Pancreatitis

Question 1

What is acute pancreatitis?

Answer 1

Abnormal activation of digestive enzymes within pancreas, leading to inflammation and autodigestion

Question 2

What mnemonic is used for causes of acute pancreatitis?

Answer 2

GET SMASHES
G - gallstones
E - ethanol
T - trauma

S - scorpion sting
M - mumps
A - autoimmune disease
S - steroids
H - hyperlipidaemia/hypercholesterolaemia
E - endoscopic retrograde cholangiopancreatography (ERCP)
D - drugs (azathioprine, diuretics, oestrogen, corticosteroids)

Question 3

What are the clinical features of acute pancreatitis?

Answer 3

PAN (pain, anorexia, vomiting)

Question 4

What abdominal examination findings might be present in acute pancreatitis?

Answer 4

Abdominal tenderness, abdominal distension, Grey Turners/Cullen’s sign

Question 5

What is the management of acute pancreatitis?

Answer 5

Usually symptomatic relief - IV fluids and analgesia

But treat undelying cause e.g. remove gallstones

Question 6

What are the complications of acute pancreatitis?

Answer 6

HDAMN
H - haemorrhage
D - disseminated intravascular coagulation
A - acute respiratory distress syndrome (ARDS)
M - multiorgan failure
N - necrosis

Question 7

What mnemonic is used for the causes of chronic pancreatitis?

Answer 7

CAMP
C - cystic fibrosis
A - alcohol
M - malnourishement
P - pancreatic duct obstruction

Question 8

Describe the pain associated with chronic pancreatitis

Answer 8

Recurrent epigastric pain that radiates to the back, relieved by sitting forward and is worse when eating/drinking

Question 9

What happens to faecal elastase in chronic pancreatitis?

Answer 9

Decreased

Question 10

What is the management of chronic pancreatitis?

Answer 10

Analgesia
Pancreatic enzyme replacement therapy
Start insulin if diabetes has developed