Acute pancreatitis

Question 1

What is the aetiology and risk factors of pancreatitis?

Answer 1

Idiopathic

Gall stones
Ethanol
Trauma

Steroids
Malignancy
Autoimmune
Scorpion stings
High cholesterol and calcium
ERCP
Drugs

I GET SMASHED

Question 2

What is the epidemiology of acute and chronic pancreatitis?

Answer 2

Acute:
Gallstones in approx 50% of cases
Chronic alc consumption in approx 25%

Chronic:
Chronic alc consumption approx 70-80%
The male to female ratio is 7:1
Average onset between 36-55
Significant risk of pancreatic CA

Question 3

What are the signs and symptoms of acute pancreatitis?

Answer 3

Sudden severe epigastric pain
Post prandial pain
Pain increases over time – radiates
across back
Nausea/vomiting
Indigestion
Pyrexia of 38°c or more
Jaundice in sclera/skin
Abdo tenderness on palpation
Tachycardia/tachypnoea

Question 4

What is the treatment for pancreatitis?

Answer 4

Supportive in nature
Analgesia
Fluids
Usually feel better after 48 hours
Lifestyle advice
Worsening advice on discharge

Question 5

What are the signs and symptoms of chronic pancreatitis?

Answer 5

Repeated episodes of severe epigastric
pain
Radiates across back
Can be post prandial or no trigger
Nausea/vomiting
Painful episodes may become more
frequent and severe
Eventually constant dull pain can
develop between episodes of severe
pain

Question 6

What are the treatment methods for chronic pancreatitis?

Answer 6

• Supportive in nature
• Analgesia
• Fluids
• Lifestyle advice
• Long term steroids
• Enzyme supplements
• Endoscopic surgery
• Pancreas resection/Total
  pancreatectomy