Pancreatitis Flashcards
pancreas has 2 main functions what are they
exocrine - digestive - added to bowels as we eat to help in digestion - chemicals (digestive enzymes) release in inactive form until reaching GI system where they become active
endocrine - release of hormones into bloodstream, causing a reaction - insulin release
pancreatitis is inflammation of the
gallbladder
during inflammation of the pancreas what happens to digestive enzymes
they are released in active form causing pancreas to auto-digest (attacking itself) caused by low perfusion
s/s of pancreatitis
n/v pain (epigastric can radiate to back) abd. distention (edema) ascites and jaundice (severe) retro-peritoneal hemorrhage (turner and Cullen sign) abnormal production of insulin
pancreatitis can be severe, t or f
true - mild to severe - can lead to necrosis which can lead to hemorrhage - higher mortality
what causes pancreatitis
low cardiac output alcohol ingestion biliary disease (gallbladder) trauma to abdomen parathyroid imbalances hypocalcemia (ominous sign)
patho of pancreatitis
injury/disruption of pancreatic acinar cells
leakage of enzymes
release of histamine and bradykinin ldg to edema
auto-digestion leads to edema, hemorrhage, necrosis
inflammation leads to obstruction of duct (ischemia)
s/s of turners sign
flank bruising
s/s of Cullen’s sign
bruising around umbilicus
***most dx lab tests for pancreatitis
***serum amylase level is high - within 12 hours of onset
hypocalcemia (ominous sign)
dx tests for pancreatitis
CT of abdomen
MRI
Ultrasound
ERCP to look at ducts to see if stones
**trt for pancreatitis
replace fluids with lactated ringers watch i/o daily weights may need to use vasopressors electrolyte replacement (calcium, K) trt of hyperglycemia initially NPO (severe) with severe n/v use NG Tube opiods (PCA) 30 degree angle - position
complications of pancreatitis
hypovolemic shock ARDS DIC renal failure type 1 diabetes (insulin release)
Ranson’s criteria
the more criteria met, the worse prognosis
