acute pancreatitis Flashcards
define acute pancreatitis?
- An acute inflammatory process of the pancreas with variable involvement of other regional tissues or remote organ systems
what is the aetiology of acute pancreatitis?
- it is the activation of the pancreatic pro-enzymes in the duct which causes inflammation
what are the major causes of acute pancreatitis?
- I GET SMASHED Iatrogenic gall stones* ethanol* trauma
steroids mumps autoimmune scorpion venom hyperlipidemia/calcaemia/thermia ERCP drugs
epidemiology of acute pancreatitis?
main cause in males
main cause in females
common
peak age is 60
- main cause in males is alcohol
- main cause in females is gallstones
what are the presenting symptoms of acute pancreatitis?
- severe epigastric pain
- radiating to the back
- relieved by sitting forward
- associated with nausea and vomiting
- often history of gallstones or alcohol
what are the signs of acute pancreatitis on examination?
- epigastric tenderness
- fever
- tachcardia/pnoea
- low bowel sounds
- may see turners sign or cullens sign
what are the main bloods to look for in acute pancreatitis?
- bloods will show high.. amylase white blood cells glucose CRP
low calcium
what does an ultrasound look for?
- biliary dilatation
- gallstones
what does an erect chest xray show?
- may show pleural effusion
- also excludes other causes
what might a CT scan show?
- shows signs of sepsis
- shows necrosis
can use scoring system balthazar score
how is acute pancreatitis assessed?
- using the GLASGOW scale
- using the acrynom
PO2
A age >55
N eutrophils >15x10^9
Ca2+<2mmol/L
uRea >16
Enzymes LDH>600
Albumin >32
Sugar >10
ransons is used for alcoholic pancreatitis
how is acute pancreatitis managed?
- fluids and electrolytes
- Ng tube if vomiting
- analgesia
- blood sugar control
- enterel feeding
- NO antibiotics
how are gallstone patients managed ?
- ERCP and sphincterotomy
how are patients with necrotising pancreatitis managed?
- necresectomy
- drainage of all necrotic tissue
local complications with acute pancreatitis ?
- pancreatic necrosis
- pseudocyst
- abscess
- ascites
- venous thrombosis