Pancreatitis Flashcards
0
Q
Hx?
A
Abdo pain, may radiate to back, chest or flank
Pain relieved by sitting up
Profuse N+V
ABDO distension
Low grade fever
Jaundice, shock (SIRS), hypocalcemia tetany and respiratory signs potentially
1
Q
Causes of pancreatitis?
A
Gallstones Ethanol Trauma Steroids Mumps/malignancy Autoimmune Scorpion bites Hyperlipidaemia Ercp Drugs
2
Q
Ix?
A
CBE EUC LFT CRP BGL
- hypocalcemia
- hyperglycemia
Serum pancreatic lipase
Rad
- ct ABDO diagnosis (normal enhancement suggests necrosis
- GB US
3
Q
How do you diagnose?
A
Typical ABDO pain
Serum lipase 3X RAISED
RADIOLOGY confirmation
4
Q
Rx disease?
A
Immediate - acute ABDO OFANSA (ABx if severe or septic)
Otherwise supportive
If gallstone pancreatitis
- cholecystectomy after resolution of acute attack
If that fails then ERCP and sphincterectomy
Severe (abcess formation or pancreatic necrosis)
- transfer to ICU
- ABCDE
- enteral nutrition (jejununal tube)
- laporotomy and debridement
5
Q
What is the modified Glasgow coma criteria?
A
PANCREAS Pa02 Age > 55 Neutrophilia WBC > 15 Calcium 16 Enzymes - LDH > 600 Albumin - 10mmol
6
Q
Complications of pancreatitis?
A
Local
- necrotizing with/out infection
- biliary obstruction
- abcess
- pseudocyst formation: collection of pancreatic secretions enclosed by granulation tissue
Systemic
- sepsis
- compartment syndrome (SIRS)
Long term
- chronic pancreatitis
- pancreatic insufficiency
