Acute Pancreatitis Flashcards Preview

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Flashcards in Acute Pancreatitis Deck (8)
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1

Classif

Mild- no complics or organ dysfunc. Resolves.
Mod- local complics and or transient organ dysfunc. Resolves in 48hr.
Sev- persis organ dysfunc. Fail to resolve in 48hr. Complics eg panc nec, abcess, pseudocyst.
Recurrent

2

causes

Gallstones
Alcohol misuse
Endoscopy
Trauma
Steroids
Surgery
Metab conds eg hyperTG, hyperCa
Infec eg mumps, cocksackie, mycoplasma pneum
Drugs eg thiazide, azathiprine, tetracycline, oestrogen
Mumps
AI

3

px

Upper or gen abdo pain, sev sudden, becomes const and more sev.
Us epigastric, can rad to back
May worsen with movem
Can be helped by fetal posit
RELIEVED BY SIT UP
Can be peritonitis
Hx gallstones and alc
NV
Anorexia
Rebound, guarding
Distension
Cullens sign- blue periumb
Grey turners- blue flanks
Jaundice
Tachy and hypot
Fever
High panc enzs in blood or urine

4

Diffs

Ulcer
Obstruc
Isch bowel, mesent infarct
AAA
MI
Bil colic
Cholecystitis
Cholangitis
Hepatitis
Gastroenteritis

5

Mx

Fluid
Foley catheter
Correct electrolytes
EWS monit
Alc withdrawal prophylaxis
O2
Analgesia
AB eg meropenem
Enteral or parenteral feed
ECRP
Cholecystectomy
Allow to eat and drink
Tx the cause

6

ix

FBC, UE, LFT, amylase or lipase, Ca, blood gas
AXR, CXR to exclude perforat, sentinel loop
US- rule out gallst and check for pseudocyst
CT- panc nec
MRI
Do amylase once then not repeat as not marker in acute pancreatits

7

Dx reqs 2 of

Amylase over 3x upper limit norm
Epig pain to back
CT ev

8

Complics

Shock
Pulm insuffic
Metabolic imbal
DIC
Multip organ dysfunc synd due to sys cytok
Sys inflamm resp synd (SIRS)- temp under 36 or over 38, pulse over 90, RR over 20, WCC under 4 or over 12.
Panc nec
Panc abcess late
Panc pseudocyst late
Panc ascites, fistulae, duct stricture, haemorrhage