Pancreatitis Flashcards
risk factors
gallbladder disease (women) chronic alcohol use (men)
mild pancreatitis
edematous/interstitial
Severe pancreatitis
necrotizing
Necrosis; organ failure; sepsis
acute
a week or 2
Chronic
fibrosis; secondary to cirrhosis; no cure
clinical manifestations
Severe Abdominal p!; left upper quadrant or mid-epigastric
sudden onset
flushing
N/V
procedure done
whipple
Grey turner’s sign
flank are is discolored
Cullens sign
blueish/greyish around belly button
infected pseudocyst
pancreatic abscess
drain immediately
Lab tests
Serum lipase level (more important)
amylase (climbs early; 24-72 hrs)
calcium/mag drops
best way to diagnose
CT scan
main treatment
NPO
if in shock:
plasma volume/volume expanders (albumin)
F/E problems
lactated ringers
Central venous pressure readings
Prevent infection
enteral nutrition
Antibiotics
Endoscopically or CT-guided percutaneous aspiration
what needs to be checked?
glucose levels q6h
Minimize pancreatic stimulation
NPO status
NG suction
decreased acid secretion
enteral nutrition if needed
if pancreatitis is r/t gallstones
ECRP surgery
diet
high carb, low protein is best
chronic: pancreatic enzyme replacement
taking enzymes for life
drink 8 oz water; wipe lips off; rinse mouth out
tests for hypocalcemia
Chvosteks sign (tap facial nerve) Trousseaus sign (bp cuff inflation)
positioning
fetal position
side-lying with HOB 45 deg
Semi fowlers
