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GI/Gen surg AM > Acute pancreatitis > Flashcards

Acute pancreatitis Flashcards

1
Q

What is acute pancreatitis?

A

Acute inflammatory process of pancreas, with variable involvement of regional/remote tissue

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2
Q

What is the pathology of acute pancreatitis?

A

Autodigestion of pancreatic tissue by enzymes –> inflammation

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3
Q

What are the classifications of acute pancreatitis?

A 
Mild= mild interstitial oedema of gland, no organ failure/complications
Moderate= organ failure that resolves within 48 hours +/- systemic complications without persistent organ failure
Severe= Pancreatic necrosis, acute fluid collection or organ failure >48 hours
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4
Q

What are the common causes of acute pancreatitis?

A

Idiopathic/iatrogenic
Gallstones
Ethanol- main cause
Trauma

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5
Q

What are the less common causes of acute pancreatitis?

A 
Steroids
Mumps
Autoimmune 
Scorpion venom
Hyperlipidaemia
ERCP
Drugs
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6
Q

What are the features of acute pancreatitis?

A 
Severe epigastric pain- can radiate to back, reaches maximum over a number of hours
Vomiting, anorexia
Pyrexia, tachycardia
Hypovolaemia
Jaundice
Ileus
Discolouration of skin
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7
Q

What investigations should be done for acute pancreatitis?

A 
Bloods
AXR
Erect CXR
Abdo US
COntrast CT
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8
Q

What bloods should be done for acute pancreatitis?

A 
Amylase
Lipase
FBC, U&E, LFTs, Ca, lipids
Coag screen
Glucose
ABG if unwell
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9
Q

What scoring system is used for pancreatitis?

A

Modified Glasgow score

>3= severe pancreatitis

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10
Q

What is the modified Glasgow score?

A 
PANCREAS
PaO2 <8
Age >55
Neutrophilia
Calcium low
Renal impairment- urea high
Enzymes raised- AST, ALT, LDH
Albumin low
Sugar high
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11
Q

How is acute pancreatitis diagnosed?

A

2 of

  • abdo pain consistent with acute pancreatitis
  • serum amylase >3x upper limit of normal
  • characteristic CT findings
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12
Q

What are the differentials for acute pancreatitis?

A 
Perforated ulcer
Acute cholecystitis
Intestinal obstruction
Mesenteric ischaemia
MI
AAA
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13
Q

What is the management of mild acute pancreatitis?

A

Monitoring- NEWS and urine output

Supportive

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14
Q

What is the management of severe pancreatitis?

A 
HDU/ITU admission
Monitoring- inc urine output
Supportive
Antibiotics 
CT after 3-10 days
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15
Q

What is the management of pancreatic necrosis?

A

Non infected= conservative

Infected= necrosectomy

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16
Q

How can non infected pancreatic necrosis be differentiated from infective?

A

Free air on CT

17
Q

Wha are the local complications of acute acreatitis?

A 
Acute fluid collection
Acute pseudocyst
Chronic pseudocyst
Abscess
Pancreatic necrosis
18
Q

What are the systemic complications of acute pancreatitis?

A 
Shock
Sepsis
DIC
AKI
Hyperglycaemia
ARDS
Organ failure
19
Q

What can cause high amylase?

A 
PAncreatitis- acute or chronic 
Gallstones 
Pancreatic trauma 
Kidney failure 
Liver failure 
Peritonitis 
PArotitis 
Chronic alcoholism

GI/Gen surg AM (28 decks)

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