Pancreatic problems Flashcards
what percentage of acute pancreatitis requires hospitalization?
20%
most cases of acute pancreatitis resolve how?
spontaneously
what happens with acute pancreatitis?
there is some obstruction of the outflow of pancreatic enzymes by way of the pancreatic and bile duct from gallstones, this build up leads to autodigestion of the pancreatic cells
what are the common clinical manifestations of acute pancreatitis?
-severe, sudden epigastric pain that may radiate to the back
-tenderness and guarding
-N/V
-distended abdomen
-hypoactive BS
-fever
-grey turner’s sign
-cullen’s sign
what labs are typically elevated with acute pancreatitis?
amylase, lipase, WBC
how is glucose affected in acute pancreatitis?
can be high or low
where is the discoloration in grey turner’s sign?
flanks
where is the discoloration in cullen’s sign?
periumbilical
what is a pseduocyst?
a fluid filled cavity that surrounds the outside of the pancreas
what is the fluid that is inside of a pseduocyst?
necrotic products and secretions
what is the highest concern with a pseudocyst?
perforation because it will cause peritonitis
what are the clinical presentation of pseudocysts?
similar to pancreatitis:
- sudden, severe epigastric pain that may radiate to the back
-N/V
-tenderness and guarding
-fever
-hypotension, tachycardia, jaundice
-grey turner’s sign
-cullen’s sign
+ palpable epigastric mass
what is an abscess related to acute pancreatitis?
a large fluid filled cavity inside of the pancreas
what is the highest concern with an abscess related to acute pancreatitis?
further infection or perforation (which would lead to perinotitis)
what is the clinical presentation for an abscess related to acute pancreatitis?
-sudden, severe epigastric pain that radiates to the back
-N/V
-hypotension, tachycardia, jaundice
-tenderness and guarding
-fever
-grey turner’s sign
-cullen’s sign
+ abdominal mass, high fever, and leukocytosis
why might a patient with acute pancreatitis develop pleural effusion?
edema and increased vascular permeability
what electrolyte disturbance is commonly seen with acute pancreatitis?
hypocalemia
if there is an excessive level of trypsin built up in the system what can it cause?
edema, necrosis, and hemorrhage
if there is an excessive level of elastase built up in the system what can it cause?
hemorrhage
if there is an excessive level of phospholipase A built up in the system what can it cause?
fat necrosis
if there is an excessive level of kallikrein built up in the system what can it cause?
edema, increased vascular permeability, smooth muscle contraction, shock
if there is an excessive level of lipase built up in the system what can it cause?
fat necrosis
what is chronic pancreatitis?
a progressive, fibrotic disease of the pancreas
what is the most common cause of chronic pancreatitis?
alcohol abuse
specifically with chronic pancreatitis and alcohol abuse what do the toxic metabolites do?
release inflammatory cytokines that cause destruction of the acinar cells and islet of langerhans
what are the risk factors associated with chronic pancreatitis?
genetics, gallstone obstruction, smoking
what are the two major signs of chronic pancreatitis?
abdominal pain and weight loss
what condition can chronic pancreatitis lead to d/t the destruction of the islet of langerhans?
diabetes
