Pancreatic Diseases Flashcards
What is acute pancreatitis?
Inflammatory disease
Autodigestion of the pancreas by protealytic enzymes
What are the 2 main causes acute pancreatitis?
Alcohol
Gallstones
Together account for 75%
What are mechanical causes of acute pancreatitis?
GALLSTONES
Blunt trauma
ERCP
What are other causes of acute pancreatitis?
Hypertriglyceridemia* Hypercalcemia Ischemia, vaculitis Viruses Genetic Idiopathic 30%
How does acute pancreatitis present?
Fever, ↑HR, +/- ↓BP, ↑RR
Jaundice
Hypoactive or absent BS
Mid epigastric tenderness
Cullen’s sign
Grey-Turner’s sign
What should your lab workup include for acute abd pain?
amylase & lipase
What imaging can you use to dx acute pancreatitis?
Plain films US: gallstones CT MRCP EUS
What are complications of acute pancreatitis?
Necrosis
Pseudocysts
Abscess
Hemorrhage
How do you treat acute pancreatitis?
NPO
IVF
Meperidine pain control
How do you treat pancreatitis when necrosis is a concern?
Imipenem
What are sx of a pancreatic pseudocyst?
Abd pain, early satiety, N/V
What are systemic complications of pancreatitis?
Resp. failure/ARDS, pulmonary edema, pleural effusion, atelectasis
Renal failure
Hypotension/shock
GI
Metabolic: Hyper/hypoglycemia
What are initial signs in Ranson’s criteria for pancreatitis?
>55 yo WBC > 16000 Glucose > 200 AST > 250 LDH > 350
What are the delayed signs in Ranson’s criteria for pancreatitis?
HCT drop > 10% BUN increase > 5 Ca < 8 pO2 < 60 albumin < 3.2 Fluid sequestration 4-5
How do you treat biliary pancreatitis?
ERCP if CBD stone
Cholecystectomy