G.I.T Flashcards
(17 cards)
Acute Pancreatitis - Presentation
- Severe epigastric pain with nausea and vomiting
- Constant, intense and is referred to upper back
Acute Pancreatitis - Characterization
-Acute onset of abdominal pain resulting from enzymatic necrosis and inflammation of pancreas
Acute Pancreatitis - Associations (main)
-80% assoc w/ gallstones and alcoholism
Acute Pancreatitis - Infectious causes
- Mumps
- Coxsackie
- Mycoplasma
Acute Pancreatitis - Drug causes
- Diuretics
- Azothioprine
- Estrogens
- Sulfanomides
Acute Pancreatitis - ischemic causes
- Shock
- Trauma
- Vascular thrombosis
- Embolism
- Vasculitis
Acute Pancreatitis - Other causes of epigastric pain (differential)
- Esophagitis (reflux)
- Gastritis
- Peptic Ulcers
- Cholecystitis
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
Acute Pancreatitis - Complications
1) ARDS
2) ATN
3) Pancreatic abscess
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)
Chronic Pancreatitis - Characterization
Repeated bouts of mild to moderate pancreatic inflammation with loss of pancreatic parenchyma and its replacement by fibrous tissue
Chronic Pancreatitis - Common epidemiology
middle aged alcoholics
Chronic Pancreatitis - Etiology
1) Pancreatic Divisum
2) Autoimmune pancreatitis
3) Tropical Pancreatitis
4) Hereditary Pancreatitis
5) CFTR mutation associated
6) 40% no obvious cause
Chronic Pancreatitis - Presentation
Repeated attacks or persistent moderate-severe abdominal and back pain
Chronic Pancreatitis - Clinical Features
1) Malabsorption
2) Diabetes
3) Pseudocysts
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)
Autoimmune Pancreatits - Synonyms
1) Lymphoblastic Sclerosing Pancreatitis
2) Duct-destructive chronic pancreatitis
3) Sclerosing chronic pancreatitis