Emergency abdomen

Question 1

What are some causes of acute pancreatitis?

Answer 1

GET SMASHED
Gallstones
Ethanol
Trauma
Steroids
Mumps
Autoimmune disease
Scorpion bite
Hypercalcaemia
ERCP
Drugs

Question 2

What drugs cause acute pancreatitis?

Answer 2

FATSHEEP
Furosemide
Azathioprine
Thiazides
Statins
H
Estrogens
Ethanol
Protease inhibs

Question 3

What are the CF of acute pancreatitis?

Answer 3

Sx - epigastric pain radiating to back, relieved. by sitting forward or curling up, sharp, N+V, hx of gallstones or alcohol

Signs - hypovolaemia, fever, guarding, Grey Turners sign = bruises in flanks, Cullen’s sign - bruising peri umbilically

Question 4

What are the ix into acute pancreatitis?

Answer 4

Bloods - FBC, U+E, LFT, lipase and amylase (x3 normal limit)
USS for gallstones
MRCP
ERCP - best as therapeutic
CT scan

Question 5

How do you classify the severity of pancreatitis?

Answer 5

Glasgow criteria
PANCREAS
PO2 reduced
Age - >55
Neutrophils raised
Ca <2 mmol/l
Renal func = urea >16mmol/l
Enzymes raised
Albumin reduced
Sugar - glucose raised

Question 6

What is the management of acute pancreatitis?

Answer 6

1. Maintain E balance and compensate for 3rd space fluid losses - fluid resus
2. Catheter
3. Analgesia
4. Anti emetics
   +/- Ca
   Insulin if needed?