ACUTE PANCREATITIS

Question 1

ACUTE PANCREATITIS IS

Answer 1

inflammation of the pancreas due to premature activation of trypsinogen
into trypsin while still in the pancreas

Question 2

majority of cases of pancreatitis are caused BY

Answer 2

1. alcoholism and gallstones
2. others:Medications such as valproate, pentamidine, didanosine
3. hypercalcemia
4. Hypertriglyceridemia,
5. ERCP
6. Trauma andd viruses as mumps

Question 3

clinical presentation

Answer 3

1.midepigastric pain with
tenderness,
2. nausea, and vomiting
3.radiate to the back
4.sever: Fever, respratory disteress , elevation WBCs

Question 4

Diagnosis

Answer 4

• Acute onset of upper abdominal pain
• Amylase or lipase >3x the upper limit of normal
• Evidence on imaging
•The most important sign of severe pancreatitis and poor prognosis is elevated or raising BUN
•most accurate test to determine the severity of pancreatitis is the CT scan
•The single most accurate test for the detection of biliary and pancreatic ductal pathology is
ERCP.

Question 5

TTT

Answer 5

1. aggressive IV fluids (250–500 mL/hr)
   2.bowel rest, and pain medication
   (use morphine and never use meperidine
   [black box warning label for seizures
2. Resume oral feeding
   4.Administer antibiotics (not with necrosis detect by biopsy)
   5.do ERCP only in asending cholangitis and non resolving biliary obstruction
   6.For gallstone pancreatitis, do cholecystectomy prior to discharge.

Question 6

AUTOIMMUNE PANCREATITIS

Answer 6

Type I presents with painless jaundice or acute pancreatitis (rare).
• ‘Sausage-shaped’ pancreas on CT
• Older man
• Elevated IgG4
Type II presents with chronic pancreatitis.
• No systemic disease
• Normal IgG4
• Need biopsy to diagnose

Question 7

TTT

Answer 7

steroids