Pancreatic Disease Lecture Powerpoint Flashcards
Sphincter of oddi
The hepatopancreatic spincter that joins together the common bile duct and the pancreatic duct
Acute pancreatitis presentation and repeating of episodes
Inflammatory process of the pancreas associated with abdominal pain (a boring pain drilling thru the gut) sometimes radiating to back only slightly relieved bending forward, shortness of breath, febrile, elevated pancreatic enzymes, and variable involvement of other regional tissue, repeated bouts may eventuate into chronic pancreatitis due to permanent alterations in function and morphology
Chronic pancreatitis definition
Ongoing inflammation of the pancreas which may be interrupted by spells of acute pancreatitis
Common causes of acute pancreatitis (6)
- biliary tract stones**
- endoscopic retrograde cholangiopancreatography
- alcohol abuse***
- scorpion sting
- coxsackievirus/mumps
- trauma
Common causes of chronic pancreatitis (3)
- alcohol abuse***
- autoimmune
- hereditary
The 3 F’s of cholellithiasis development
- fat (obese)
- fertile (child bearing age)
- forty
Common duct theory
The idea that because a gallstone lodges in the duct that is common between the pancreas and the gallbladder, the pancreas becomes inflamed as a result and can cause acute pancreatitis
Drugs that are known to cause acute pancreatitis (3)
- estrogens
- nitrofurantoin
- sulfonamides
Pancreatitis lab studies (6) and the expected results of them
- Serum amylase (can be elevated, not specific)
- ***serum lipase (specific for pancreatic disease) –> hospitalization
- serum electrolytes (many get hypocalcemic)
- Lipids (elevated)
- blood sugar (hyperglycemia)
- LFT’s (prognostic indicators)
Acute pancreatitis imaging studies (3)
- abdominal ultrasound (1st line)
- Confirmatory CT
- ERCP can be 3rd line in urgent intervention
Treatment for acute pancreatits (6)
- maintain NPO
- IV fluids
- pain control (meperidine or dilaudid)
- IV antiemetic
- determine cause and treat
- surgical management in severe necrotic situations
Complications of acute pancreatitis (4)
- pseudocyst
- calcification
- abscess formation
- shock or bleed
Ranson’s prognostic signs/APACHE
An assessment of factors to determine point values that when added up assess risk of mortality of patient with acute pancreatitis clinical course, <2 mortality is 0% and >7 is up to 95%
Common presentation of chronic pancreatitis (4)
- pain
- alcohol history
- weight loss (drinking calories)
- steatorrhea
Chronic pancreatitis treatment (6)
- supplemental pancreatic enzymes
- fat restriction on diet
- stop alcohol
- pain control
- surgery
- whipple procedure (intense surgery cutting out damaged area of pancreas and readjoin vasculature)
