Acute Pancreatitis Flashcards
What is Acute Pancreatitis
Inflammation of the pancreas
What are the IGETSMASHED causes of Acute pancreatitis
Idiopathic Gallstones Ethanol Trauma Steroids Mumps Autoimmune Scorpion venom Hypercalcemia ERCP Drugs (Azitioprine NSAID ACEinhibitor)
How can gallstones cause Acute Pancreatitis
Gallstone obstructs Pancreas secretion Increased Digestive enzymes in pancreas Host Defences (A1AT) overwhelmed = Autodigestion = Inflammation and leaked enzymes
How can hypercalcemia cause Autodigestion of pancreas
Increased premature enzymatic activation (a1at)
How does a patient with Acute pancreatitis present
Sudden Epigastric pain to the back w/jaundice, pyrexia
- Grey Turner’s (Flank bleed)
- Cullens (Periumbilical bleed)
What two signs are specific of acute pancreatitis
Grey Turners
Cullen’s
What is the difference between Grey turners and Cullens Sign
Grey Turner’s = Flank bleed
Cullen’s = Periumbilical bleed
How is Acute pancreatitis investigated
Raised amylase and lipase (GOLD) Erect CXR (Exclude gastroduodenal perf.) Abdo USS (Diagnose Gallstones as cause)
What is the GS Investigation for acute pancreatitis
Raised Serum amylase and lipase
What factors must be present to diagnose Acute pancreatitis (Any 2…)
Symptoms
Raised Amylase/Lipase
Abdo USS confirm
What are the two string systems used in Pancreatic scoring
APACHE2 (Severity in 24hr)
Glasgow and Parson Score (Predicted attack after 2 days)
How is Acute Pancreatitis treated
Nil by mouth w/ NG Feed
IV fluid
Analgesia
Prophylaxis w/Abx
What is the major complication w/ acute pancreatitis
SIRS Systemic Inf. Response Syndrome -Tachycardia -Tachypnoea -Pyrexia -Raised WCC
What 4 symptoms are found in SIRS
Tachycardia
Tachypnoea
Pyrexia
Raised WCC
