E2-Pancreas Patho Flashcards
What is acute pancreatitis?
Inflammation of pancreas
What is the cause of acute pancreatitis?
Obstruction of the outflow of pancreatic enzymes usually r/t pancreatic and bile duct obstruction (usually gallstone)
Also: Alcohol, drugs, viral infection
The backup of of enzymes leads to..
auto digestion of pancreatic cells
Autodigestion of pancreatic cells causes
PANCREATITIS
-Vascular damage
-Coagulopathy
-Necrosis
-Fat necrosis within pancreas
What are the pancreatic enzymes and causes
- Trypsin: edema, necrosis, hemorrhage
- Elastase: Hemorrhage
- Phospholipase A: fat necrosis
- Kallikrein: Edema, vascular permeability, smooth muscle contraction, shock
- Lipase: Fat necrosis
What is vascular permeability?
enlarged abdomen from fluid leaking into the space causing ascites
leads to shock
Acute pancreatitis manifesations
-Epigastric pain: severe
-Sudden onset
-Radiates to back
-Guarding
-Tenderness
-N/V
-abdominal distention
-Hypoactive bowels
-Hypotension
-Tachycardia
-Jaundice
What do labs look like in acute pancreatitis?
Increased Amylase, Lipase, and WBC
Glucose can be increased or decreased
Unique manifestations of acute pancreatitis that could occur?
-Cyanosis or green/yellow/brown discoloration of abdomen
-Ecchymoses: severe, hemorrhagic pancreatitis (leaky vessels)
1. Flanks (Grey Turners sign)
2. Periumbilical (Cullen’s sign)
Acute pancreatitis complications?
- Pseudocyst
- Abscess
- Pulmonary complications (from pain or pleural effusion)
- Hypotension –> shock
- Tetany from hypocalcemia
What is pseudocyst?
Fluid-filled cavity that surrounds the outside of the pancreas (CT scan)
Pseudocyst results in
scarring and inflammation of areas near pancreas
Clinical manifestations of pseudocyst?
-similar to pancreatitis + palpable epigastric mass
What is the biggest concern of pseudocyst?
May perforate –> peritonitis
What is a pancreatic abscess?
A large fluid filled cavity inside the pancreas
