Pancreatitis

Question 1

Acute pancreatitis

Answer 1

An acute inflammatory process that leads to necrosis of the pancreatic parenchyma.

Question 2

Chronic pancreatitis

Answer 2

a progressive fibroinflammatory process of the pancreas that results in permanent structural damage, which leads to impairment of exocrine and endocrine function

Question 3

Signs

Answer 3

May have evidence of jaundice (Pancreas swelling blocks pancreatic and common ducts and blocks removal of bilirubin pigment)

Question 4

Investigations

Answer 4

Simple examinations – BP, pulse, urine dipstick

▪ Blood tests – Full blood count, urea/electrolytes (checks liver function too), inflammation markers, liver
function tests, clotting, calcium, glucose.
1) Hyperglycaemia, hypocalcaemia.
2) CRP measures time since pancreatic attack.
3) Elevated white count, bilirubin and liver enzymes.

▪ Complex blood tests – Amylase, Lipase, Triglycerides, Elevated in pancreatitis.

Simple imaging – X-rays, Ultrasound

Cross-sectional imaging – CT scan, MRCP scans.

▪ Invasive tests – ERCP.

Question 5

Local Complications

Answer 5

▪ Pancreatic necrosis.
▪ Fluid collections.
▪ Splenic vein thromboses.
▪ Chronic pancreatitis.

Question 6

Systemic Complications

Answer 6

▪ Hypovolaemia. LOW VOLUME
▪ Hypoxia. LOW OXYGEN
▪ Hypocalcaemia. LOW CALCIUM
▪ Hyperglycaemia. HIGH SUGAR
▪ DIC (Disseminated intravascular coagulation- clots aroud body)
▪ Multiple organ failure.

Question 7

Signs + symptoms of acute pancreatitis

Answer 7

severe abdominal pain, nausea, vomiting, diarrhoea, fever, and shock