Acute Pancreatitis Flashcards
Function of the pancreas?
- endocrine
- exocrine
endocrine: alpha and beta cells secrete hormones like insulin
exocrine: secrete digestive enzymes
pathophysiology of acute pancreatitis?
Sudden inflammation and haemorrhaging of pancreas due to destruction by its own digestive enzymes. (Self-perpetuating pancreatic enzyme-mediated autodigestion.
what are the 2 leading causes?
gallstones and alcohol
GET SMASHED
Causes of Acute Pancreatitis?
Gallstones (35%)
Ethanol (35%) **
Trauma
Steroids
Mumps
Autoimmune
Scorpion venom
Hyperlipidaemia Hypothermia Hypercalcaemia
ERCP (5%), Emboli
Drugs (azathioprine, mesalazine, sulfasalazine, furosemide)
Features of Acute pancreatitis
- pain?
- nausea and vomiting?
- jaundice?
- fever?
- what tends to relieve pain?
- what is cullen’s sign?
- what is grey-turner’s sign?
severe epigastric pain radiating to back
yes
yes
yes
sitting forwards
cullen’s sign = periumbilical discolouration - intrabdominal haemorrhage from pancreatitis
grey tuner’s sign: flank discolouration - retroperitoneal haemorrhage from pancreatitis
what happens to serum amylase in acute pancreatitis
what else causes a smaller rise in amylase?
x3 rise
cholecystitis + GI perforation
why would you do an axr/erect CXR?
to exclude perforation
presents similar to?
peritonitis
what is gold standard for Ix?
CT scan
what is an indicator of severe pancreatitis?
CRP^^^ is >36h
how do you assess severity of pancreatitis?
modified Glasgow criteria
how do you manage pancreatitis?
‘DRIP + SUCK’
drip = IV therapy (IV fluids, analgeisa, NBM and insert catheter to monitor urine >3Oml/hr
suck = wide bore NG tube to drain gastric contents - ensures bowel is rested and help with nausea and vomiting
do you give Abx for acute pancreatitis?
NO - not bacterial infection
if pancreatitis is due to gallstones - what is the Tx post relief of symptoms?
cholecystectomy
if they have pancreatitis due to obstructed biliary tree - tx?
ERCP
