Pancreatitis Flashcards
What is acute pancreatitis?
Acute pancreatitis is the sudden inflammation of the pancreas, which can range from mild discomfort to a severe, life-threatening illness.
What are the two main types of acute pancreatitis?
Interstitial oedematous pancreatitis (most common, better prognosis) and necrotising pancreatitis (more severe, involves pancreatic tissue necrosis).
What is the prevalence of acute pancreatitis in the UK?
Approximately 56 cases per 100,000 annually.
What are the most common causes of acute pancreatitis in the UK?
Gallstones and alcohol consumption.
What mnemonic can help remember the causes of acute pancreatitis?
“I GET SMASHED”: Idiopathic, Gallstones, Ethanol, Trauma, Steroids, Mumps/malignancy, Autoimmune disease, Scorpion sting, Hypertriglyceridemia/Hypercalcaemia, ERCP, Drugs.
What are common risk factors for acute pancreatitis (4)?
Male gender, increasing age, obesity, and smoking.
What is the typical presentation of pain in acute pancreatitis?
Severe epigastric pain that may radiate to the back, often associated with nausea and vomiting.
What past medical history is relevant in assessing acute pancreatitis?
History of gallstones, biliary disease, or previous episodes of pancreatitis.
What social history factors are important in acute pancreatitis?
Alcohol intake and smoking habits.
What are Cullen’s and Grey-Turner’s signs?
Cullen’s sign: periumbilical bruising; Grey-Turner’s sign: flank bruising; both may indicate severe pancreatitis with haemorrhage.
What initial blood tests are important in suspected acute pancreatitis?
Serum amylase or lipase (typically elevated), liver function tests, calcium, triglycerides, and full blood count.
What imaging modality is commonly used to assess acute pancreatitis?
Abdominal ultrasound to identify gallstones and assess the pancreas.
What criteria are used to assess the severity of acute pancreatitis?
Glasgow-Imrie criteria, Ranson’s criteria, and APACHE II score.
What is the first-line management for acute pancreatitis?
Supportive care including intravenous fluids, analgesia, and monitoring for complications.
When are antibiotics indicated in acute pancreatitis?
Antibiotics are not routinely indicated unless there is evidence of infected pancreatic necrosis or other infections.
What is a common local complication of acute pancreatitis?
Pancreatic pseudocyst formation.
What systemic complications can arise from acute pancreatitis?
Acute respiratory distress syndrome (ARDS), renal failure, and disseminated intravascular coagulation (DIC).
What lifestyle modification can reduce the risk of recurrent acute pancreatitis?
Abstaining from alcohol and smoking cessation.
What is the role of endoscopic retrograde cholangiopancreatography (ERCP) in acute pancreatitis?
ERCP is indicated in cases of gallstone pancreatitis with cholangitis or persistent bile duct obstruction.
What is the mortality rate for severe acute pancreatitis?
Approximately 15%.
What is the significance of elevated serum lipase in acute pancreatitis?
Elevated serum lipase is more specific and remains elevated longer than amylase in acute pancreatitis.
What dietary recommendations are made during recovery from acute pancreatitis?
Early enteral nutrition is encouraged once the patient is stable, starting with a low-fat diet.
What is the potential outcome of recurrent acute pancreatitis?
Development of chronic pancreatitis.
What is the importance of monitoring serum calcium in acute pancreatitis?
Hypocalcaemia can occur due to fat saponification and is associated with severe disease.
