Acute Pancreatitis Flashcards
What is acute pancreatitis
The inflammation of the pancreatic parenchyma Q
What are two features pancreatitis
Fat necrosis
Oedema
What features are common in a blood test for someone with acute pancreatitis
High Serum amylase levels
Raised lipase enzymes
What are the main causes for acute pancreatitis
Gall stones
Alcohol
Trauma
What is the pathological reason for the inflammation in acute pancreatitis from gall stones
The destructive effects of built up activated pancreatic enzymes
What is the pathological reason for the inflammation in acute pancreatitis from trauma/drugs
Acinar cells can get damaged
What is the pathological reason for the inflammation in acute pancreatitis from alcohol
Alcohol increases enzyme secretion which has destructive effects on the pancreas and creates leaky vessels
Why do you get fat necrosis in acute pancreatitis
Fatty-tissue necrosis is probably caused by lipase (one of the few pancreatic enzymes that need no activation) after an abrupt effusion of zymogens from peripheral acinar cells into the interstitial space
What group of enzymes causes fat necrosis in acute pancreatitis
Lipolytic enzymes
What does the released fat in fat necrosis do?
It binds calcium causing hypocalcaemia in the body
What group of enzymes destroy acinar tissue, blood vessels and islets of langerhaans in acute pancreatitis
Proteolytic enzymes
What happens to the body if the islets of langerhaans are destroyed
Hyperglycaemia as blood glucose will rise.
What are the signs and symptoms of acute pancreatitis
Epigastric pain that radiates to back
Anorexia
Nausea and Vomitting
What are the features of grey turners sign
Grey Turner’s sign refers to bruising of the flanks, the part of the body between the last rib and the top of the hip. The bruising appears as a blue discoloration
What is Grey turner’s sign important in acute pancreatitis
It can predict a severe attack of acute pancreatitis
How long down Grey Turner’s sign take to devlop
24-48 hours
What is Cullen’s signs
Cullen’s sign is superficial edema and bruising in the subcutaneous fatty tissue around the umbilicus
What is Cullen’s sign important in from an acute pancreatitis perspective
It can predict a severe attack of acute pancreatitis
What investigations should be carried out for acute pancreatitis
Bloods - for raised serum amylase and lipase
Ultrasound - to detect cause eg gall stones
CT - to rule out complications
What are complications associated with acute pancreatitis (x6)
Haemmorhage Disseminated intravasular coagulation Acute respiratory distress syndrome Multiorgan failure Necrosis Acute renal failure
What is Disseminated intravasular coagulation
Disseminated intravascular coagulation is a condition in which small blood clots develop throughout the bloodstream, blocking small blood vessels. The increased clotting depletes the platelets and clotting factors needed to control bleeding, causing excessive bleeding
What is acute respiratory distress syndrome
Acute respiratory distress syndrome (ARDS) is a life-threatening condition where the lungs cannot provide the body’s vital organs with enough oxygen. It’s usually a complication of a serious existing health condition.
What is the treatment for acute pancreatitis
Symptomatic relief
IV fluids
Analgesia
Treat the underlying cause
In a FBC what could be raised in a patient with acute pancreatitis
Serum amylase
Serum lipase
Bilirubin
What percentage of acute pancreatitis is mild
70%
What percentage of acute pancreatitis is severe
30%
What are the two categories of acute pancreatitis
Mild
Severe
