7. Acute and chronic pancreatitis

Question 1

How common is it?

Answer 1

Acute is more common that chronic
Quite common
Increasing incidence

Question 2

Who does it affect?

Answer 2

7M:1F

Average age of onset is 36-55 years

Question 3

What causes it?

Answer 3

(A) IGETSMASHED, gallstones, alcohol

(C) TIGARO, toxic

Question 4

What risk factors are there?

Answer 4

Alcohol, obesity, smoking, FH

Question 5

How does it present?

Answer 5

Acute / chronic abdo pain (can radiate to back), worse after eating, fever, N+V
(C) Weight loss, steatorrhoea

Question 6

What signs may the patient have on examination?

Answer 6

Tachycardia, fever, hypotension, diaphoresis

Decreased bowel sounds, guarding, tender abdomen, distension

Question 7

Which other conditions might present similarly?

Answer 7

Peptic ulcer, cholangitis, cholecystitis, bowel perforation / obstruction, mesenteric ischaemia, DKA, hepatitis, MI, appendicitis

Question 8

How would you investigate?

Answer 8

FBC, CT, ultrasound, MRCP

Question 9

What treatments are there?

Answer 9

(A) IV fluids, nutritional support, analgesics, treat underlying cause (cholecystectomy)
(C) Lifestyle changes, steroids, pain relief
Pancreatectomy, resection

Question 10

What are the complications?

Answer 10

Pseudocysts, pancreatic necrosis and infection, acute can lead to chronic