acute pancreatitis Flashcards

1
Q

define acute pancreatitis?

A
  • An acute inflammatory process of the pancreas with variable involvement of other regional tissues or remote organ systems
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2
Q

what is the aetiology of acute pancreatitis?

A
  • it is the activation of the pancreatic pro-enzymes in the duct which causes inflammation
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3
Q

what are the major causes of acute pancreatitis?

A
- I GET SMASHED 
Iatrogenic 
gall stones*
ethanol*
trauma 
steroids 
mumps 
autoimmune 
scorpion venom 
hyperlipidemia/calcaemia/thermia 
ERCP 
drugs
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4
Q

epidemiology of acute pancreatitis?
main cause in males
main cause in females

A

common
peak age is 60
- main cause in males is alcohol
- main cause in females is gallstones

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5
Q

what are the presenting symptoms of acute pancreatitis?

A
  • severe epigastric pain
  • radiating to the back
  • relieved by sitting forward
  • associated with nausea and vomiting
  • often history of gallstones or alcohol
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6
Q

what are the signs of acute pancreatitis on examination?

A
  • epigastric tenderness
  • fever
  • tachcardia/pnoea
  • low bowel sounds
  • may see turners sign or cullens sign
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7
Q

what are the main bloods to look for in acute pancreatitis?

A
- bloods will show high..
amylase 
white blood cells 
glucose 
CRP 

low calcium

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8
Q

what does an ultrasound look for?

A
  • biliary dilatation

- gallstones

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9
Q

what does an erect chest xray show?

A
  • may show pleural effusion

- also excludes other causes

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10
Q

what might a CT scan show?

A
  • shows signs of sepsis
  • shows necrosis
    can use scoring system balthazar score
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11
Q

how is acute pancreatitis assessed?

A
  • 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

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12
Q

how is acute pancreatitis managed?

A
  • fluids and electrolytes
  • Ng tube if vomiting
  • analgesia
  • blood sugar control
  • enterel feeding
  • NO antibiotics
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13
Q

how are gallstone patients managed ?

A
  • ERCP and sphincterotomy
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14
Q

how are patients with necrotising pancreatitis managed?

A
  • necresectomy

- drainage of all necrotic tissue

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15
Q

local complications with acute pancreatitis ?

A
  • pancreatic necrosis
  • pseudocyst
  • abscess
  • ascites
  • venous thrombosis
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16
Q

systemic complications with acute pancreatitis ?

A
  • multiorgan failure
  • sepsis
  • renal failure
  • ARDs
  • diabetes
  • hypocalcaemia
17
Q

long term complications of acute pancreatitis ?

A
  • chronic pancreatitis
18
Q

prognosis of acute pancreatitis ?

A

20% is severe with high mortality

80% is mild