Acute Pancreatitis Flashcards
Pancreatitis
Inflammation of the pancreas
Pancreatitis can be
Acute or chronic
Pancreatitis can also be classified as
Mild to severe
Pancreatitis occurs when the pancreas …..
Becomes damaged and malfunctions as a result of increased secretion and blockage of ducts
Pancreatic tissue may be digested by it’s own enzymes
Mild acute pancreaititis
Absence of organ failure and local or systemic complications
Moderately severe acute pancreatitis
Transient organ failure or local or systemic complications without persistent organ failure
Severe acute pancreatitis
Persistent organ failure that may involve one or multiple organs
Symptoms of acute pancreatitis
Acute onset of persistent severe epigastric pain
Nausea
Vomiting
Most common causes of acute oancreatitis
Biliary disease
Alcohol abuse
Other causes of acute pancreatitis
Trauma inflammation from adjacent peptic ulcer or abdominal infection Pregnancy Mumps Tumors congenital causes vascular thrombosis or embolism drugs
Lab values of acute pancreatitis
Serum amylase rises (6-12 hours)
Serum lipase rises (4-8 hours)
Complications
Hemorrhage
pseudocyst formation
inflammatory mass
intrapancreatic and extra-pancreatic fluid
Most common cause of acute pancreatitis
Gallstones
Sonographic appearance of acute pancreatitis
“•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”
Fluid collections that do not resolve
Pseudocysts
Pseudocysts are always
Acquired
When do pseudocysts develop
4-6 weeks after the onset of pancreatitis
most common sites for fluid collection
Lesser sac Anterior pararenal spaces Mesocolon Perirenal spaces Peripancreatic soft-tissue spaces
Pancreatic pseudocyst
a collection of fluid that arises from the loculation of inflammatory processes, necrosis, or hemorrhage
when do pancreatic pseudocysts develop
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.
Most common location of pseudocyst
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)
Fluid more commonly occurs…..
In the left pararenal space than the right
Most common complication of a pseudocyst
Spontaneous rupture
3% of ruptured psuedocysts
Drain directly into the peritoneal cavity
Clinical symptoms of ruptured pseudocyst
Sudden shock
Peritonitis
Pancreatic ascites
Pancreatic pseudocyst ruptures into the abdomen
