Acute Pancreatitis Flashcards
What is it?
Acute inflammation of the Pancreas by enzyme-mediated autodigestion
What is the acronym for the main causes?
G-Gallstones
E-Ethanol
T-Trauma
S-Steroids M-Mumps A-Autoimmune S-Scorpion Venom H-Hyperlipidaemia, Hypothermia, Hypercalcaemia E-ERCP/Emboli D-Drugs e.g Azathioprine
What severity scale does pancreatitis use?
Glasgow Severity Scale
PaO2 <8, >55y/o, Neutrophilia, Calcium <2, Urea >16, Albumin <32, Sugar >10
Is it common?
Relatively common, usually caused by Gallstones and Alcohol
Symptoms (4)
Severe epigastric pain radiating to the back, nausea, vomiting, pain after alcohol
Signs (6)
Tachycardia, hypotension, oliguria (state of sepsis), reduced bowel sounds, cullens and grey turners sign
Differentials (3)
MI, Reflux, Cholecystitis
What bloods would you do?
Serum Amylase, Serum Lipase, CRP, FBC, U&E, LFT, Blood Glucose, Calcium
Other Investigations (6)
Urinary Amylase, CXR, Abdominal Ultrasound, CT (assesses pancreatic necrosis), MRI, MRCP
First line treatment (2)
Nil by mouth, IV fluid rescucitation
Other treatment: (3)
Analgesia, ERCP and Gallstone removal, prophylactic antibiotics to prevent pancreatic necrosis
Complications (7)
Shock, Respiratory Distress, Renal Failure, Pancreatic Necrosis, Pancreatic Insufficiency (causing diabetes and malabsorption), Abscess, Pseudocyst