumption, and secondary prevention, such as the regular monitoring of individuals at risk. Healthcare Provider Training: Improving healthcare professional training in all the latest diagnostic and management practices for acute pancreatitis. Maintaining good knowledge among clinicians on acute pancreatitis can lead to better outcomes for patients, as well as universal patterns of care. 6. Patient Support and Education Patient Education: Patients were educated on acute pancreatitis management in terms of dietary advice, adherence to therapy, and early warning signs and symptoms of recurrent acute pancreatitis. Support services: Support services for patients suffering from acute pancreatitis, including counseling and support groups, must be developed to cope with the emotional and psychic burdens of illness. It is hoped that once the recommendations are implemented, the understanding of acute pancreatitis, its prevention, and its management will dramatically change for better patient outcomes and health care strategies. Declarations Ethics approval and consent to participate Ethical approval for this study was granted by the Institutional Review Board (IRB) of the University of Medical Sciences and Technology (see Appendix A) and the IRB of King Faisal Hospital, Rwanda (see Appendix B). The study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki. Given the retrospective nature of the study, obtaining informed consent directly from patients was not feasible. However, a waiver of consent was approved by the IRB of King Faisal Hospital. To ensure confidentiality, all patient data were anonymized or deidentified prior to analysis. The data were stored securely on restricted-access servers and used solely for research purposes. No personally identifiable information was included in the dissemination of the results. Consent for publication Not applicable. Availability of data and material The datasets generated and/or analyzed during the current study are available from the corresponding author upon reasonable request. Competing interests The authors declare that they have no competing interests. Funding This study received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. Authors' contributions O.M. designed the study, collected and analyzed the data, and drafted the manuscript. A.H. contributed to data interpretation and provided critical input on the manuscript. S.F. supervised the research and provided overall guidance and final approval of the manuscript. All the authors reviewed and approved the final version. Acknowledgments First and foremost, I thank Allah (SWT) for His guidance and blessings throughout this journey. The author gratefully acknowledges Dr. Shikama Felicien for his expert supervision and unwavering guidance throughout the research process. We also extend our sincere appreciation to Dr. Ahmed Abdulrahman Ahmed Hashim for his significant contributions as coauthor, particularly in data interpretation and for providing critical insights during manuscript preparation. References Banks PA, Freeman ML. Practice Guidelines in Acute Pancreatitis. Am J Gastroenterology. 2006;101(10):2379-2400. Yadav D, Lowenfels AB. The Epidemiology of Pancreatitis and Pancreatic Cancer. Gastroenterology. 2013;144(6):1252-1261. GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396(10258):1204-1222. Forsmark CE, Vege SS, Wilcox CM, Murad MH, Yadav D. Acute Pancreatitis. N Engl J Med. 2016;375(20):1972-1981. Lankisch PG, Apte M, Banks PA; Acute Pancreatitis Classification Working Group. Acute panceatitis. Lancet. 2013;381(9861):51-62. Petrov MS, Yadav D. Global Epidemiology and Holistic Prevention of Pancreatitis. Nat Rev Gastroenterol Hepatol. 2019;16(3):175-184. Wang GJ, Gao CF, Wei D, Wang C, Ding SQ. Acute pancreatitis: Etiology and common pathogenesis. World Journal of Gastroenterology [Internet]. 2009;15(12):1427. Muniraj T, Gajendran M, Thiruvengadam S, Raghuram K, Rao S, Devaraj P. Acute pancreatitis. Dis Mon. 2012;58(2):98–144. doi:10.1016/j.disamonth.2012.01.005. National Institute of Diabetes and Digestive and Kidney Diseases. Definition & Facts for Pancreatitis | NIDDK [Internet]. National Institute of Diabetes and Digestive and Kidney Diseases. 2019. Available from: https://www.niddk.nih.gov/health-information/digestive-diseases/pancreatitis/definition-facts Nesvaderani M, Eslick GD, Vagg D, Faraj S, Cox MR. Epidemiology, etiology and outcomes of acute pancreatitis: a retrospective cohort study. Int J Surg. 2015;23:68–74. Banks PA, Bollen TL, Dervenis C, et al. Classification of acute pancreatitis—2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013;62(1):102–111. Lankisch PG, Apte M, Banks PA. Acute pancreatitis. Lancet. 2015;386(9996):85–96. Parenti DM, Steinberg W, Kang P. Infectious Causes of Acute Pancreatitis. Pancreas [Internet]. 1996 Nov 1;13(4):356–71. Available from: https://journals.lww.com/pancreasjournal/Abstract/1996/11000/Infectious_Causes_of_Acute_Pancreatitis.5.aspx Rawla P, Bandaru SS, Vellipuram AR. Review of infectious etiology of acute pancreatitis. Gastroenterol Res. 2017;10(4):153–158. [PMC free article] [PubMed] [Google Scholar]. Noel RA, Braun DK, Patterson RE, Bloomgren GL. Increased risk of acute pancreatitis and biliary disease observed in patients with type 2 diabetes: a retrospective cohort study. Diabetes Care. 2009;32(5):834–838. [PMC free article] [PubMed] [Google Scholar]. Janisch N, Gardner T. Recent advances in managing acute pancreatitis [version 1; peer review: 2 approved]. F1000Res. 2015;4(F1000 Faculty Rev):1474. doi:10.12688/f1000research.7172.1. Roberts SE, Morrison-Rees S, John A, Williams JG, Brown TH, Samuel DG. The incidence and etiology of acute pancreatitis across Europe. Pancreatology. 2017 Mar;17(2):155–65. Aydın Şeref Köksal, Mukaddes Tozlu, Orhan Sezgin, Dilek Oğuz, İsmail Hakkı Kalkan, Engin Altıntaş, et al. Acute pancreatitis in Turkey: Results of a nationwide multicenter study. Pancreatology. 2024 May 1;24(3):327–34. Alkabbani SS, AlHalak RH, Smady A, Fuad Alsaraj. The Epidemiology of Acute Pancreatitis in a Tertiary Care Hospital in Dubai. Annals of African Medicine [Internet]. 2024 Jan 1 [cited 2024 Aug 13];23(1):36–9. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10922180/ ‌20 Wang J, Li J, Zhang J, et al. Management of acute pancreatitis: a systematic review and meta-analysis. Drugs . 2022;82(11):1487-1501 Kobayashi M, Yoshida Y, Koga T, et al. Nationwide epidemiological survey of acute pancreatitis in Japan. Pancreas . 2011;40(4):563-570. Kobayashi M, Yoshida Y, Koga T, et al. Nationwide epidemiological survey of acute pancreatitis in Japan. Pancreas . 2014;43(8):1265-1272. Wang J, Li J, Zhang J, et al. Management of acute pancreatitis: a systematic review and meta-analysis. Drugs . 2023;83(1):145-157 Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6917772","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":481015952,"identity":"a7eb7d37-297f-498a-8fab-4f72950ffeb6","order_by":0,"name":"Osama Mokhtar","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA/0lEQVRIiWNgGAWjYNACAwYehgOJDQwJFUAOM3MDEVoKoFo+nAFpYSRGywcgPpDAwDizDcQjoIWf//DTDT8M6mT4jic3v+adVxvN3w7U8qNiG04tkjPSzG72GBzmkTzzsM2ad9vx3BmHGRsYe87cxqnF4AaD2Q0egwM8BjcS24x5tx3LbQBqYWZsw6Pl/PFvN/8Y1EG1zDmWO5+glgM5Zrd5DJhBWpofzmyoyd1ASIvkjJyy2zJQvzB8OHYgdyNQy0F8fuHnP77t5ps/dfZ8x9Mff0ioqcudd/7wwQc/KnBrQQZsEgwMh8GsA0SpBwJmYIzWEat4FIyCUTAKRhAAAGwpZbVmiEd6AAAAAElFTkSuQmCC","orcid":"","institution":"University of Medical Sciences and Technology","correspondingAuthor":true,"prefix":"","firstName":"Osama","middleName":"","lastName":"Mokhtar","suffix":""},{"id":481015953,"identity":"ac118d1a-7ee2-4a83-8014-37b5e66f1f7d","order_by":1,"name":"Ahmed Hashim","email":"","orcid":"","institution":"University of Medical Sciences and Technology","correspondingAuthor":false,"prefix":"","firstName":"Ahmed","middleName":"","lastName":"Hashim","suffix":""},{"id":481015954,"identity":"1132337a-e66a-44c7-bc08-21ce954add3c","order_by":2,"name":"Shikama Felicien","email":"","orcid":"","institution":"University of Medical Sciences and Technology","correspondingAuthor":false,"prefix":"","firstName":"Shikama","middleName":"","lastName":"Felicien","suffix":""}],"badges":[],"createdAt":"2025-06-18 00:08:17","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6917772/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6917772/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":86240465,"identity":"93aa2e6f-b958-4c9e-9d5e-2c1e5b26f8e9","added_by":"auto","created_at":"2025-07-08 10:35:01","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":63107,"visible":true,"origin":"","legend":"\u003cp\u003eFigure 2.1: Incidence of acute pancreatitis among patients (N = 65)\u003c/p\u003e","description":"","filename":"2.1.png","url":"https://assets-eu.researchsquare.com/files/rs-6917772/v1/2c5d71dd4080a42fd27a2571.png"},{"id":86241497,"identity":"0d98dfa2-76ac-4e33-abcb-361aad155083","added_by":"auto","created_at":"2025-07-08 10:43:01","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":36631,"visible":true,"origin":"","legend":"\u003cp\u003eFigure 2.2: Chronic conditions among the patients (N = 65)\u003c/p\u003e","description":"","filename":"2.2.png","url":"https://assets-eu.researchsquare.com/files/rs-6917772/v1/83a8b84929449bbbb6bb69a1.png"},{"id":86240467,"identity":"8ad5ae08-d72f-4e0d-a0ae-4d9079e28d08","added_by":"auto","created_at":"2025-07-08 10:35:01","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":14462,"visible":true,"origin":"","legend":"\u003cp\u003eFigure 2.3 shows the etiology of acute pancreatitis among the patients (N = 65).\u003c/p\u003e","description":"","filename":"2.3.png","url":"https://assets-eu.researchsquare.com/files/rs-6917772/v1/55d1452c653a2e6e05121f29.png"},{"id":86241498,"identity":"fb54c338-299d-42e7-912e-815ec301fba5","added_by":"auto","created_at":"2025-07-08 10:43:01","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":16549,"visible":true,"origin":"","legend":"\u003cp\u003eFigure 2.4: Symptoms of acute pancreatitis among the patients (N = 65)\u003c/p\u003e","description":"","filename":"2.4.png","url":"https://assets-eu.researchsquare.com/files/rs-6917772/v1/a65612d5570d5bd56c26a995.png"},{"id":86241499,"identity":"d2a62062-7990-45af-acc3-e88a2edfcf74","added_by":"auto","created_at":"2025-07-08 10:43:01","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":13731,"visible":true,"origin":"","legend":"\u003cp\u003eFigure 2.5: Imaging findings among the patients (N = 65)\u003c/p\u003e","description":"","filename":"2.5.png","url":"https://assets-eu.researchsquare.com/files/rs-6917772/v1/ff0624ec08dce1da37e6e59a.png"},{"id":88370609,"identity":"4aeb74b7-a74d-4d6a-8f66-88632a50dafe","added_by":"auto","created_at":"2025-08-05 19:01:45","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1670880,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6917772/v1/607aeb67-0215-4c4d-81da-bc6f22df40ae.pdf"},{"id":86240472,"identity":"8bf42c1f-988e-4c14-9487-ee52670eb69d","added_by":"auto","created_at":"2025-07-08 10:35:01","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":1553848,"visible":true,"origin":"","legend":"","description":"","filename":"Appendix.docx","url":"https://assets-eu.researchsquare.com/files/rs-6917772/v1/14b3362d5bc9e5a8c645a701.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Prevalence and Epidemiological Profile of Acute Pancreatitis in King Faisal Hospital: Retrospective descriptive study from 2014--2024","fulltext":[{"header":"1 Introduction","content":"\u003cdiv id=\"Sec2\" class=\"Section2\"\u003e\n \u003ch2\u003e1.1. Background\u003c/h2\u003e\n \u003cp\u003eAcute pancreatitis (AP), an inflammatory condition affecting the pancreas, poses a significant global health challenge because of its potential for severe complications, high morbidity, and mortality ([^1^] Banks \u0026amp; Freeman \u003cspan class=\"CitationRef\"\u003e2006\u003c/span\u003e). Understanding the prevalence and epidemiological profile of acute pancreatitis is essential for effective public health planning, resource allocation, and the development of targeted preventive strategies. This research aims to contribute to this understanding by investigating the prevalence and key epidemiological factors associated with acute pancreatitis.\u003c/p\u003e\n \u003cp\u003eThe incidence of AP has shown notable variations across regions and populations, reflecting the complex interplay of genetic, environmental, and lifestyle factors ([^2^] Yadav \u0026amp; Lowenfels \u003cspan class=\"CitationRef\"\u003e2013\u003c/span\u003e). Variations in healthcare access and diagnostic practices further contribute to the diversity of reported prevalence rates. According to the Global Burden of Disease Study 2019, millions of new cases of AP have been reported, along with substantial mortality and disability-adjusted life years (DALYs) attributable to the condition. The study also highlighted significant regional differences, emphasizing the need for a nuanced understanding of the epidemiological landscape specific to each locality ([^3^] GBD \u003cspan class=\"CitationRef\"\u003e2019\u003c/span\u003e).\u003c/p\u003e\n \u003cp\u003eAlcohol use, gallstones, and differences between populations are well-known factors linked to the development of acute pancreatitis ([^4^] Forsmark et al. \u003cspan class=\"CitationRef\"\u003e2016\u003c/span\u003e) ([^5^] Lankisch et al. \u003cspan class=\"CitationRef\"\u003e2013\u003c/span\u003e). Yet, despite these common causes, there\u0026apos;s still a lack of detailed data from regions like ours. With this study, we aim to explore the patterns of acute pancreatitis in our setting to help fill that gap. By sharing findings that reflect local realities, we hope to support more tailored prevention efforts, better patient care, and policies that reflect the needs of similar communities.Acute pancreatitis is a disease that attacks the pancreas, one of the visceral organs located behind the stomach. The pancreas produces digestive enzymes and hormones, including insulin. AP occurs when digestive enzymes affect the pancreas and cause inflammation ([^9^] NIDDK 2019). There are two types of pancreatitis: acute and chronic pancreatitis, both of which are serious and can lead to complications ([^10^] Nesvaderani et al. \u003cspan class=\"CitationRef\"\u003e2015\u003c/span\u003e). Acute pancreatitis is a medical emergency, with symptoms ranging from a mild form, which resolves with effective treatment within days, to a severe form that can lead to organ failure and even death ([^11^] Banks PA et al. 2013). AP can be classified into mild AP, where systemic complications and organ failure are absent; moderate AP, where organ failure occurs but can be resolved with effective treatment; and severe AP, where one or multiple organ failures become persistent ([^11^] Banks PA et al. 2013). Globally, AP occurs annually in approximately 30 per 100,000 people ([^12^] Lankisch et al. \u003cspan class=\"CitationRef\"\u003e2015\u003c/span\u003e). Certain individuals, particularly males and those with a personal or family history of gallstones or a positive family history of pancreatitis, are at greater risk of being affected by acute or chronic pancreatitis ([^9^] NIDDK 2019). The signs and symptoms of AP vary and may include pain in the right upper quadrant radiating to the back, nausea, and vomiting that worsens with eating. Fever may occur, and jaundice may appear when the gallbladder is affected by gallstones ([^9^] NIDDK 2019). Bile duct obstruction by gallstones and heavy alcohol use are the two most common causes of AP, accounting for approximately 80% of cases ([^13^] Parenti DM et al. 1996). Other causes include direct trauma, certain medications (e.g., statins, ACE inhibitors, oral contraceptive/hormone replacement therapy (HRT), diuretics, antiretroviral therapy, and oral hypoglycemic agents), infections (bacterial, viral, parasitic, and fungal), smoking, and tumors ([^14^] Rawla P et al. \u003cspan class=\"CitationRef\"\u003e2017\u003c/span\u003e). Autoimmune diseases such as cystic fibrosis, high blood fat levels, obesity, and recent procedures such as endoscopic retrograde cholangiopancreatography (ERCP) can also contribute to AP ([^9^] NIDDK 2019). Additionally, type 2 diabetes mellitus is associated with a 2.8-fold greater risk of AP ([^15^] Noel RA et al. 2009). Unclear (idiopathic) causes have become more common, and although the disease is rare in children, the number of pediatric cases has rapidly increased ([^16^] Janisch N et al. 2015).\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\n \u003ch2\u003e1.2 Problem statement\u003c/h2\u003e\n \u003cp\u003eDespite its global significance as a gastrointestinal ailment, acute pancreatitis has not been extensively researched within the population served by King Faisal Hospital (KFH). This lack of detailed knowledge about the incidence, distribution, and risk factors for acute pancreatitis in this particular healthcare setting hinders the development of effective interventions, diagnostic strategies, and management protocols. A comprehensive understanding of the epidemiological landscape of acute pancreatitis in KFH is crucial for optimizing patient care, informing healthcare policies, and contributing to the broader body of knowledge on this condition in the Rwandan healthcare context. Consequently, there is a pressing need for a thorough investigation to outline the prevalence and epidemiological characteristics of acute pancreatitis in KFH. This research will not only benefit the local patient population but also enhance the global understanding of acute pancreatitis within the context of King Faisal Hospital and similar healthcare settings.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e\n \u003ch2\u003e1.3 Justification\u003c/h2\u003e\n \u003cp\u003eThis study aimed to understand the prevalence and characteristics of acute pancreatitis in Kigali. By uncovering the extent and specific factors contributing to its occurrence, this research provides valuable insights into the local burden and unique patterns of the condition. The findings will guide improved healthcare planning and targeted interventions for people in Kigali. Additionally, contributing to global knowledge, this research facilitates comparisons and advancements in patient care strategies, ultimately enhancing healthcare effectiveness tailored to the specific needs of the population in Kigali.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e\n \u003ch2\u003e1.4 Research question\u003c/h2\u003e\n \u003cp\u003eWhat is the prevalence and epidemiological profile of AP in Kigali, Rwanda?\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e1.5 Research Hypothesis\u003c/strong\u003e\u003c/p\u003e\n \u003cul\u003e\n \u003cli\u003e\n \u003cp\u003eNull Hypothesis: There is no significant difference in the prevalence and epidemiological profile of acute pancreatitis at King Faisal Hospital from 2014\u0026ndash;2023 compared with previous years or other populations.\u003c/p\u003e\n \u003c/li\u003e\n \u003cli\u003e\n \u003cp\u003eAlternative Hypothesis: There is a significant difference in the prevalence and epidemiological profile of acute pancreatitis at King Faisal Hospital from 2017\u0026ndash;2023 compared with previous years or other populations.\u003c/p\u003e\n \u003c/li\u003e\n \u003c/ul\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e\n \u003ch2\u003e1.6 Research objectives\u003c/h2\u003e\n \u003cp\u003e\u003cstrong\u003eGeneral Objective\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eTo determine the prevalence and epidemiological profile of acute pancreatitis (AP) in Kigali, Rwanda.\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eSpecific Objectives\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e-To determine the prevalence of acute pancreatitis (AP) in Kigali, Rwanda, and KFH.\u003c/p\u003e\n \u003cp\u003e-To identify the most common causes of AP in Kigali, Rwanda, and KFH.\u003c/p\u003e\n \u003cp\u003e-To characterize the clinical presentation of AP in Kigali, Rwanda, KFH.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e\n \u003ch2\u003e1.7 Literature Review\u003c/h2\u003e\n \u003cp\u003e\u003cstrong\u003eAGE/GENDER\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eDemographic considerations play a pivotal role in shaping the epidemiological landscape of acute pancreatitis. Studies have reported age-specific patterns, indicating an increased incidence in middle-aged and older populations ([^3^] GBD \u003cspan class=\"CitationRef\"\u003e2019\u003c/span\u003e) ([^1^] Banks \u0026amp; Freeman \u003cspan class=\"CitationRef\"\u003e2006\u003c/span\u003e). Gender differences have also been noted, with some regions reporting higher incidence rates in men than in women. ([^3^] GBD \u003cspan class=\"CitationRef\"\u003e2019\u003c/span\u003e) Pancreatitis associated with alcohol consumption tends to be more prevalent in men, although gender distinctions diminish when alcohol intake levels are comparable. Further research is essential to explore whether genetic factors contribute to an increased risk in men. In women, pancreatitis is often linked to factors such as gallstones, ERCP, and autoimmune diseases, or it may be idiopathic. The variations in the distributions of age and sex across different geographic regions are likely attributed to variations in the underlying causes of pancreatitis. ([^2^] Yadav \u0026amp; Lowenfels \u003cspan class=\"CitationRef\"\u003e2013\u003c/span\u003e)\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eEtiology\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eAP has numerous identifiable causes, with approximately 75%-85% of patients having easily identifiable triggers. In developed nations, the predominant causes of acute pancreatitis are obstruction of the common bile duct by stones (38%) and alcohol abuse (36%). Gallstone-induced pancreatitis occurs when gallstones migrate and cause obstruction in the bile duct, pancreatic duct, or both. This obstruction leads to increased duct pressure, subsequently triggering unregulated activation of digestive enzymes and promoting pancreatitis ([^7^] Wang et al. \u003cspan class=\"CitationRef\"\u003e2009\u003c/span\u003e). AP can potentially be triggered by endoscopic retrograde cholangiopancreatography (ERCP). Following the procedure, 35%-70% of patients may experience asymptomatic hyperamylasemia. The risk of inducing acute pancreatitis is greater with ERCP when it is performed to treat Oddi sphincter dysfunction than when it is used for gallstone removal from the bile duct. ([^3^] GBD \u003cspan class=\"CitationRef\"\u003e2019\u003c/span\u003e) The etiology of acute pancreatitis is notably diverse, with gallstone-related causes and alcohol consumption standing out prominently ([^4^] Forsmark et al. \u003cspan class=\"CitationRef\"\u003e2016\u003c/span\u003e) ([^5^] Lankisch et al. \u003cspan class=\"CitationRef\"\u003e2013\u003c/span\u003e). Gallstone-induced pancreatitis often results from the migration of gallstones, leading to ductal obstruction and subsequent pancreatic inflammation. Alcohol, on the other hand, is recognized as a significant risk factor, contributing to a substantial proportion of cases ([^4^] Forsmark et al. \u003cspan class=\"CitationRef\"\u003e2016\u003c/span\u003e) Gallstone disease is the leading cause of acute pancreatitis worldwide and is responsible for 20\u0026ndash;70% of cases in Western countries. Its prevalence increases with age, contributing to the increasing incidence of acute pancreatitis. The obstruction of the sphincter of Oddi by gallstones was the first confirmed cause of acute necrotizing pancreatitis. Women are more affected by the higher prevalence of gallstones. While gallstones can cause acute pancreatitis in children, this is less common than in drug-induced cases. Transabdominal ultrasound (TUS) is recommended for initial evaluation to detect gallbladder stones and biliary ductal dilatation, which may indicate cholangitis. ([^23^] Wang et al. \u003cspan class=\"CitationRef\"\u003e2023\u003c/span\u003e)\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eSocioeconomic factors\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eSocioeconomic factors play crucial roles in shaping the prevalence and outcomes of acute pancreatitis. Studies have explored the influence of socioeconomic status on disease incidence, access to healthcare, and treatment outcomes ([^6^] Petrov \u0026amp; Yadav \u003cspan class=\"CitationRef\"\u003e2019\u003c/span\u003e). Addressing these disparities is essential for achieving equitable healthcare.\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eDefinitions\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eAP is defined by the presence of 2 of the 3 criteria4: 1. Abdominal pain characteristic of AP; 2. Serum amylase and/or lipase 3 times the upper limit of normal; and 3. Characteristic findings of AP on computed tomography (CT) scan. In 1992, the Atlanta International Symposium classified AP into mild AP (edematous/interstitial pancreatitis), which has a mortality rate of 1%, and severe AP.\u003c/p\u003e\n \u003cp\u003e(necrotizing pancreatitis), which constitutes approximately 20\u0026ndash;30% of AP cases, with a mortality rate of approximately 20\u0026ndash;30%. ([^8^] Muniraj et al. 2012)\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eSimilar studies\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eA study conducted in Japan in 2011 estimated that the total number of patients with acute pancreatitis (AP) was 63,080, with a 95% confidence interval of 57,678\u0026ndash;68,484. This resulted in a prevalence rate of 49.4 per 100,000 individuals. The male‒female ratio was 1.9, with an average age of 58.5 years for males and 65.3 years for females. Alcoholic AP was more common among men, whereas gallstone AP was more prevalent in women. The overall mortality rate for AP patients was 2.6%, increasing to 10.1% for severe cases. ([^22^] Kobayashi et al. \u003cspan class=\"CitationRef\"\u003e2014\u003c/span\u003e)\u003c/p\u003e\n \u003cp\u003eA study conducted in Japan in 2007 estimated that 57,560 patients were treated for acute pancreatitis (AP), with a 95% confidence interval of 48,571\u0026ndash;66,549, leading to a prevalence rate of 45.1 per 100,000 individuals. The male‒female ratio was 2.0, with a mean age of 56.6 years for men and 64.6 years for women. Alcohol-induced AP was more common in men, whereas gallstone-induced AP was more prevalent in women. The overall mortality rate for AP patients was 1.9%, increasing to 8.0% in severe cases. ([^21^] Kobayashi et al. \u003cspan class=\"CitationRef\"\u003e2011\u003c/span\u003e)\u003c/p\u003e\n \u003cp\u003eA study conducted by Peter Szatmary, Tassos Grammatikopoulos, Wenhao Cai, Wei Huang, Rajarshi Mukherjee, Chris Halloran, Georg Beyer, and Robert Sutton provides valuable insights into the risk factors and prevalence of acute pancreatitis. According to their research, various etiological factors contribute to the onset of this condition, with a significant focus on the role of alcohol consumption. Heavy alcohol consumption is a well-established cause of acute pancreatitis, and its incidence varies significantly by region. In North America and Europe, alcohol is frequently cited as the second most common cause of acute pancreatitis, accounting for up to one-third of cases. In Eastern Europe, it is the leading cause. The incidence of acute alcoholic pancreatitis ranges from as low as 2% in Latin America and less than 10% in China to as high as 46% in Japan and 70% in Finland. ([^20^] Wang et al. 2022)\u003c/p\u003e\n \u003cp\u003eA study conducted by Stephen E. Roberts, Sian Morrison-Rees, Ann John, John G. Williams, Tim H. Brown, and David G. Samuel reported the prevalence of acute pancreatitis across 17 European countries, with rates ranging from 4.6\u0026ndash;100 per 100,000 people. The highest prevalence was typically observed in Eastern or Northern Europe, although these rates varied on the basis of the criteria used for case ascertainment. Among 20 studies examining prevalence trends, all but three indicated percentage increases over time, with an overall median increase of 3.4% per year and a range from \u0026minus;\u0026thinsp;0.4\u0026ndash;73%. Southern Europe, including Greece, Turkey, Italy, and Croatia, presented the highest ratios of gallstones to alcohol-related causes, whereas the lowest ratios were primarily found in Eastern Europe, including Latvia, Finland, Romania, Hungary, Russia, and Lithuania. ([^17^] Roberts et al. \u003cspan class=\"CitationRef\"\u003e2017\u003c/span\u003e)\u003c/p\u003e\n \u003cp\u003eA study conducted by Xiao et al. and Shen et al. investigated the various etiologies of acute pancreatitis (AP) and revealed that these causes are significantly influenced by geographical and demographic factors. Their research revealed that biliary etiology was the predominant cause of AP, accounting for 67.1% of cases. This finding aligns with the global trend where gallstones are identified as the leading cause of AP, particularly prevalent in developed nations. The prominence of biliary pancreatitis is particularly evident among female patients and older patients, reinforcing observations from previous studies. These findings underscore the critical role of biliary factors in the development of AP and highlight the need for targeted prevention and treatment strategies, considering the demographic and regional variations in disease etiology. ([^18^] Aydın Şeref K\u0026ouml;ksal et al. 2024)\u003c/p\u003e\n \u003cp\u003eA study conducted in Dubai in February 2024 investigated 19 patients admitted with acute pancreatitis, with only 2 of these patients requiring admission to the intensive care unit (ICU). The patient cohort included 10 males (52%) and 9 females (47%), with ages ranging from 5\u0026ndash;66 years and an average age of 41 years. The mean age for males was 42 years, whereas for females, it was 40 years. Hospital stays varied from 1 to 11 days, with a mean duration of 3 days. Patients were grouped into three age categories: 1\u0026ndash;29 years, 30\u0026ndash;59 years, and 60 years and older. The majority, 15 patients, fell into the 30\u0026ndash;59 years age group. At admission, abdominal pain was universally reported (100%), with other symptoms, including vomiting in 10 patients (52.63%), fever in 2 patients (10.53%), and weight loss in 2 patients (10.53%). In terms of etiology, idiopathic pancreatitis emerged as the most common cause, affecting 11 patients (52.63%), followed by biliary pancreatitis in 21.05% of the patients. Other causes included alcohol-related pancreatitis, malignancy, and COVID-19-related pancreatitis, each contributing to 5.26% of the cases. ([^19^] Alkabbani et al.2024)\u003c/p\u003e\n\u003c/div\u003e"},{"header":"2 Results","content":"\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e\n \u003ch2\u003e2.1 Sociodemographic data:\u003c/h2\u003e\n \u003cp\u003eAmong the 65 patients included in this study, the majority were males {72.3%}, and most of the patients were aged 25\u0026ndash;35 years {44.6%}, with a mean age of 37 years. Furthermore, most of the patients were married {61.5%} and not employed {46.2%}, but {38.5%} had their own business.\u003c/p\u003e\n \u003cdiv class=\"gridtable\"\u003e\n \u003ctable id=\"Tab1\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 2.1\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eSociodemographic data of the patients (N\u0026thinsp;=\u0026thinsp;65)\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eSocio-Demographic Data\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eCount\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eValid N %\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e27.7%\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e72.3%\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"5\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eLess than 25 Year Old\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e9\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e13.8%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e25\u0026ndash;35 Year Old\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e29\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e44.6%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e36\u0026ndash;45 Year Old\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e16\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e24.6%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e46 --55 Year Old\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e4\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e6.2%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eMore than 55 Year Old\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e7\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e10.8%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003eStatus\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarried\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e40\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e61.5%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eSingle\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e25\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e38.5%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"5\"\u003e\n \u003cp\u003e\u003cstrong\u003eOccupation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eEngineer\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e3\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e4.6%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003ePrivet Business\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e25\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e38.5%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eManager\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e3\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e4.6%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eGovernmental employee\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e4\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e6.2%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eNot employed\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e30\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e46.2%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e\n \u003ch2\u003e2.2 Prevalence of Acute Pancreatitis:\u003c/h2\u003e\n \u003cp\u003eThis study revealed that {28 patients (43.1%)} had previous episodes of acute pancreatitis, whereas {56.9%} had not experienced any prior episodes.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\n \u003ch2\u003e2.3 Medical history\u003c/h2\u003e\n \u003cp\u003eFew portion of the patients in this study had a chronic condition {33.8%}, and only {12.3%} had a family history of chronic conditions. Moreover, the majority of the patients were alcoholic {75.4%}, but {20%} were smokers. DM and HTN are the most common chronic conditions {10.8}.\u003c/p\u003e\n \u003cdiv class=\"gridtable\"\u003e\n \u003ctable id=\"Tab2\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 2.2\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eThe medical history of the patients (N\u0026thinsp;=\u0026thinsp;65)\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eMedical History\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eCount\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eValid N %\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eAny Chronic condition?\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e43\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e66.2%\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e33.8%\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003eFamily History of chronic conditions\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e57\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e87.7%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e8\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e12.3%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003eHistory of Alcohol\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e16\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e24.6%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e49\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e75.4%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003eHistory of smoking\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e52\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e80.0%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e13\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e20.0%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n \u003cul\u003e\n \u003cli\u003e\n \u003cp\u003e\u003cstrong\u003eChronic conditions\u003c/strong\u003e:\u003c/p\u003e\n \u003c/li\u003e\n \u003c/ul\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\n \u003ch2\u003e2.4 Etiology:\u003c/h2\u003e\n \u003cp\u003eAlcohol and gallstones were the most common causes of acute pancreatitis among patients {78.5%} and {27.7%, respectively.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e\n \u003ch2\u003e2.5 Symptoms:\u003c/h2\u003e\n \u003cp\u003eIn terms of symptoms of acute pancreatitis, abdominal pain, nausea and vomiting were the most common symptoms among the patients {100%}, {81.5%} and {81.5%}, respectively.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec14\" class=\"Section2\"\u003e\n \u003ch2\u003e2.6: Severity:\u003c/h2\u003e\n \u003cp\u003eIn this study, most of the cases were a little or to some extent severe {23.8%} and {22.2%}, whereas only {9.5%} were very severe cases.\u003c/p\u003e\n \u003cdiv class=\"gridtable\"\u003e\n \u003cp\u003eTable 2.3: Severity of acute pancreatitis among the patients (N = 65)\u003c/p\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"585\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 234px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCount\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eValid N %\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"5\" valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSeverity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNot severe\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e5\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e7.9%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eA little\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e15\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e23.8%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTo some extend\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e14\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e22.2%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSevere\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e23\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e36.5%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVery severe\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e6\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e9.5%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec15\" class=\"Section2\"\u003e\n \u003ch2\u003e2.7 Investigations:\u003c/h2\u003e\n \u003cp\u003eOnly {26.2%} of the patients had a serum amylase\u0026thinsp;\u0026gt;\u0026thinsp;3 times the upper limit of the normal range (ULN), and {23.1%} had a serum lipase\u0026thinsp;\u0026gt;\u0026thinsp;3 times the ULN.\u003c/p\u003e\n \u003cdiv class=\"gridtable\"\u003e\n \u003ctable id=\"Tab4\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 2.4\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eshows the results of the serum enzyme investigations among the patients (N\u0026thinsp;=\u0026thinsp;65).\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eSerum enzymes\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eCount\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eValid N %\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eSerum amylase\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;3 times ULN\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e73.8%\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u0026gt;\u0026thinsp;3 times ULN\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e26.2%\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003eSerum Lipase\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;\u0026thinsp;3 times ULN\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e50\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e76.9%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026gt;\u0026thinsp;3 times ULN\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e15\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e23.1%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n \u003cp\u003e\u003cstrong\u003eImaging\u003c/strong\u003e:\u003c/p\u003e\n \u003cp\u003eThis study revealed that the most frequent imaging methods for acute pancreatitis were CT and U/S {76.9%} and {43%, respectively.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec16\" class=\"Section2\"\u003e\n \u003ch2\u003e2.8 Hospital Management and Outcomes:\u003c/h2\u003e\n \u003cp\u003eIn this study, most of the patients admitted for less than 5 days {53.8%} underwent conservative treatment {84.6%} and improved {66.2%}, whereas {4.6%} were unresolved. Necrosis was the most prevalent complication {9.2%}. Finally, most of the patients required more 3-week follow-up {63.1%}.\u003c/p\u003e\n \u003cp\u003eTable 2.5: Hospital management and outcomes of the patients (N = 65)\u003c/p\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHospital Management and Outcome\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCount\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eValid N %\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDuration of admission\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLess than 5 days\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e35\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e53.8%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e5 -- 10 days\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e26\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e40.0%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMore than 10 days\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e4\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e6.2%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTreatment\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eConservative\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e55\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e84.6%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eConservative, interventional\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e9\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e13.8%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eInterventional\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.5%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOutcome\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eImproved\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e43\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e66.2%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRecovered\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e19\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e29.2%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eUnresolved\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e3\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e4.6%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"6\" valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eComplications\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eARDS\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e2\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e3.1%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNecrosis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e6\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e9.2%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNone\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e52\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e80.0%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eParalytic ileus\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.5%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePost ERCP\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.5%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePseudocyst\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e3\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e4.6%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFollow up duration\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLess than 1 week\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e5\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e7.7%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1 -- 2 weeks\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e16\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e24.6%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026gt;2 \u0026nbsp;-- 3 weeks\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e3\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e4.6%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026gt; 3 -- 4 weeks\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e41\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e63.1%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e"},{"header":"3 Methods","content":"\u003cp\u003e\u003cstrong\u003e3.1 Study Design\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study is a retrospective, descriptive facility-based study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.2 Study Setting/Area\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study will take place at King Faisal Hospital, Kigali, Rwanda. A multispecialty quaternary hospital was established in 1991 with the help of the Saudi Funds for Development (SCP). Data will be obtained from the health records of patients who have been diagnosed with acute pancreatitis\u003cstrong\u003e.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.3 Study\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003epopulation\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eRecords of patients who were diagnosed with acute pancreatitis at King Faisal Hospital within the specified study period.\u003c/p\u003e\n\u003cp\u003eThe inclusion criterion was patients who were diagnosed with acute pancreatitis at King Faisal Hospital from February 2014 to June 2024.\u003c/p\u003e\n\u003cp\u003eThe exclusion criteria were patients with incomplete or missing health records and patients who were diagnosed outside the specified study period.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.4 Sampling\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.4.1 Sample\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003esize\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe total number of patients diagnosed with acute pancreatitis meeting the inclusion criteria and satisfying the exclusion criteria between February 2014 and June 2024 were included in the study. This totaled 65 patients.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.4.2 Sample technique\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll case files of patients who were diagnosed with acute pancreatitis from February 2014 to June 2024 were obtained via the total coverage nonrandom sampling technique\u003cstrong\u003e.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.5 Data\u003c/strong\u003e\u003cstrong\u003ecollection techniques used for the different study populations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data collection process took a range of 1 month. During this process, a list of eligible acute pancreatitis patients was compiled from the patients' register records after the required ethical approval and data collection agreement were obtained. The medical records of eligible patients were obtained from the medical records archive. The required data were collected via a checklist that covers the research objectives.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eIndependent variables:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e1. Smoking status\u003c/p\u003e\n\u003cp\u003e2. History of hyperlipidemia\u003c/p\u003e\n\u003cp\u003e3. History of hypertension\u003c/p\u003e\n\u003cp\u003e4. History of diabetes\u003c/p\u003e\n\u003cp\u003e5. History of alcohol consumption\u003c/p\u003e\n\u003cp\u003e6. Age\u003c/p\u003e\n\u003cp\u003e7. Gender\u003c/p\u003e\n\u003cp\u003e8. Previous history of AP\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDependent variable:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePresence or absence of APs\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.6 Data management and analysis plan\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe collected data retrieved from the collection sheet (from the medical records) were exported into Microsoft Excel and then imported into the Statistical Package for Social Sciences (SPSS) version 25. The descriptive percentage was calculated as (frequency * 100/sample size) and is presented in the tables and figures. The chi-square test was used to assess significant associations. The P value was considered significant when it was \u0026lt; 0.05.\u003c/p\u003e\n\u003cp\u003eAmylase 3 times ULN (Upper Limit Normal range) = 330 IU/L\u003c/p\u003e\n\u003cp\u003eLipase 3 times ULN = 480 IU/L\u003c/p\u003e"},{"header":"4 Discussion","content":"\u003cp\u003e\u003cstrong\u003e4.1\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eSociodemographic data\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOur study revealed that acute pancreatitis is more common in males (72.3%) than in females and mainly occurs in those aged 25--35 years, with a mean age of 37 years. This male predominance concurs with other studies reporting that acute pancreatitis is common in males, especially those with alcohol-related etiologies ([^3^] GBD 2019) ([^20^]\u0026nbsp;Wang et al. 2022)).\u0026nbsp;In contrast\u0026nbsp;to our study, in which the average age is 37 years, the literature mostly includes an older age group, with an average age of 56--65 years ([^21^]\u0026nbsp;Kobayashi et al. 2011)) ([^22^]\u0026nbsp;Kobayashi et al. 2014). This difference may thus be due to regional variations in the demographic profile of acute pancreatitis patients.\u003c/p\u003e\n\u003cp\u003eMarital status: 61.5% of our patients were married, while 46.2% were not employed, among whom 38.5% were engaged in private business. These socioeconomic factors may affect the prevalence of the disease and various strategies for the management of patients. The relatively high unemployment rate and business proprietorship rate in our retrospective descriptive study might indicate some socioeconomic conditions unique to our study population.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e4.2 Prevalence of Acute Pancreatitis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA past history of acute pancreatitis in 43.1% of patients indicates a significant recurrence rate and therefore is a chronic, relapsing condition. This rate is similar to that reported in some global studies that emphasize recurrence in acute pancreatitis patients, while it is slightly higher than that reported in studies where the recurrence rate is low. ([^19^]\u0026nbsp;Alkabbani et al.2024) ([^10^] Nesvaderani\u0026nbsp;et al. 2015) ([^8^]\u0026nbsp;Muniraj et al. 2012))\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e4.3 Medical\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003ehistory\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOur study revealed that 75.4% of the patients had a history of alcohol use, which is much greater than the global average in which alcohol is the leading cause of acute pancreatitis ([^20^]\u0026nbsp;Wang et al. 2022). The high prevalence of alcohol use in our retrospective\u0026nbsp;study underscores\u0026nbsp;its critical role in the etiology of acute pancreatitis in our region.\u0026nbsp;Additionally, 33.8%\u0026nbsp;of the patients had chronic conditions, and 12.3%\u0026nbsp;of them had a positive family history\u0026nbsp;of\u0026nbsp;chronic diseases, which was consistent with other studies indicating\u0026nbsp;the\u0026nbsp;commonality of chronic conditions, such as diabetes and hypertension,\u0026nbsp;in acute pancreatitis patients. In this study, a lower prevalence of smoking (20%)\u0026nbsp;than that reported in\u0026nbsp;other studies\u0026nbsp;seemed to reflect regional differences in habits related to smoking and their association with pancreatitis.\u0026nbsp;([^18^]\u0026nbsp;Aydın Şeref Köksal et al. 2024)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e4.4 Etiology\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn this study, alcohol (78.5%) and gallstones (27.7%) were identified as the most common causes of acute pancreatitis. This concurs with the literature, which usually quotes these two factors as predominant causes in different regions ([^4^]\u0026nbsp;Forsmark et al. 2016) ([^5^]\u0026nbsp;Lankisch et al. 2013). The high prevalence of alcohol-induced pancreatitis in our study concurs with data from regions with high alcohol consumption\u0026nbsp;rates, such as\u0026nbsp;Eastern Europe and Finland ([20]\u0026nbsp;Wang et al. 2022). Gallstone-induced pancreatitis, although less common in our cohort, is well documented in\u0026nbsp;the\u0026nbsp;literature as another significant etiology, particularly in developed nations ([^4^] Forsmark et al. 2016) ([^23^]\u0026nbsp;Wang et al. 2023).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e4.5 Symptoms\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAmong all patients, 100% experienced abdominal pain, while nausea and vomiting were observed in 81.5% of the patients. These symptoms are typical manifestations of acute pancreatitis, as abdominal pain, nausea, and vomiting are common modes of presentation ([^4] Forsmark et al. 2016), ([^7^]\u0026nbsp;Wang et al. 2009). The fact that abdominal pain\u0026nbsp;is\u0026nbsp;a universal complaint\u0026nbsp;confirms\u0026nbsp;its status as a core diagnostic symptom of acute pancreatitis, as confirmed by robust clinical literature ([^4^] Forsmark et al. 2016), ([^18^]\u0026nbsp;Aydın Şeref Köksal et al. 2024).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e4.6 Severity\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWith respect to severity, most cases in our study were mild to moderate, with 46% classified as either \"a little\" or \"to some extent.\" Only 9.5% of the cases were very severe. Indeed, such a distribution suggests that our cases are generally less severe than some studies that have a greater proportion of severe cases, thus showing a somewhat favorable severity profile. The lower prevalence of very severe cases in our study might be related to differences in patient management or to variations in disease presentation. ([^10^] Nesvaderani\u0026nbsp;et al. 2015) ([^2^]\u0026nbsp;Yadav \u0026amp; Lowenfels 2013)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e4.7 Investigations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe laboratory results revealed that only 26.2% of the patients had a serum amylase level higher than three times the ULN, and elevated serum lipase was detected in only 23.1% of the patients. These percentages are much lower than would be predicted by using classic diagnostic criteria for acute pancreatitis, which commonly include an elevated enzyme level as part of the definition ([^7^]\u0026nbsp;Wang et al. 2009), ([^8^]\u0026nbsp;Muniraj et al. 2012).\u0026nbsp;Differences in the assay used or the\u0026nbsp;time of enzyme measurement might explain these findings.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e4.8 Imaging\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eCT was the most commonly used imaging modality (76.9%), whereas ultrasound was the most commonly used imaging modality (43%). This preference for CT is understandable, given the high sensitivity and diagnostic accuracy for acute pancreatitis cited in the literature. Ultrasound is often used for an initial assessment, more specifically for identifying gallstones, and would thus support this role in the diagnostic process. ([^18^]\u0026nbsp;Aydın Şeref Köksal et al. 2024)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e4.9 Hospital Management and\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eOutcomes\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAmong the patients, 53.8% were admitted for less than 5 days, whereas 84.6% received conservative treatment. The findings therefore explicitly agree with the standard management practice in acute pancreatitis, in which the mainstay of treatment is conservation ([^23^]\u0026nbsp;Wang et al. 2023). High rates of improved\u0026nbsp;outcomes (66.2%)\u0026nbsp;and complications\u0026nbsp;such as\u0026nbsp;necrosis\u0026nbsp;(9.2%)\u0026nbsp;mirror typical disease progress and management\u0026nbsp;outcomes. This is further supported by the fact that 63.1% of patients required follow-up for more than three weeks, thus necessitating continued monitoring and care in the management of acute pancreatitis. ([^21^]\u0026nbsp;Kobayashi et al. 2011)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eLimitations \u0026amp; recommendation\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study has certain limitations. As a retrospective, single-center analysis, it is subject to inherent biases associated with secondary data use, including incomplete or missing clinical information and potential misclassification. The findings may not be generalizable beyond the population served by King Faisal Hospital due to regional variations in healthcare access, referral patterns, and patient demographics. Moreover, the descriptive design precludes causal inference. Several important variables—such as alcohol intake, smoking status, nutritional history, and socioeconomic indicators—were unavailable, limiting comprehensive analysis of risk factors. Additionally, the extended 10-year study period may have introduced temporal variations due to evolving diagnostic criteria, clinical practices, or record-keeping standards.\u003c/p\u003e"},{"header":"5 Conclusion","content":"\u003cp\u003e\u003cstrong\u003e5.1 Conclusion\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study describes the demographic, clinical, and etiological profile of acute pancreatitis in a tertiary care center in Rwanda. Alcohol was identified as the predominant cause, especially among young male patients. While the findings are consistent with global literature, they underscore the importance of local risk factor assessment. Given the limitations of the retrospective, single-center design, further prospective multicenter studies are recommended to support evidence-based regional strategies.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e5.2 Recommendation:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOn the basis of the observations derived from this study and their comparison with the literature available on the subject, the following recommendations are proposed for the management of acute pancreatitis to improve the understanding of the disease process:\u003c/p\u003e\n\u003cp\u003e1. Enhanced Public Awareness and Prevention\u003c/p\u003e\n\u003cp\u003eHeavy alcohol consumption, therefore, should be stressed through public health campaigns.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAn effective educational program to link heavy drinking to pancreatitis can lead to a long way toward prevention.\u003c/p\u003e\n\u003cp\u003eLifestyle modifications: Awareness campaigns should include lifestyle modifications such as dietary changes and smoking cessation because they are also linked with acute pancreatitis.\u003c/p\u003e\n\u003cp\u003e2. Best Practices in Diagnosis and Monitoring\u003c/p\u003e\n\u003cp\u003eEarly Diagnosis: Due to the variability of enzyme levels and imaging findings, a multimodal approach for diagnosis might be the best, combining clinical presentation, serum enzyme levels, and imaging studies to achieve an early and accurate diagnosis.\u003c/p\u003e\n\u003cp\u003eStandardization of Enzyme Measurement: In view of the low levels of enzymes noted in our study, standardization of measurement techniques for serum amylase and lipase and uniformity at the time of sample collection may yield better results in diagnosis.\u003c/p\u003e\n\u003cp\u003eRegular monitoring: As acute pancreatitis is a chronic process with a significant recurrence rate, patients with a previous history should be regularly followed up and monitored for early recognition of relapses and management of complications.\u003c/p\u003e\n\u003cp\u003e3. Individualized Management Algorithms\u003c/p\u003e\n\u003cp\u003eRegional Variations: Management strategies should focus on regional epidemiological profiles. For example, in areas where there is a high consumption of alcohol, specifically designed interventions could aim to reduce the amount of alcohol use, and in areas with a large prevalence of gallstones, more attention might need to be given to gallstone-related complications.\u003c/p\u003e\n\u003cp\u003eGrading of severity and severity-based treatment: The need to grade the severity of the condition and treat it accordingly is realized. More aggressive modes of management with close monitoring are associated with better outcomes in patients with severe acute pancreatitis.\u003c/p\u003e\n\u003cp\u003e4. Comprehensive Research and Data Collection\u003c/p\u003e\n\u003cp\u003eLongitudinal studies: Longitudinal studies on acute pancreatitis need to be conducted to understand the long-term outcomes and recurrence rates of the disease process. This would lead to a better understanding of the chronic management of the disease process and the outcomes of different modes of treatment.\u003c/p\u003e\n\u003cp\u003eRegional Epidemiological Research: More regional epidemiological research on acute pancreatitis must be conducted to determine regional variations in etiology and prevalence. This would facilitate an understanding of the differences that might lead to more focused prevention and treatment strategies.\u003c/p\u003e\n\u003cp\u003eEtiological factors: Elucidate how other potential etiological factors and their interactions contribute to acute pancreatitis. Examples include the role of genetic predisposition, dietary factors, and environmental factors in causing a disease.\u003c/p\u003e\n\u003cp\u003e5. Healthcare Policy and Training\u003c/p\u003e\n\u003cp\u003ePolicy development: Designing and implementing healthcare policies for acute pancreatitis prevention and management Such policies need to include primary prevention, such as a reduction in alcohol consumption, and secondary prevention, such as the regular monitoring of individuals at risk.\u003c/p\u003e\n\u003cp\u003eHealthcare Provider Training: Improving healthcare professional training in all the latest diagnostic and management practices for acute pancreatitis. Maintaining good knowledge among clinicians on acute pancreatitis can lead to better outcomes for patients, as well as universal patterns of care.\u003c/p\u003e\n\u003cp\u003e6. Patient Support and Education\u003c/p\u003e\n\u003cp\u003ePatient Education: Patients were educated on acute pancreatitis management in terms of dietary advice, adherence to therapy, and early warning signs and symptoms of recurrent acute pancreatitis.\u003c/p\u003e\n\u003cp\u003eSupport services: Support services for patients suffering from acute pancreatitis, including counseling and support groups, must be developed to cope with the emotional and psychic burdens of illness.\u003c/p\u003e\n\u003cp\u003eIt is hoped that once the recommendations are implemented, the understanding of acute pancreatitis, its prevention, and its management will dramatically change for better patient outcomes and health care strategies.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch3\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/h3\u003e\n\u003cp\u003eEthical approval for this study was granted by the Institutional Review Board (IRB) of the University of Medical Sciences and Technology (see Appendix A) and the IRB of King Faisal Hospital, Rwanda (see Appendix B). The study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki. Given the retrospective nature of the study, obtaining informed consent directly from patients was not feasible. However, a waiver of consent was approved by the IRB of King Faisal Hospital. To ensure confidentiality, all patient data were anonymized or\u0026nbsp;deidentified\u0026nbsp;prior to analysis.\u0026nbsp;The data\u0026nbsp;were stored securely on restricted-access servers and used solely for research purposes. No personally identifiable information was included in the dissemination of\u0026nbsp;the results.\u003c/p\u003e\n\u003ch3\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/h3\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003ch3\u003e\u003cstrong\u003eAvailability of data and material\u003c/strong\u003e\u003c/h3\u003e\n\u003cp\u003eThe datasets generated and/or analyzed during the current study are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003ch3\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/h3\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003ch3\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/h3\u003e\n\u003cp\u003eThis study received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.\u003c/p\u003e\n\u003ch3\u003e\u003cstrong\u003eAuthors' contributions\u003c/strong\u003e\u003c/h3\u003e\n\u003cp\u003eO.M. designed the study, collected and analyzed the data, and drafted the manuscript. A.H. contributed to data interpretation and provided critical input on the manuscript. S.F. supervised the research and provided overall guidance and final approval of the manuscript. All the authors reviewed and approved the final version.\u003c/p\u003e\n\u003cp\u003eAcknowledgments\u003cbr\u003e\u0026nbsp;First and foremost, I thank Allah (SWT) for His guidance and blessings throughout this journey. The author gratefully acknowledges Dr. Shikama Felicien for his expert supervision and unwavering guidance throughout the research process. We also extend our sincere appreciation to Dr. Ahmed Abdulrahman Ahmed Hashim for his significant contributions as coauthor, particularly in data interpretation and for providing critical insights during manuscript preparation.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eBanks PA, Freeman ML. Practice Guidelines in Acute Pancreatitis. Am J Gastroenterology. 2006;101(10):2379-2400.\u003c/li\u003e\n \u003cli\u003eYadav D, Lowenfels AB. The Epidemiology of Pancreatitis and Pancreatic Cancer. Gastroenterology. 2013;144(6):1252-1261.\u003c/li\u003e\n \u003cli\u003eGBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990\u0026ndash;2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396(10258):1204-1222.\u003c/li\u003e\n \u003cli\u003eForsmark CE, Vege SS, Wilcox CM, Murad MH, Yadav D. Acute Pancreatitis. N Engl J Med. 2016;375(20):1972-1981.\u003c/li\u003e\n \u003cli\u003eLankisch PG, Apte M, Banks PA; Acute Pancreatitis Classification Working Group. Acute panceatitis. Lancet. 2013;381(9861):51-62.\u003c/li\u003e\n \u003cli\u003ePetrov MS, Yadav D. Global Epidemiology and Holistic Prevention of Pancreatitis. Nat Rev Gastroenterol Hepatol. 2019;16(3):175-184.\u003c/li\u003e\n \u003cli\u003eWang GJ, Gao CF, Wei D, Wang C, Ding SQ. Acute pancreatitis: Etiology and common pathogenesis. World Journal of Gastroenterology [Internet]. 2009;15(12):1427.\u003c/li\u003e\n \u003cli\u003eMuniraj T, Gajendran M, Thiruvengadam S, Raghuram K, Rao S, Devaraj P. Acute pancreatitis. Dis Mon. 2012;58(2):98\u0026ndash;144. doi:10.1016/j.disamonth.2012.01.005.\u003c/li\u003e\n \u003cli\u003eNational Institute of Diabetes and Digestive and Kidney Diseases. Definition \u0026amp; Facts for Pancreatitis | NIDDK [Internet]. National Institute of Diabetes and Digestive and Kidney Diseases. 2019. Available from: https://www.niddk.nih.gov/health-information/digestive-diseases/pancreatitis/definition-facts\u003c/li\u003e\n \u003cli\u003eNesvaderani M, Eslick GD, Vagg D, Faraj S, Cox MR. Epidemiology, etiology and outcomes of acute pancreatitis: a retrospective cohort study. Int J Surg. 2015;23:68\u0026ndash;74.\u003c/li\u003e\n \u003cli\u003eBanks PA, Bollen TL, Dervenis C, et al. Classification of acute pancreatitis\u0026mdash;2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013;62(1):102\u0026ndash;111.\u003c/li\u003e\n \u003cli\u003eLankisch PG, Apte M, Banks PA. Acute pancreatitis. Lancet. 2015;386(9996):85\u0026ndash;96.\u003c/li\u003e\n \u003cli\u003eParenti DM, Steinberg W, Kang P. Infectious Causes of Acute Pancreatitis. Pancreas [Internet]. 1996 Nov 1;13(4):356\u0026ndash;71. Available from: https://journals.lww.com/pancreasjournal/Abstract/1996/11000/Infectious_Causes_of_Acute_Pancreatitis.5.aspx\u003c/li\u003e\n \u003cli\u003eRawla P, Bandaru SS, Vellipuram AR. Review of infectious etiology of acute pancreatitis. Gastroenterol Res. 2017;10(4):153\u0026ndash;158. [PMC free article] [PubMed] [Google Scholar].\u003c/li\u003e\n \u003cli\u003eNoel RA, Braun DK, Patterson RE, Bloomgren GL. Increased risk of acute pancreatitis and biliary disease observed in patients with type 2 diabetes: a retrospective cohort study. Diabetes Care. 2009;32(5):834\u0026ndash;838. [PMC free article] [PubMed] [Google Scholar].\u003c/li\u003e\n \u003cli\u003eJanisch N, Gardner T. Recent advances in managing acute pancreatitis [version 1; peer review: 2 approved]. F1000Res. 2015;4(F1000 Faculty Rev):1474. doi:10.12688/f1000research.7172.1.\u003c/li\u003e\n \u003cli\u003eRoberts SE, Morrison-Rees S, John A, Williams JG, Brown TH, Samuel DG. The incidence and etiology of acute pancreatitis across Europe. Pancreatology. 2017 Mar;17(2):155\u0026ndash;65.\u003c/li\u003e\n \u003cli\u003eAydın Şeref K\u0026ouml;ksal, Mukaddes Tozlu, Orhan Sezgin, Dilek Oğuz, İsmail Hakkı Kalkan, Engin Altıntaş, et al. Acute pancreatitis in Turkey: Results of a nationwide multicenter study. Pancreatology. 2024 May 1;24(3):327\u0026ndash;34.\u003c/li\u003e\n \u003cli\u003eAlkabbani SS, AlHalak RH, Smady A, Fuad Alsaraj. The Epidemiology of Acute Pancreatitis in a Tertiary Care Hospital in Dubai. Annals of African Medicine [Internet]. 2024 Jan 1 [cited 2024 Aug 13];23(1):36\u0026ndash;9. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10922180/\u003c/li\u003e\n \u003cli\u003e\u0026zwnj;20 Wang J, Li J, Zhang J, et al. Management of acute pancreatitis: a systematic review and meta-analysis. \u003cem\u003eDrugs\u003c/em\u003e. 2022;82(11):1487-1501\u003c/li\u003e\n \u003cli\u003eKobayashi M, Yoshida Y, Koga T, et al. Nationwide epidemiological survey of acute pancreatitis in Japan. \u003cem\u003ePancreas\u003c/em\u003e. 2011;40(4):563-570.\u003c/li\u003e\n \u003cli\u003eKobayashi M, Yoshida Y, Koga T, et al. Nationwide epidemiological survey of acute pancreatitis in Japan. \u003cem\u003ePancreas\u003c/em\u003e. 2014;43(8):1265-1272.\u003c/li\u003e\n \u003cli\u003eWang J, Li J, Zhang J, et al. Management of acute pancreatitis: a systematic review and meta-analysis. \u003cem\u003eDrugs\u003c/em\u003e. 2023;83(1):145-157\u003cstrong\u003e\u003cbr\u003e\u003c/strong\u003e\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Acute pancreatitis, Etiology, Alcohol, Gallstones, Rwanda","lastPublishedDoi":"10.21203/rs.3.rs-6917772/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6917772/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAcute pancreatitis is one of the most important acute gastrointestinal conditions worldwide, although its prevalence and etiology vary across countries and regions. This study investigated regional and national patterns in the prevalence and etiology of acute pancreatitis, demographic patterns in prevalence, and trends over time in prevalence in Kigali, Rwanda.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eObjective:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTo determine the prevalence of acute pancreatitis (AP) in Kigali, Rwanda, KFH.\u003c/p\u003e\n\u003cp\u003e-To identify the most common causes of AP in Kigali, Rwanda, and KFH.\u003c/p\u003e\n\u003cp\u003e-To characterize the clinical presentation of AP in Kigali, Rwanda, KFH.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis retrospective study analyzed patients from medical wards between 2014 and 2024. The study excluded patients with a history of chronic pancreatitis or incomplete files. Additionally, a structured review was conducted to examine the prevalence and etiology of acute pancreatitis in hospitalized patients.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA study of 65 acute pancreatitis patients revealed that most were male, aged 25--35 years, with an average age of 37 years. Common causes included alcohol (75.4%) and gallstones (27.7%). The symptoms were mainly abdominal pain, nausea, and vomiting. Most cases were mild to moderate, with 9.5% very severe. Diagnostic imaging frequently includes CT scans and ultrasounds. Most patients were hospitalized for under 5 days, received conservative treatment, and improved. Necrosis was a notablecomplication in 9.2% of the patients.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e:\u003c/p\u003e\n\u003cp\u003eThis study reveals important patterns in the demographics, clinical features, and management of acute pancreatitis patients. Although the findings are consistent with global\u003c/p\u003e\n\u003cp\u003etrends, significant regional variations in causes, severity, and socioeconomic factors highlight the necessity for localized prevention and treatment strategies. More research into these regional differences is crucial for refining acute pancreatitis care approaches.\u003c/p\u003e","manuscriptTitle":"Prevalence and Epidemiological Profile of Acute Pancreatitis in King Faisal Hospital: Retrospective descriptive study from 2014--2024","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-07-08 10:34:56","doi":"10.21203/rs.3.rs-6917772/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"d29ba639-589b-4ee6-b1f0-d521d91b749d","owner":[],"postedDate":"July 8th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-08-05T18:53:38+00:00","versionOfRecord":[],"versionCreatedAt":"2025-07-08 10:34:56","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6917772","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6917772","identity":"rs-6917772","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}