Severity of pancreatitis
BUN
SIRS
temp, HR, RR, and WBC ; if 2 or more than positive
3 or more - more aggressive monitoring
evaluate biliary tree with pancreatitis
US of abdomen
if diagnosis of pancreatitis is unclear
CT without IV contrast
if pancreatitis after 72 hours has persistent SIRS to evaluate for NECROTIZING pancreatitis
CT with IV ( or MRI)
Pancreatitis Treatment
symptomatic tx for interstitial 1) fluid resuscitation (lactated ringers) 2) pain management 3) supplemental O2 other tx: -observe for signs of organ failure: respiratory depression and renal failure -nutrition(ASAP) -ERCP
Pancreatitis complications
pseudocysts (EUS to drain it when symptomatic)-most common
necrotizing pancreatitis and abscess
GI bleeding (Hemosuccus pancreatitis-emergency bleeding through the duct of the pancreas)
splenic infarction
organ failure, Respiratory insufficiency, renal failure
chronic pancreatitis
analyze fecal fats for steatorrhea
Chronic pancreatitis treatment
pain control-Narcotics pancreatic enzyme supplement insulin endoscopic therapy surgical therapy
Chronic pancreatitis, radiology
anatomical abnormalities (calcifications + abnormalities of pancreatic duct)
imagining studies most frequent way of diagnosis
most sensitive is EUS
Initial tests for pancreatic cancer
US and CT scan
definitive tests for pancreatic cancer
endoscopy: aspiration biopsy, ERCP
Blood tests of pancreatic cancer
CEA, POA used to monitor not diagnosis!
