Acute Pancreatitis Flashcards
What is acute pancreatitis?
acute inflam of the pancreas
what is the prognosis of acute pancreatitis?
morbidity can be high with severe pancreatitis
it is important to determine severity of disease for prognosis
what are the most common causes of acute pancreatitis? (3)
- gallstones
- alcohol
- hypertriglyceridemia
what does I GET SMASHED stand for for acute pancreatitis?
mnemonic for common etiologies of acute pancreatitis
Idiopathic
Gallstones
EtOH - alcohol
Trauma
Steroid use
Malignancy
Autoimmune
Scorpion sting
Hyperlipidemia
ERCP
Drugs
What is the pathophys for acute pancreatitis w/ gallstone etiology?
gallstone obstruction at ampulla of vater ➔ backup of bile and pancreatic juices in the pancreas ➔ inflammation of the pancreas
What is the pathophys for acute pancreatitis w/ alcohol etiology?
alcohol ➔ directly toxic to the pancreas ➔ inflammation
What are common s/s you might see in acute panceratitis?
- epigastric pain, radiating to pack and gets better positionally
- nausea, vomiting, anorexia
- systematically unwell: fever, tachycardia, hypotension
- decreased bowel sounds ➔ paralytic ileus
- retroperitoneal bleeding ➔ Grey-Turner’s sign and Cullen’s sign
What is the 3 criteria in the Atlanta criteria for acute pancreatitis?
only require 2/3 for diagnosis
- lipase or amylase >3x ULN
- abdo pain consistent with acute pancreatitis presentation
- imaging consistent with acute pancreatitis
What ix would you order for acute pancreatitis?
- serum lipase
- cbc with diff
- electrolytes
- liver - ALT/AST/ALP/GGT
- creatinine/BUN
- lipid panel
Imaging
1. CT w/ contrast of an U/S
How would you treat acute pancreatitis presenting to ED?
- admit to ICU
- secure IV access
- supportive care - oxygen, pain medication, bowel rest
- consider TPN and abx prophylaxis
- treat underlying etiology ➔ ERCP for stone or cholecystectomy
