Acute Pancreatitis

Question 1

Acute Pancreatitis

Answer 1

When pancreas becomes inflamed due to auto-digestion.

Question 2

Acute Pancreatitis Aetiology: GET SMASHED

Answer 2

Gallstones
Ethanol
Trauma
Steroids
Mumps
Autoimmune
Scorpion venom
Hyperlipidaemia, Hypothermia
ERCP & Emboli
Drugs - Sodium valporate
Idiopathic

Question 3

Acute Pancreatitis Complications: TAPPPS

Answer 3

Thrombosis
ARDS
Pancreatic Necrosis
Pancreatic Abscess
Pseudocyst 
Sepsis
Renal Failure
DIC

Question 4

Acute Pancreatitis Symptoms

Answer 4

Sudden severe abdominal pain - can radiate to the back, and may be relieved by sitting forwards
Diarrhoea, Collapse, Nausea/Vomiting.

Question 5

Acute Pancreatitis Signs

Answer 5

Dehydration
Abdominal Tenderness
Fever
Tahcycardia
Jaundice
Ileus
Periumbilical Bruising 
Shock - sudden drop in blood flow throughout the body.

Question 6

Acute Pancreatitis Investigations

Answer 6

Serum Amylase - raised x4
Abdominal US
CXR 
CT
AXR
ERCP
Bloods - amylase, FBC, U&E, LFTs, Calcium, Glucose, Serum Lipase, Lipids

Question 7

Acute Pancreatitis Assessment

Answer 7

3 or more positive factors detected within 48 hours of onset it suggests severe pancreatitis and should prompt transfer to IT.
Factors include:
PaO2 = <8kPa
Age = >55 years/old, Neutrophilia = WBC > 15 x 109/L,
Calcium = <2mmol/L, Renal function = Urea >16mmol/L,
Enzymes = LDH > 600iu/L AST > 200iu/L, Albumin = < 32g/L, Sugar = Blood glucose > 10mmol/L (CRP > 150mg/L also indicates severe pancreatitis).

Question 8

Acute Pancreatitis General Treatment

Answer 8

Oxygen via nasal tubes
Nutritional support
Analgesia - morphine or pethidine
Blood transfusion 
Insulin 
IV fluids
Naso-gastric tube