Alimentary system 13 - Pancreatitis Flashcards
What is acute pancreatitis?
An acute inflammatory process leading to necrosis of the pancreatic parenchyma
List the symptoms of acute pancreatitis
- Severe abdominal pain
- Nausea
- Vomiting
- Diarrhoea
- Fever
- Shock (high heart rate, low blood pressure)
- Slow capillary refill
What imaging may be used to assess pancreatitis?
- X ray
- Abdominal X ray
- Ultrasound
- CT scan
- MRCP
What invasive test can be used to assess pancreatitis?
ERCP
List the scoring systems for pancreatitis
- Ransons criteria
- Apache II
- SIRS
Compare the ransons and SIRS criteria
- Ransons has to be conducted with 2 assessments, one at 0 hours and one after 48 hours to look at changes
- SIRS two or more out of high/low temp, high heart rate, high respiratory rate, high WBC count
List the risk factors for severe pancreatitis
- Necrosis vs non-necrosis
- Organ failure
- Age
- Co-morbidities
- Alcohol
List the main causes of pancreatitis
- Gallstones
- Ethanol
- Trauma
- Steroids
- Mumps
- Autoimmune
- Scorpion bite
- Hyperlipidaemia/ hypercalcaemia/ hypothermia
- ERCP
- Drugs
What drugs can cause pancreatitis?
Azathioprine/valproate
List the systemic complications of pancreatitis
- Hypovolaemia
- Hypoxia
- Hypocalcaemia
- Hyperglycaemia
- DIC
- Multiple organ failure
List the localised complications of pancreatitis
- Pancreatic necrosis
- Fluid collections - mature into pseduocysts
- Splenic vein thrombosis/ pseudoaneurysm
- Chronic pancreatitis
List the treatments of pancreatitis
- Fluids
- Painkillers
- Nutrition
- Organ support
- Management of complications
Define chronic pancreatitis
A progressive fibroinflamamtory process of the pancreas that results in permanent structural damage, leading to impairment of exocrine and endocrine function
List the consequences of chronic pancreatitis
- Malabsorption
- Loss of 90% exocrine function
- Fat soluble vitamin malabsorption (ADEK)
List the investigations of chronic pancreatitis
- Plain x-ray
- CT scan
- Faecal elastase
