13. Abdominal pain and pancreatitis Flashcards
What is acute pancreatitis?
Acute inflammatory process that leads to necrosis of the pancreatic parenchyma.
What are the signs and symptoms of acute pancreatitis?
Severe abdominal pain Nausea Vomiting Diarrhoea Fever Shock
What investigations can be used for suspected acute pancreatitis?
Blood tests Imaging (Chest/ abdominal x-ray, ultrasound, CT) Invasive test (ERCP)
Risk factors influencing severity of acute pancreatitis
Necrosis vs non necrosis Organ failure Age Co-morbidities Alcohol
Pneumonic for causes of acute pancreatitis
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What are the causes of acute pancreatitis?
Gall stones Ethanol Trauma Steroids Mumps Autoimmune Scorpion bite Hyperlipidaemia/-calacaemia/-thermia ERCP Drugs (azathioprine)
6 systemic complications of acute pancreatitis
Hypovolaemia Hypoxia Hypocalcaemia Hyperglycaemia DIC Multiple organ failure
4 localised complications of acute pancreatitis
Pancreatic necrosis
Fluid collections – mature into pseduocysts
Splenic vein thrombosis/pseudoaneurysm
Chronic Pancreatitis
What are the supportive treatments for acute pancreatitis?
Fluids Painkillers Nutrition Organ Support Management of complications
What is chronic pancreatitis?
Progressive fibroinflammatory process of the pancreas that results in permanent structural damage, which leads to impairment of exocrine and endocrine function
What are the consequences of chronic pancreatitis?
Malabsorption
Loss of 90% exocrine function
Fat soluble vitamin malabsorption (A, D, E, K)
What 3 investigations may be performed for suspected chronic pancreatitis?
Plain X-ray (pancreas outlined with calcification)
CT scan
Faecal elastase (enzyme secreted by pancreas, low levels indicate pancreatic insufficiency)
What are the management strategies for chronic pancreatitis?
Stop alcohol and smoking
Small meals with low fat
PPI and pancreatic supplements
Analgesia
