Acute Pancreatitis

Question 1

What is acute pancreatitis?

Answer 1

Condition where the pancreas becomes inflamed (swollen) over a short period of time

Question 2

What are the causes of acute pancreatitis?

Answer 2

I GET SMASHED:

Iatrogenic

Gallstones
Ethanol abuse
Trauma

Spider bites
Mumps
Autoimmune
Steroids
Hypercalaemia or hyperlipidaemia
ERCP
Drugs

Question 3

What are some risk factors of acute pancreatitis?

Answer 3

Age
Afro-caribbean ethnicity
Gender
Obesity
Type 2 diabetes
Family history

Question 4

How can acute pancreatitis be diagnosed? (2 of 3 criteria)

Answer 4

2 of 3 following:

Clinical features consistent with pancreatitis (e.g. classical-sounding pain)

Elevation of serum amylase OR serum lipase (at least 3x the upper limit)

Radiological features (e.g. inflammation shown on CT or ultrasound)

Question 5

How do you classify acute pancreatitis? (Glasgow score)

Answer 5

PANCREAS:

PaO2 <8kPa
Age >55 years old
Neutrophilia 
Calcium < 2 mmol/L
Renal function - urea > 16 mmol/L
Enzymes - LDH > 600 iu/L; AST > 200iu/L
Albumin <3.2 g/L (serum)

Sugar - blood glucose > 10 mmol/L

Question 6

How many hours after admission can the Glasgow score predict severity of acute pancreatitis?

Answer 6

48 hours

Question 7

What is the first-line management of acute pancreatitis?

Answer 7

IV fluids, catheterisation, O2, analgesia, nutritional support.

Question 8

How do we alleviate pain symptoms of acute pancreatitis?

Answer 8

• IV paracetamol or IV morphine
• Then add IV antiemetics

(Consider benzodiazepines if withdrawing from alcohol)