Pancreatitis Flashcards
Acute pancreatitis
Inflammation of the pancreas do to escape of pancreatic enzymes into surrounding tissue, resulting in an auto digestive states of the pancreas
Pancreatitis causes/incidence
** gallbladder disease
** heavy alcohol use
Hypercalcemia, hyperlipidemia
Trauma
Medication such as sulfa, thiazides, Lasix, estrogen, or azathioprine
Pancreatitis signs/symptoms
Abrupt onset of steady, severe epigastric pain worsened by walking and laying supine
Pain that is improved by sitting and leaning forward
Pain usually radiates to the back but may radiate elsewhere
Nausea and vomiting is usually present
Weakness, sweating, anxiety and severe attacks
Pancreatitis physical findings
Upper abdomen tender to palpation, usually without guarding, rigidity or rebound tenderness
Distended abdomen
Absent bowel sounds
Fever
Tachycardia
Pallor, cool skin
Mild jaundice common
If hemorrhagic gray Turner sign, cullens sign
Grey’s Turner Syndrome
Flank discoloration
Cullen’s Sign
Umbilical discoloration
Pancreatitis lab/diagnostics
WBC elevation
Hyperglycemia
LDH and AST elevation
Serum amylase and lipase elevated and 90% of cases
BUN and coagulation values may be elevated
Hypocalcemia levels less than seven associated with tetany
Elevated CRP suggests pancreatic necrosis
CT scan more useful than ultrasound
Pancreatitis management
Ranson’s criteria Bedrest NPO Aggressive IV volume repletion NG suction Pain control Once patient is pain-free and has bowel sounds, may start clear liquid diet
Ranson’s criteria
George Washington got lazy after he broke CABE
5–6 respecters equals 40% mortality, greater than seven risk factors equal approximately 100% mortality
Greater than 55 WBC’s > 16 Glucose > 200 LDH > 350 AST >250
After 48 hours
HCT >10 drop BUN increase > 5 Calcium < 8 Arterial O2 < 60 Base deficit > 4 Estimated fluid sequestration > 6000ml
