Acute Pancreatitis Flashcards
What is acute pancreatitis?
Acute pancreatitis refers to acute inflammation of the pancreas.
What is the prevalence of acute pancreatitis in the United Kingdom?
Approximately 56 cases per 100,000 annually.
What is the mortality rate for severe acute pancreatitis?
Severe acute pancreatitis has a high mortality rate of approximately 15%.
What are the two types of acute pancreatitis?
Interstitial oedematous pancreatitis (most common, better prognosis) and necrotising pancreatitis (5-10%, more severe).
What are the most common causes of acute pancreatitis in the UK?
Gallstones and alcohol.
What mnemonic can help remember the causes of acute pancreatitis?
“I GET SMASHED”: Idiopathic, Gallstones, Ethanol, Trauma, Steroids, Mumps/malignancy, Autoimmune disease, Scorpion sting, Hypertriglyceridemia/Hypercalcaemia, ERCP, Drugs (azathioprine, thiazides, septrin, tetracyclines).
What are the risk factors for acute pancreatitis?
Male gender, increasing age, obesity, and smoking.
What are the typical symptoms of acute pancreatitis?
Severe epigastric pain radiating to the back, nausea, vomiting, and decreased appetite.
What past medical history is relevant in assessing acute pancreatitis?
History of gallstones, biliary disease, or previous pancreatitis.
How can recent surgical procedures relate to acute pancreatitis?
Recent procedures, such as ERCP, can be associated with the development of acute pancreatitis.
What social history factors are important in acute pancreatitis?
Alcohol intake and smoking habits.
What family history is pertinent to acute pancreatitis?
Family history of hereditary pancreatitis.
What are common clinical examination findings in acute pancreatitis?
Epigastric tenderness, abdominal distension, and reduced bowel sounds.
What systemic signs might be present in acute pancreatitis?
Fever, hypotension, and tachycardia, indicating a systemic inflammatory response.
What is Cullen’s sign?
Periumbilical bruising associated with acute pancreatitis.
What is Grey-Turner’s sign?
Flank bruising associated with acute pancreatitis.
What initial investigations are important in suspected acute pancreatitis?
Serum amylase and lipase levels, liver function tests, and abdominal ultrasound.
What imaging modality is preferred to detect gallstones in acute pancreatitis?
Abdominal ultrasound.
What scoring system is used to assess the severity of acute pancreatitis?
The Glasgow-Imrie criteria.
What are the components of the Glasgow-Imrie criteria?
Age >55 years, WBC >15x10^9/L, glucose >10 mmol/L, urea >16 mmol/L, AST >200 IU/L, LDH >600 IU/L, calcium <2 mmol/L, albumin <32 g/L, and PaO2 <8 kPa.
What is the initial management for acute pancreatitis?
Supportive care with intravenous fluids, analgesia, and monitoring for complications.
When are antibiotics indicated in acute pancreatitis?
Antibiotics are not routinely indicated unless there is evidence of infected pancreatic necrosis or other infections.
What lifestyle modifications are recommended after an episode of acute pancreatitis?
Abstinence from alcohol and smoking cessation.
What surgical intervention might be necessary in gallstone-induced acute pancreatitis?
Cholecystectomy may be required to prevent recurrence.
What are potential complications of acute pancreatitis?
Pancreatic necrosis, pseudocyst formation, abscess, and systemic complications like organ failure.
