Pancreatitis - Summary Notes

Pancreatitis
Acute Pancreatitis Risk Factors:


causes:
smoking
-




Scorpion Venom Uncontrolled DM
- -




obesity Anabolic steroids Cystic Fibrosis
-
- -




gene.
Chronic Alcoholism
Autoimmunity (1qG4)
-
-




Gallstones -Mumps, CMV, EBU Iiatrogenic Scorpion/venom
-




Hypercalcemia Gallstones Mumps
-




Drugs (e.g. Tamaxifen, Furosemide, Oestrogen) Ethanol Autoimmune
-




Trauma Steroids
·
Gallstones is mostcommon cause.
Hypercalcaemia
They cause Common Bile Duct/Pancretic Duct
Obstruction, ERC9(90st)
to bile/
leading enzyme and
reflux
:.autodigestion. Drugs

·
Chronic Alcoholism is 2nd common cause.
most

can cause duct blockage increased secretions toxicity all
leading to
autodigestion.
+ + -




Diagnosis:

1. Abdo Pain:
epigastric, radiates to back/(shoulder, share/constant, nausea/ vomiting,
relieved when bending forward, 18/10 severity.

2. Raised
Enzymes:raised serum Amylase and lipase.

3.
Imaging:ContrastCTor MRI.

only when uncertain or rule differential.
out




Clueing signs:Jaundice sugg. Gallstones, Cachexia alcohol abuse,
·



suga.
Extreme muscle hypertrophy sugg. anabolics.


Differentials:Pneumonia, pericarditis, aortic
·


aneurysm,
Upper Gl ulceration/obstruction/ischaemia, etc.


Acute Pancreatitis Complications:
Management:
Organ Failures
-




underlying and supportpatient:
Treat
Biliary Obstruction/ Jaundice, effects
·

cause
-



mass
~
-


Small Bowel obstruction
1. to 95% sats.
Oxygenation
2. Fluid resusitation to relieve shock.
3. Pain/nausea relief.
·
Autoimmune Pancreatitis
4.Enteral or Parenteral nutrition. can be treated with
Steroid (e.g. Prednisolonel.
·


usually no antibiotics needed despite infection markers.
Antibiotics for Infected necrotic pancreatitis.
given