Flashcards in *Biliary tract and pancreas disorders 3 (Lecture 11) Deck (85)
What are the 3 main pancreatic diseases?
What are the 5 parts of the pancreas?
What do alpha islet cells release?
What do Beta islet cells release?
What do Delta islet cells release?
What do PP cels release?
What are the 2 categories of acute pancreatitis?
What is the predominant feature of mild acute pancreatitis?
interstitial oedema of the gland
Associated with minimal organ dysfunction and an uneventful recovery
What is severe acute pancreatitis?
Associated with organ failure and/ or local complications such as necrosis (with infection), pseudocyst or abscess
What viral infections can cause acute pancreatitis?
Coxsackie B (can cause hand foot and mouth disease)
What other factor can cause acute pancreatitis apart from GET SMASHED?
What genetic factors can cause acute pancreatitis?
Cationic trypsinogen gene
What drugs can cause pancreatitis? (4)
What autoimmune disease can cause pancreatitis?
IgG4-related autoimmune disease
What causes necrosis of the pancreas during pancreatitis?
Inflammation of the parenchyma causing hypoperfusion
How is acute pancreatitis diagnosed?
History (e.g. gallstones, alcohol, drugs, trauma, infection, ERCP)
What is peritonism?
having the clinical signs of shock and peritonitis
Possible examination findings for acute pancreatitis? (5)
Blood tests performed to look for acute percents?
Imaging for acute pancreatitis? (5)
Findings on AXR suggestive of possible AP? (2)
What is a sentinel loop?
dilatation of a segment of small intestine
What is the purpose of carrying out an US for AP?
To rule out biliary pancreatitis
What is the purpose of carrying out a CT scan for acute pancreatitis?
Assess severity of pancreatitis
Decide on interventions and follow up
Look for complications (e.g. fluid collection, necrosis, ascites, bleeding, abscess)
Use of ERCP in AP?
Not as a diagnostic tool!
Used for treatment of CBD stones with obstruction cholangitis as an emergency procedure
Used for treatment of acute biliary pancreatitis (if no index cholecystectomy possible)
What is the glasgow prognostic score?
PaO2 less than 8kPa
Age greater than 55 years
Neutrophils greater than 15 X 10^9/L
Calcium less than 2mmol/L
Renal function: urea greater than 16mmol/L
Enzymes (AST/ ALT greater than 200 or LDH greater than 600)
Albumin less than 32 g/L
Sugar (glucose less than 10 mol/L)
*any 3 factors means acute severe pancreatitis
What Glasgow prognostic score = acute severe pancreatitis?
Apart form the Glasgow prognostic score, what is another scoring system that can be used to acute pancreatitis?
Ranson score (only for alcohol-induced pancreatitis)
Balthazar score - used to assess percentage of necrosis and severity score from a CT scan (CT severity index)
Symptoms of acute pancreatitis? (7)
Epigastric/ diffuse abdominal pain +/- radiation to the back
Nausea and vomiting
Loss of appetite +/- weight loss