Pancreatitis Flashcards
What are the causes of chronic pancreatitis. (7)
Alcohol (60-80%).
Rarely: familial, cyctic fibrosis, haemochromatosis, pancreatic duct obstruction (stone/tumour), raised PTH, congenital (pancreas divisum).
What are the symptoms of acute pancreatitis. (8)
Epigastric pain ‘bores’ through to the back.
Pain relieved by sitting forward or hot water bottles on epigastrium/back.
Bloating.
Steatorrhoea.
Weight loss.
Brittle diabetes.
Jaundice due to obstruction of CBD (rarely).
Symptoms relapse and worsen.
What is erytheme ab igne’s.
Mottled dusky greyness of the skin following chronic application of hot water bottles.
How is chronic pancreatitis diagnosed.
Ultrasound and CT.
What confirms a diagnosis of chronic pancreatitis.
Pancreatic calcifications seen on ultrasound/CT.
What are the complications of chronic pancreatitis. (7)
Pseudocyst. Diabetes. Biliary obstruction. Local arterial aneurysm. Splenic vein thrombosis. Gastric varices. Pancreatic carcinoma.
What is chronic pancreatitis.
Continuous inflammation with irreversible structural changes to the pancreas.
What is seen on the blood results of a patient with chronic pancreatitis. (3)
Raised serum amylase.
Raised serum lipase.
Abnormal faecal elastase.
What is the differential diagnosis for patients presenting with chronic pancreatitis. (2)
Pancreatic carcinoma.
Chronic pancreatitis.
What are the complications of chronic pancreatitis. (4)
Pancreatic pseudocyst is the most common complication (a fluid collection surrounded by granulation tissue).
Ascites.
Pleural effusions.
Increased risk of malignancy.
What is involved in acute pancreatitis.
Self-perpetuating pancreatic inflammation by enzyme-mediated autodigestion.
What are the causes of acute pancreatitis. (13)
Gallstones. Ethanol. Trauma. Steroids. Mumps. Autoimmune. Scorpion venom. Hyperlipidaemia, hypothermia, hypercalcaemia. ECRP and emboli. Drugs.
Also: pregnancy, neoplasia and no cause found.
What are the symptoms of acute pancreatitis. (4)
Gradual or sudden severe epigastric or central abdominal pain.
Pain radiates to the back.
Pain may be relieved by sitting forward.
Vomiting is prominent.
What are the physical signs of acute pancreatitis. (9)
May be mild or serious. Tachycardia. Fever. Jaundice. Shock. Ileus. Rigid abdomen. Local or generalised tenderness. Periumbilical bruising (Cullen's sign). Flank bruising (Grey Turner's sign).
What is the cause of Cullen’s and Grey Turner’s signs in acute pancreatitis.
From blood vessel autodigestion and retroperitoneal haemorrhage.