OnlineMedEd: Surgery: General - "Pancreas"

Question 1

The pain of pancreatitis presents as ______________.

Answer 1

epigastric pain that radiates to the back and relieves with leaning forward; it can also worsen with food

Nausea and vomiting may be present.

Question 2

How is pancreatitis diagnosed?

Answer 2

Lipase

Amylase is often falsely positive.

Question 3

Pancreatitis is treated with _____________.

Answer 3

IVF, NPO with slowly advanced diet, and pain control

Question 4

List the four most common causes of acute pancreatitis.

Answer 4

• Gallstones
• Alcohol
• Hypertriglyceridemia
• Medication side effects (HAART, valproate, GLP-1 agonists)

Question 5

In what cases of pancreatitis would you do a CT scan?

Answer 5

•Toxic patients (leukocytosis, hypotension, fever):

• Hours to days: necrotizing pancreatitis
• Days to weeks: look for an abscess

•Early satiety, weight loss, and abdominal pain:
- Pseudocyst

Question 6

How is necrotizing pancreatitis treated?

Answer 6

• ICU for stabilization (and allowing the necrotic area to congeal)
• Necrosectomy
• Carbapenem for FNA-proven infected abscess/necrotic area

Question 7

What is the management of pancreatic abscess?

Answer 7

I&D followed by antibiotics

Question 8

Give the parameters for when to drain a pseudocyst.

Answer 8

Remember the pseudoSIX:

• Less than 6 cm and less than 6 weeks old: watch and wait
• Greater than 6 cm or greater than 6 weeks old: I&D