L22: Acute Pancreatitis Flashcards
What is acute pancreatitis
Inflammation of the pancreas with exocrine enzymes causing damage to the organ
What are the causes of pancreatitis
I GET SMASHED
- idiopathic
- gallstones
- ethanol (alcohol)
- trauma
- mumps
- scorpion venom
- hypercalcaemia
- ERCP
- drugs
What is the history/presentation of acute pancreatitis
- epigastric pain or left upper quadrant pain
- sudden onsent
- relief by sitting forward
- vomiting
- past history of gallstones
- alcohol consumption
On examination how can pancreatitis present
Signs of shock Jaundice Alcoholic liver disease Absent bowel sounds Epigastric mass Cullens sign- bruising in the bladder region Grey turners sign- bruising in the flank
What is the management of acute pancreatitis
Oxygen Iv fluids Analgesia Catheter Ng tube if they persist vomiting
What is chronic pancreatitis
Chronic irreversible inflammation and or fibrosis of the pancreas
As a result of acute pancreatisis what can happen to the pancreas
Fibrosis
Dilatation
Calcification of pancreatic ducts and branches
What happens to the islet of langerhans in chronic pancreatitis
Fail to produce insulin
What happens to the acinar cells in chronic pancreatitis
Fail to produce enzymes for digestion
What’ are the causes of chronic pancreatitis
Alcohol Idiopathic Smoking Autoimmune and genetic conditions e.g cystic fibrosis Drugs Gallstones Tropical
What are the symptoms of chronic pancreatitis
Epigastric pain that radiates to the back Nausea Vomiting Reduced appetite Diabetes Malabsorption Weight loss Diarrhoea Steattorhea
What is the management of chronic pancreatitis
Analgesia
Pancreatic enzyme replacement
Smoking and alcohol cessation
Why does pancreatic cancer have a poor diagnosis
The symptoms only present when there is metastasis
What is the symptoms of pancreatic cancer
Painless obstructive jaundice Epigastric pain radiation to the back Relieved by sitting forward Weight loss Diabetes Acute pancreatitis
What are the signs of pancreatic cancer
Jaundice- due to the head of the pancreas compressing the common bile duct which prevents outflow of bile Hepatomegaly RUQ mass Epigastric mass Ascites Weight loss Anorexia
