acute pancreatitis

Question 1

what is acute pancreatits

Answer 1

-reversible inflammation of pancreas

-

Question 2

what is acute pancreatitis due to

Answer 2

due auto digestion (digestive enzymes breakdown structural components in the pancreas)

Question 3

acute pancreatits becomes_____ and is _______

Answer 3

systemic and is life threatening

Question 4

what are the functions of the pancreas

Answer 4

• digestive (exocrine)

- hormones (endocrine)

Question 5

etiology of acute pancreatits

Answer 5

• alcohol abuse (70%)
• gallstones (because potentially obstruct flow of bile
• idiopathic (approx 10%)
• others such as pancreatitc trauma & drugs)

Question 6

what causes 70% of acute pancreatits

Answer 6

alcohol abuse

Question 7

how are the pancreatic enzymes activated

Answer 7

duodenum activation of pancreatit enzymes via bile

Question 8

what is the patho of acute pancreatits

Answer 8

-if bile flow is obstructed then premature activation of enzymes in the pancreas occurs because of backflow of bile, resulting in enzymatic damage to the pancreas (causing autodigestion, hemorrhage, necrosis)

Question 9

the alcholic patho of pancreatits

Answer 9

• increased secretion of pancreatic secretions (enzymes)
• Constricts sphincter (sphincter of Oddi) in pancreatic duct
• pancreatic juices back up into gall bladder

Question 10

what are the manifestations of acute pancreatits

Answer 10

(often arrive after a heavy meal or alcohol binge)

• severe abdominal pain (epigastric, periumbilical) (raidiates to back, chest & flank)
• large volume 3rd spacing (ascities) d/t inflammation (formation of exudate) & large amount of perfusion to pancreas (hyperemia)
• may cause hypovolemia & vasccular collapse which may cause hypvolemic shock & death

Question 11

when do the manifestations often occur

Answer 11

-often arrive after a heavy meal or alcohol binge

Question 12

how do you diagnose?

Answer 12

• labs (amaylase & lipase & CRP) (CRP will indicate inflm but does not indicate location of inflm)
• ultrasoung, CT
• Serum markers (amaylase & lipase)

Question 13

what are the serum markers that are the primary diagnosis for acute pancreatitis

Answer 13

amylase & lipase which are 2 pancreatic enzymes, if there are these enzymes will indicate pancreatits but high levels of the enzymes does not correlate to severity of pancreatits

Question 14

treatment

Answer 14

• address underlying problem: alcohol abuse or obstruction

- differs for mild and severe

Question 15

why is treatment of acute pancreaitis so important?

Answer 15

because it is almost 90% reversible

Question 16

treatment of acute pancreatits is based on ____

Answer 16

severity

Question 17

how do you treat mild acute pancreatits

Answer 17

approx 1 wk recovery

• pain, fluids/lytes (fluid shift fx)
• NPO to take away bile & pancreatic juices, parental nutrition that doesn’t go through there can be given

Question 18

how do you treat severe acute pancreaitits

Answer 18

• ICU
• support: renal & circulatory (loss of fluid to 3rd space l/o perfusion to kidneys causing renal circulatory problems) hepatobiliary (ducts are linked & complications arise) pulm support (ARDS-acute respiratory distress)
• IV opiates (morphine)
• surgery may be indicated