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General Surgery > Pancreatitis > Flashcards

Pancreatitis Flashcards

1
Q

What is acute pancreatitis?

A

Inflammation of pancreas - immature activation of trypsin + phospholipase A

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2
Q

Causes of acute pancreatitis

A

Gallstones
Ethanol
Trauma

Steroids
Mumps
Autoimmune
Scorpion sting
Hyperlipidaemia
ERCP
Drugs (azathioprine, NSAIDs, diuretics)
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3
Q

Clinical features of acute pancreatitis

A

Severe epigastric pain - radiates to back
Nausea
Vomiting

Epigastric tenderness
Grey-Turners/Cullens sign

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4
Q

What is Grey-Turners sign?

A

Bruising on the flanks

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5
Q

What is Cullen’s sign?

A

Bruising around the umbilicus

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6
Q

Investigations for suspected acute pancreatitis

A

Serum amylase - 3x normal
LFTs - assess gallstone cause
Serum lipase

Ultrasound
CT - 6-10 days after admission

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7
Q

What is the Glasgow Scoring?

A 
PaO2 - <8kPa
Age - >55years
Neutrophil count - >15x10^9 /L
Calcium - <2mmol/L
Raised plasma urea - >16mmol/L
Enzyme (LDH) - >600iu/L
Albumin - <32 g/L
Sugar (glucose) >10mmol/L

> 3 = at risk of acute pancreatitis

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8
Q

Management of acute pancreatitis

A

Treat underlying cause

Supportive treatment

  • Fluids
  • NG tube
  • analgesia
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9
Q

What is pancreatic necrosis?

A

Ischaemic infarction of pancreatic tissue due to ongoing inflammation

Occurs 7-10 days fer onset of pancreatitis

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10
Q

What is chronic pancreatitis?

A

Chronic fibro-inflammatory disease of the pancreas

Progressice and irreversible damage to the pancreatic tissue

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11
Q

Causes of chronic pancreatitis

A 
Alcohol abuse
Idiopathic
Hyperlipidaemia
Hypercalcaemia
Autoimmune
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12
Q

Pathophysiology of chronic pancreatitis

A

Large duct disease

  • dilation and dysfunction of large pancreatic ducts (visible on imaging)
  • pancreatic fluid changes composition
  • diffuse pancreatic calcification
  • more common in males

Small duct disease

  • normal on imaging
  • no pancreatic calcification
  • more common in females
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13
Q

Clinical features of chronic pancreatitis

A

Chronic pain

  • epigastric
  • radiates to back

Symptoms secondary to endocrine/exocrine dysfunction

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14
Q

Investigations for suspected chronic pancreatitis

A

BM - check for endocrine dysfunction
Serum calcium

Abdominal ultrasound
CT

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15
Q

Management of chronic pancreatitis

A

Analgesia

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General Surgery (15 decks)

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