What might be the Ca findings in acute pancreatitis?
Hypercalcaemia - can be the cause of the pancreatitis
Hypocalcaemia - can be a complication of acute pancreatitis (particularly if severe)
Upper RQ Pain + Fever + Obstructive jaundice = ???
How are LFTs with pancreatitis?
Deranged with obstructive picture
What is Whipple's procedure?
A procedure to remove pancreatic cancer
- Involves removal of part of the pancreas and duodenum
How do you calculate the anion gap?
(Na + K) - (Bicarb + Cl)
What system is used to assess pancreatitis severity?
How must you treat cholangitis?
Broad spectrum antibiotics
What can you do if a gall bladder isn't seen on first US?
Have them fast for 18hours so the gall bladder fills more and stones are easier to see
What is the pattern of pain in pancreatitis?
Suddeon onset epigastric
Radiating straight through to back
How do you management pancreatitis?
Antibiotics (though no proven benefit)
ERCP and sphincterotomy
How does the pain from biliary colic usually present?
RUQ or epigastric
Sometime radiating around the R to the back
Episodic, lasting 15 minutes
What is the pathophysiology of biliary colic?
Stones form in the gall bladder where bile is stationary >
CCK released in response to fatty meal causes gall bladder contraction >
Stone blocks cystic duct >
Contraction against the blockage causes pain
Why might someone with pancreatitis have reduced breath sounds at the lung bases?
What is a classic sign of pancreatitis?
Patient lies very still as movement of the lumbar spine will directly irritate the pancreas
How are the LFTs in biliary colic?
What might be found on US of abdo in cholangitis?
Stone in gall bladder
Dilated common bile duct
Stone in common bile duct (50% not found)
What is the palliative treatment for pancreatic cancer?
Stenting of common bile duct to relieve obstruction
- Metal (non-metastatic)
- Plastic (metastatic)