Pancreatitis Flashcards
1
Q
Acute pancreatitis definition
A
Characterised by self-perpetuating autodigestion of pancreas, oedema and hypovolaemia as fluid trapped in gut and peritoneum
2
Q
Pancreatitis causes
A
Gallstones Ethanol Trauma Steroids Mumps Autoimmune Scorpion sting (Trinidad) Hyperlipidaemia/Hypothermia ERCP Drugs
3
Q
Symptoms and signs pancreatitis
A
Epigastric pain radiating to back, relieved when sat forward Periumbilical bruising (Cullen's sign), flank bruising (Grey-Turners)
4
Q
Tests pancreatitis
A
Raised serum amylase (although levels may start to fall after 24h) + raised serum lipase
ABG to monitor O2/pH
CT is best for severity
5
Q
Complications pancreatitis
A
Shock/Sepsis Renal failure (amylase excreted renally) Pancreatic necrosis/abscess Bleeding/ Thrombosis ARDS
6
Q
Pancreatitis management
A
Acute:
Severity assessment ongoing using PANCREAS mnemonic, transfer to ITU/HDU if necessary
Nil by mouth, consider TPN
Treat cause and complications
Surgery if debridement of necrotic tissue needed
Chronic pancreatitis:
Creon, fat-soluble vitamins, low-fat diet may help
7
Q
Assessing severity pancreatitis
A
PaO2 <8 Age >55 Neutrophilia WCC>15 Calcium <2 Renal function Urea >16 Enzymes LDH >600, AST >200 Albumin <32 Sugar blood glucose >10
