Acute Pancreatitis

Question 1

Pancreatitis

Answer 1

Inflammation of the pancreas

Question 2

Pancreatitis can be

Answer 2

Acute or chronic

Question 3

Pancreatitis can also be classified as

Answer 3

Mild to severe

Question 4

Pancreatitis occurs when the pancreas …..

Answer 4

Becomes damaged and malfunctions as a result of increased secretion and blockage of ducts
Pancreatic tissue may be digested by it’s own enzymes

Question 5

Mild acute pancreaititis

Answer 5

Absence of organ failure and local or systemic complications

Question 6

Moderately severe acute pancreatitis

Answer 6

Transient organ failure or local or systemic complications without persistent organ failure

Question 7

Severe acute pancreatitis

Answer 7

Persistent organ failure that may involve one or multiple organs

Question 8

Symptoms of acute pancreatitis

Answer 8

Acute onset of persistent severe epigastric pain
Nausea
Vomiting

Question 9

Most common causes of acute oancreatitis

Answer 9

Biliary disease

Alcohol abuse

Question 10

Other causes of acute pancreatitis

Answer 10

Trauma
inflammation from adjacent peptic ulcer or abdominal infection
Pregnancy
Mumps
Tumors
congenital causes
vascular thrombosis or embolism
drugs

Question 11

Lab values of acute pancreatitis

Answer 11

Serum amylase rises (6-12 hours)

Serum lipase rises (4-8 hours)

Question 12

Complications

Answer 12

Hemorrhage
pseudocyst formation
inflammatory mass
intrapancreatic and extra-pancreatic fluid

Question 13

Most common cause of acute pancreatitis

Answer 13

Gallstones

Question 14

Sonographic appearance of acute pancreatitis

Answer 14

“•Ranges from normal size to focal/diffuse enlargement
•Hypoechoic
•Borders are distinct but irregular
•Enlargement of the head causes depression on IVC
•Commonly have gallstones
•Pancreatic duct may be enlarged
•May have peripancreatic fluid collections”

Question 15

Fluid collections that do not resolve

Answer 15

Pseudocysts

Question 16

Pseudocysts are always

Answer 16

Acquired

Question 17

When do pseudocysts develop

Answer 17

4-6 weeks after the onset of pancreatitis

Question 18

most common sites for fluid collection

Answer 18

Lesser sac
Anterior pararenal spaces 
Mesocolon 
Perirenal spaces
Peripancreatic soft-tissue spaces

Question 19

Pancreatic pseudocyst

Answer 19

a collection of fluid that arises from the loculation of inflammatory processes, necrosis, or hemorrhage

Question 20

when do pancreatic pseudocysts develop

Answer 20

when pancreatic enzymes escape from the gland and break down tissue to form a sterile abscess somewhere in the abdomen
They generally take on the contour of the available space around them and are therefore not always spherical, as true cysts are.
More than one pseudocyst may be present.

Question 21

Most common location of pseudocyst

Answer 21

Lesser sac anterior to the pancreas and posterior to the stomach
2nd most common is the anterior pararenal space (posterior to the lesser sac, Gerota fascia)

Question 22

Fluid more commonly occurs…..

Answer 22

In the left pararenal space than the right

Question 23

Most common complication of a pseudocyst

Answer 23

Spontaneous rupture

Question 24

3% of ruptured psuedocysts

Answer 24

Drain directly into the peritoneal cavity

Question 25

Clinical symptoms of ruptured pseudocyst

Answer 25

Sudden shock

Peritonitis

Question 26

Pancreatic ascites

Answer 26

Pancreatic pseudocyst ruptures into the abdomen