Pancrease

Question 1

What are causes of Acute Pancreatitis

Answer 1

Chronic Alcoholism
Gall stones in Sphincter of Oddi
Trauma(blunt or penetrating)
ERCP
Infection ( bacteria, virus)
Hereditary
Drugs
Congenital anomalies of the pancrease eg annular
Hypercalcemia
Hypertriglyceremia
Toxins eg snake venom, insecticide
Autoimmune Dsz
Tumors especially those in periampullary reg

Question 2

What is the Pathogenesis of Acute Pancreatitis

Answer 2

Increased vascular permeability
Hemorrhage
Eedema
Leakage of fluid to surrounding structures
Spread to cause further systemic problems
Bacteremia
Damage to GI Mucosa
GI Bleeding
ARDS
SIRS
Multi Organ Failure
Formation of Pseudocysts locally which could get infected forming Pancreatic abscess

Question 3

What is the cardinal symptom in Acute Pancreatitis

Answer 3

Upper abdominal pain

Question 4

Clinical Features in A. Pancreatitis

Answer 4

Upper abdominal pain
Fever
Hiccups
Jaundice in 25% of cases
Abdomen tenderness
Rigidity
Guarding
Cullen sign
Grey Turner Sign

Question 5

What is Vandzant sign and which condition is it seen

Answer 5

Ça of Pancrease

Question 6

Surgical intervention is done in mild pancreatitis t/f

Answer 6

False only severe

Question 7

Limitations of Serum amylase

Answer 7

Raised in the first 4-5 days of disease
Can be raised in other conditions eg Disease of Salivary gland, obstruction to flow of bile
Doesn’t reflect the severity of disease

Question 8

Conservative of Acute Pancreatitis

Answer 8

NPO to reduce pancreatic juice release
Analgesia :Opiods (pethidine)
Antibiotics
IV fluid preferably Ringers / may later switch to jejunostomy to by pass Pancrease

Question 9

What is the criteria for doing Surgical intervention in A. Pancreatitis

Answer 9

Surgicallu amenable Cause eg necrosis or complications eg pseudocyts