Acute Pancreatitis

Question 1

Brief description of pancreatitis?

Answer 1

• Pancreatic inflammation
• 90% self-limiting
• Can be life threatening

Question 2

What are 4 possible causes for pancreatitis?

Answer 2

1. Alcohol abuse (accounts for ~70%)
2. Idiopathic
3. Cholelithiasis
4. Trauma or drugs

Question 3

What activates the pancreatic enzymes in the duodenum?

Answer 3

Bile and trypsin ??

Question 4

What process results in the premature activation of pancreatic enzymes?

Answer 4

Duct obstruction cause bile stasis/reflux which can activate trypsin and other pancreatic enzymes

Question 5

What causes the auto-digestion of the pancreas? What does this result in?

Answer 5

The prematurely activated enzymes of the pancreas cause auto-digestion which can cause inflm, hemorrhage, necrosis, etc

Question 6

Why does alcohol contribute to acute pancreatitis?

2

Answer 6

• Alcohol triggers pancreatic secretions in the absence of food
• Constricts the sphincter of oddi, causing retrograde flow = bile and trypsin meet = auto-digestion

Question 7

What are the mnfts of acute pancreatitis?

Answer 7

• Acute onset pain
• Large volume 3rd spacing
• Hypotension
• Tachycardia
• Resp distress
• Fever

Question 8

The acute onset pain of pancreatitis may occur following…

Answer 8

…an alcohol binge or large meal

Question 9

What are 2 complication of acute pancreatitis?

Answer 9

• Hypovolemia/hypovolemic shock

- Vascular collapse

Question 10

What is used to diagnose acute pancreatitis?

Answer 10

• Amylase, lipase
• CRP
• New biomarks
  
  • Tumor necrosis factor
  • Tripsinogen

Question 11

Where are tumor necrosis factor and tripsinogen also produced?

Answer 11

In other places in the body ??

Question 12

What is the treatment for mild acute pancreatitis?

Answer 12

• NPO to decrease pancreatic secretions
• Pain management
• Fluid and ‘lyte replenishment

Question 13

How long should a pt with acute pancreatitis stay NPO?

Answer 13

For the shortest amount of time possible, the sooner they are oral ad lib the better their prognosis is

Question 14

What is the treatment for severe acute pancreatitis?

Answer 14

• Multi organ support
• Circulatory system affected by major fluid shift
• May need treatment for cholelithiasis if they are
  involved
• Monitor their respiratory status for acute resp distress
  syndrome
• IV opioids
• Surgery ?

Question 15

What is acute resp distress syndrome?

Answer 15

Occurs when fluid accumulates in your lungs, makes breathing difficult and causes oxygen desaturation