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Flashcards in G.I.T Deck (17)
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1

Acute Pancreatitis - Presentation

-Severe epigastric pain with nausea and vomiting
-Constant, intense and is referred to upper back

2

Acute Pancreatitis - Characterization

-Acute onset of abdominal pain resulting from enzymatic necrosis and inflammation of pancreas

3

Acute Pancreatitis - Associations (main)

-80% assoc w/ gallstones and alcoholism

4

Acute Pancreatitis - Infectious causes

1. Mumps
2. Coxsackie
3. Mycoplasma

5

Acute Pancreatitis - Drug causes

1. Diuretics
2. Azothioprine
3. Estrogens
4. Sulfanomides

6

Acute Pancreatitis - ischemic causes

1. Shock
2. Trauma
3. Vascular thrombosis
4. Embolism
5. Vasculitis

7

Acute Pancreatitis - Other causes of epigastric pain (differential)

1. Esophagitis (reflux)
2. Gastritis
3. Peptic Ulcers
4. Cholecystitis

8

Acute Pancreatitis - Clincal Features

1) Leukocytosis
2) DIC
3) Hemolysis
4) Peripheral vascular collapse
5) Shock with ATN, ARDS
6) Hypocalcemia (due to saponification) - tetany
7) Raised amylase levels in first 24 hours
8) Raised lipase levels within 72-96 hours

9

Acute Pancreatitis - Complications

1) ARDS
2) ATN
3) Pancreatic abscess

10

Acute Pancreatitis - Morphology

1) Focal areas of fat necrosis in pancreas and peripancreatic tissues and abdominal cavity
2) Chalky white areas of Ca++ deposition (saponification) - appear radiopaque on radiographs
3) Severe cases - Necrosis of pancreatic tissue (acini, ducts, and islets) with hemorrhage (hemorrhagic pancreatitis)

11

Chronic Pancreatitis - Characterization

Repeated bouts of mild to moderate pancreatic inflammation with loss of pancreatic parenchyma and its replacement by fibrous tissue

12

Chronic Pancreatitis - Common epidemiology

middle aged alcoholics

13

Chronic Pancreatitis - Etiology

1) Pancreatic Divisum
2) Autoimmune pancreatitis
3) Tropical Pancreatitis
4) Hereditary Pancreatitis
5) CFTR mutation associated
6) 40% no obvious cause

14

Chronic Pancreatitis - Presentation

Repeated attacks or persistent moderate-severe abdominal and back pain

15

Chronic Pancreatitis - Clinical Features

1) Malabsorption
2) Diabetes
3) Pseudocysts

16

Chronic Pancreatitis - Complications

1) Pleural effusions
2) Pancreatic Pseudocyst
3) Diabetes
4) Pain from perineural fibrosis
5) Pancreatic calcification
6) Stones in pancreatic duct
7) Ascites
8) Fat malabsorption (steatorrhea, dec vit K)

17

Autoimmune Pancreatits - Synonyms

1) Lymphoblastic Sclerosing Pancreatitis
2) Duct-destructive chronic pancreatitis
3) Sclerosing chronic pancreatitis