Flashcards in Acute Pancreatitis Deck (17):
Diagnostic step for patients suspected pancreatitis from Cholelithiasis?
Right upper quadrant abdominal ultrasound
Patients with mild right upper quadrant abdominal pain with heavy meals?
Pancreatitis versus biliary colic pain?
Location of pain: radiating straight to the back vs RUQ
Accompanied by nausea and vomiting vs not
Think severe pancreatitis with what initial signs?
AST > 250
Think severe pancreatitis with what signs 48 hours After admission?
BUN rise > 5
Base deficit > 4
Arterial PO2 < 60
Serum calcium < 8
Hematocrit drops >10 points
Cyst within the pancreas not lying by epithelial cells, associated with chronic pancreatitis
Most common causes of pancreatitis in the US?
1. Alcohol especially following binge drinking
2. Biliary tract disease (gallstones)
When is hypertriglyceridemia a cause of acute pancreatitis?
Levels are more than 1000
When patients have no gallstones seen on ultrasound and no other predisposing factor likely cause of pancreatitis?
Biliary tract disease (biliary sludge, or sphincter of Oddi dysfunction)
Biliary sludge a.k.a.?
Acute pancreatitis: what makes pain better? What makes pain worse?
Sitting up and bending forward. Food.
Three reasons acute pancreatitis patients are volume depleted?
2. No oral intake
3. Inflammatory process creates third spacing, sequestering large volumes of fluid in the peritoneal cavity
Most common test to diagnose pancreatitis? Good for? Can also be elevated in?
More specific test?
Amylase level. Rises within hours and remains elevated for 3 to 4 days. GI Ischemia with infarction or perforation, vomiting
Serum lipase (remains elevated longer than amylase)
Treatment of pancreatitis?
1. pancreatic rest (withholding food or liquids by mouth)
2. narcotic analgesia (with meperidine)
3. IV fluids
One can oral liquid be restarted in patients with acute pancreatitis?
When the pain has largely subsided and the patient has bowel sounds
Most common cause of death in patients with pancreatitis?