Acute Pancreatitis Flashcards
What is acute pancreatitis
Inflammation of the pancreas causing epigastric pain lasting for less than 24hrs
Give 12 causes of Pancreatitis
I GET SMASHED
Which drugs can cause pancreatitis
S - sulphonamides
A - azathioprine
N - NSAIDs
D - diuretics
What are the two most common causes of acute pancreatitis
Gall stones
Alcohol binge
Why do you get hypocalcaemia with pancreatitis
Pancreatic lipase is released from the pancreas leading to fat necrosis, fatty acids react with the calcium in the blood leading to calcium deposits in the pancreas which systemically reduces calcium levels
Give 6 clinical features of pancreatitis
- Epigastric pain radiating to the back
- Jaundice
- Signs of tetany eg - muscle spasms
- Grey turners and cullens
- Nausea and vomiting
- Patient sits forward
Give 8 differential diagnosis for epigastric pain
- AAA
- Gastritis
- Peptic ulceration
- MI
- Acute and chronic pancreatitis
- Oesophagitis
- GORD
- Aortic dissection
What are the blood investigations you would order for epigastric pain
- Serum amylase ( must be 3x the upper limit for pancreatitis diagnosis)
- Serum lipase
- Serum calcium
- FBC
- Blood glucose
- LFTs
- U&Es
- CRP
What imaging modalities would you order to investigate Pancreatitis
- Abdominal USS - can show if gall stone is causing pancreatitis
- Abdominal X-ray - sentinel loop sign
- CT abdo
What are the factors looked into when working out the Glasgow risk score for pancreatitis
P A N C R E A S
Give an example of a radiological scoring system used in pancreatitis
Balthazar scoring system
There is no curative treatment for acute pancreatitis, what conservative measures are used to treat pancreatitis
High flow Oxygen IV fluids Rest pancreases - NBM Analgesia - according to WHO pain ladder NG tube Broad spectrum Abx ERCP + sphincterotomy if gallstones is the cause Total parenteral nutrition Catheterisation
What are local complications of pancreatitis
Pancreatic necrosis and peri pancreatic necrosis
Fluid collections around the pancreas => Pancreatic pseudocysts
Pancreatic abscess
What are the systemic complications of pancreatitis
Hypocalcaemia
Diabetes mellitus
Adult respiratory distress syndrome
When is acute severe pancreatitis diagnosed
When 3 of the Glasgow irie score has been fulfilled
