Acute Pancreatitis

Question 1

acute pancreatitis

Answer 1

reversible inflm of pancreas d/t autodigestion (self-limiting)

Question 2

etiology

Answer 2

• alcohol abuse
• idiopathic
• gall stones
• injury, trauma
• drugs that are toxic to pancreas

Question 3

patho

Answer 3

• gall bladder obstruction –> prematurely activated pancreatic Es –> autodigestion –> can lead to inflm, hemorrhage, necrosis of pancreas
• alcohol –> excess pancreatic secretion and constriction of Sphincter of Oddi –> pancreatic juice builds up in bile ducts –> bile reflux in pancreas

Question 4

mnfts

Answer 4

• acute onset of epigastric and periumbilical pain that radiates to back, chest, and flank (usually after alcohol binge or large meal)
• excessive 3rd spacing

Question 5

why does 3rd spacing manifest

Answer 5

pancreas is richly vascularized –> inflm leads to hyperemia –> exudate produced –> inc CHP –> fluid moves from vessels into interstitial space of pancreas

Question 6

dx

Answer 6

• labs (amylase, lipase)
• imaging (U/S, CT)
• serum markers

Question 7

what serum markers for dx

Answer 7

• TNF (tumor necrosis factor)
• trypsinogen
• proteases

Question 8

tx for mild cases

Answer 8

• Pt NPO (limit pancreatic secretions)
• pain management
• 3rd spacing management (fluids/electrolytes)

Question 9

tx for severe cases

Answer 9

• ICU (prevent multi-organ failure)
• IV opiates for severe pain
• Sx (remove stones)