Pancreas Flashcards
acute pancreatitis severity
mild edema to severe hemorrhagic necrosis
risk factors for acute pancreatitis
middle age
african americans more likely
come causes of acute pancreatitis
biliary tract disease (women)
ETOH abuse (men)
others like GI procedures
pathogenesis of pancreatitis
pancreatic cells are injured
pancreatic enzymes are activated
autodigestion
causes mild to severe pancreatitis
what does trypsin cause
edema
necrosis
hemorrhage
what does elastase cause
hemorrhage
what does phospholipase A cause
fat necrosis
what does kallikrein cause
edema
vascular permeability
smooth muscle contraction
shock
what does lipase cause
fat necrosis
clinical manifestation of acute pancreatitis
- LUQ or epigastric pain: sudden onset, may radiate to back, tenderness
- accompanying sx: NV, abdominal distention, hypo BS, fever, hypotension, tachycardia, jaundice
- amylase, lipase, glucose, WBC all increase
- cyanosis or green-yellow/brown discoloration of the abdomen
- ecchymoses: Flanks (grey turner), Periumbilical (cullen)
complications of acute pancreatitis
pseudocyst
abscess
pulmonary complication
hypotension
tetany from hypocalcemia
increase risk for clotting
why do pulmonary complication occur with acute pancreatitis
fluid can build up
enzymes that leak cause damage –> pain and makes deep breaths hard
why does tetany from hypocalcemia occur with acute pancreatitis
lipase casuses fat necrosis which generates fatty acids that bind to Ca and deposit into peritoneum
what is a pseudocyst
fluid filled cavity that surrounds the OUTSIDE of the pancreas
what is the fluid of a pseudocyst composed of
necrotic products and secretions
what is the result of a pseudocysts
inflammation and scarring of areas near the pancreas
clinical manifestations of pseudocyst
same as pancreatitis but with a palpable epigastric mass
can a pseudocyst perforate
yes, all the necrotic contents spill out and lead to peritonitis –> rigid abdomen
what is a pancreatic abscess
large fluid filled cavity INSIDE the pancreas
what is the cause of a pancreatic abscess
extensive necrosis
what are further complications of a pancreatic abscess
infection or perforation
clinical manifestations of pancreatic absess
pancreatitis sx plus abdominal mass, high fever, and leukocytosis
what is chronic pancreatitis
inflammation in the pancreas that persists over weeks to months
main cause of chronic pancreatitis
ETOH abuse
