Exam 2 - Pancreatic Problems Flashcards
(44 cards)
Acute pancreatitis
usually mild and resolves spontaneously. Only 20% lead to hopitalization
cause of acute pancreatitis
OBSTRUCTION of the outflow of pancreatic enzymes, usually related to pancreatic and bile duct obstruction (usually gallstones)
acute pancreatitis can also be caused by
alcohol, drugs, viral infection
Backup of enzymes
leads to autodigestion of pancreatic cells - causes inflammation
pancreatitis leads to
vascular damage
coagulopathy
necrosis
fat necrosis
Trypsin leads to
Edema, necrosis, hemorrhage
Elastase leads to
hemorrhage
Phospholipase A leads to
fat necrosis
Kallikrein leads to
Edema, vascular permeability, smooth muscle contraction (pain), shock
Lipase leads to
Fat necrosis (breakdown)
Acute pancreatitis manifestations
SEVERE EPIGASTRIC PAIN
Sudden onset
may radiate to back
tenderness/guarding
Where does the pain come from?
Edema plus irritation and inflammation of space around it
Accompanying symptoms
N/V, abdominal distention, hypo BS
fever
hypotension, tachycardia, jaundice
Decreased BP and Increased HR
Lab symptoms of pancreatitis
amylase, lipase, glucose, WBS
Monitor glucose!
Other clinical manifestations
cyanosis or green/yellow/brown discoloration of abdomen
ecchymoses
what is ecchymoses
flanks - grey turners
periumbilical - cullens sign
hemorrhagic pooling. very rare.
acute pancreatitis complications
pseudocyst
abscess
pulmonary complications
hypotension - shock (hypovolemic)
tetany from hypocalcemia
pulmonary complications
pain, pleural effusion - edema
pseudocyst complications
fluid filled cavity that surrounds the outside of the pancreas - necrotic products and secretions
results in inflammation and scarring of areas near the pancreas
clinical presentation of pseudocyst
similar to pancreatitis plus a palpable epigastric mass
if pseudocyst perforate
peritonitis
complications of pancreatic abscess
large fluid filled cavity INSIDE pancreas. Results of extensive necrosis in the pancreas
Pancreatic abscess may
become infected or perforate
clinical presentation of pancreatic abscess
similar to pancreatitis plus abdominal mass, high fever, and leukocytes (INFECTION)
