Pancreatitis Flashcards
What are the most significant causes of acute pancreatitis?
GS and EtOH
What are the signs and symptoms for acute pancreatitis and how can it be diagnosed using labs and imaging?
severe “boring” epigastric abdominal pain with radiation to the back; nausea/vomiting secondary to pain, fever.
The pain typically lessens when the patient leans forward or lies in a fetal position.
What signs are used to assess the severity of acute pancreatitis?
Ransons criteria
What is the medical management for acute pancreatitis?
- Oral intake must be stopped to prevent continued secretion of pancreatic juices.
- Fluid volume must be restored and maintained. Parenteral hyperalimentation should be started early to prevent nutritional depletion.
- Pain is managed with an opiod
What are the two categories of chronic pancreatitis?
Obstructive and Non-obstructive
What is the predominant cause of non-obstructive pancreatitis
Chronic EtOH abuse is the primary cause
What are the clinical manifectations of chronic pancreatitis?
episodic or continuous pain, steatorrhea with diarrhea and weight loss - can also have endocrine deficiencies; pseudocysts, fistulas, biliary obstruction. CA, SBBOG
What is the gold standard for diagnosing chronic pancreatitis amd what are simpler tests for moderate to severe pancreatitis?
Abdominal plain film radiography
What are the controllable risk factors for the development of pancreatic cancer.
Controllable risk factors for developing pancreatic cancer are smoking, high fat diet, exposure to carcinogens
What are the presenting signs and symptoms for pancreatic cancer?
Epigastric pain, weight loss
Obstructive jaundice
Anorexia, nausea/vomiting
Nonspecific and insidious- depends on where the CA develops
What is the most reliable method for diagnosing and staging pancreatic cancer?
CT and MRI, EUS (can be used for staging after acquire biopsies)
What is acute pancreatitis?
Autodigestion of pancreas that results in edema, vascular injury, tissue loss and necrosis.
What lab result would you expect in a patient with acute pancreatitis?
Elevated amylase and lipase (>300)
Elevated AST and ALT
Leukocytosis
What lab result would you expect in a patient with chronic pancreatitis?
Amylase and lipase are normal to mild elevation
Bilirubin increased
Hyperglycemia
X-ray: Pancreatic calcifications
ERCP
What is the treatment for chronic pancreatitis?
Pain control
Enzyme replacement
Surgery: last resort
