Acute Pancreatitis Flashcards
1
Q
Acute pancreatitis?
A
- Is when the pancreas become inflamed (swollen) over a short period of time. Acute pancreatitis is a clinical diagnosis, based mainly on the presenting features and amylase level.
2
Q
Causes ?
A
• Short list of causes:
- Gallstones
- Alcohol
- Post-ERCP
• Long list of causes
• Mnemonic : I GET SMASHED
- I : Idiopathic
- G : Gallstones
- E : Ethanol (alcohol consumption)
- T : Trauma
- S : Steroids
- M : Mumps
- A : Autoimmune
- S : Scorpion sting
- H : Hyperlipidemia
- E : ERCP
- D : Drugs
3
Q
Clinical presentation?
A
- Severe epigastric pain
- Radiating to the back
- Abdominal tenderness
- Associated with vomiting
- Systemically unwell
4
Q
Investigations?
A
- FBC (white blood cells)
- U&E (urea)
- LFT
- Calcium
- ABG
- Amylase ( raised more than 3times, in chronic might not rise cause pancreas has reduced function)
- Lipase ( also raised, it’s more sensitive and specific than Amylase)
- CRP ( to monitor the level of inflammation)
- CT abdomen ( can access for complications of pancreatitis)
- Ultrasound
5
Q
The criteria for the Glasgow score?
A
• The Glasgow score is used to assess the severity of pancreatitis :
- 0-1 : mild pancreatitis
- 2 : moderate pancreatitis
- 3 or more : severe pancreatitis
• The criteria for the Glasgow score can be remembered using the PANCREAS mnemonic :
P: PaO2 < 8 KPa
A: Age > 55yo
N: Neutrophils (WBC>15)
C: Calcium < 2
R: uRea > 16
E: Enzymes (LDH > 600 or AST/ALT >200)
A: Albumin <32
S: Sugar (glucose >10)
6
Q
Complications?
A
- Necrosis of pancreas
- Chronic pancreatitis
- Abscess formation
7
Q
Differential diagnosis?
A
- Peptic ulcer disease
- Cholecystitis (inflammation of the gallbladder)
- Cholangitis ( inflammation of the bile duct system)
8
Q
Management?
A
- Nil by mouth
- IV fluids
- Analgesia
- Careful monitoring
- Treatment of gallstones in gallstones pancreatitis (cholecystectomy)
- Antibiotics, if there is evidence of a specific infection (abscess of infected necrosis area)
- Treatment of complications
