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)
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