2: Acute Pancreatitis, Chronic Pancreatitis Flashcards
What is pancreatitis
Inflammation pancreas
How is acute pancreatitis differentiated from chronic pancreatitis
Acute pancreatitis disrupts secretory function of the pancreas with no structural changes.
How can the causes of acute pancreatitis be remembered
I.GET.SMASHED.
What are the causes of acute pancreatitis
Idiopathic Gall stones Ethanol Trauma Steroids Mumps Autoimmune Scorpion Hyperlipidaemia, hypothermia, hypercalcaemia Ethanol Drugs: NSAIDs, azathiopri ne
How does acute pancreatitis present clinically
Epigastric pain that radiates to the back. Improve on leaning forwards. Associated with nausea and vomiting.
How will severe pancreatitis present
Peritonism
Shock
What are two-signs of retroperitoneal haemorrhage
Cullens - peri-umbilical haemorrhage
Grey-Turner’s - haemorrhage of the flanks
Explain pathophysiology of pancreatitis
Pancreatitis causes pre-mature activation of digestive enzymes. If released into circulation degrade fats and blood vessels - can lead to retroperitoneal haemorrhage.
Inflammation in pancreatitis also causes vasodilation and third space losses of fluid which may result in dehydration.
What blood tests are ordered for pancreatitis
Serum amylase
Serum lipase
LFT
What serum amylase is indicative of pancreatitis
> 3 times upper limit of normal
What does an ALT >150 indicate
Gallstone pancreatitis
How will serum lipase present in pancreatitis
Raised.
It is more accurate for pancreatitis - however unavailable in some hospitals
What imaging may be ordered for acute pancreatitis
AUS
When is AUS ordered
Suspect gallstone pancreatitis
When is contrast enhanced CT performed
Unidentified pathology