Pancreatitis Flashcards
(10 cards)
What are the causes of acute pancreatitis?
Idiopathic
Gallstones
Ethanol
Trauma
Steroids
Mumps
Autoimmune
Scorpion bite
Hypercalcaemia
ERCP
Drugs e.g. NSAIDS, azathioprine, furosemide
What are clinical features of acute pancreatitis?
Severe epigastric pain that radiates to back
N&V
OFten epigastric tenderness
Cullen’s sign-periumbilical bruising
Grey-Turner’s sign- flank bruising
What are the investigations for acute pancreatitis?
Bloods
- raised serum amylase/lipase
Imaging
- US abdo for gallstones
- CT for oedema or necrosis
What is the severity scoring for acute pancreatitis?
Modified glasgow criteria
PaO2 8
Age >55
Neutrophils >15
Calcium <2
Renal- Urea >16
Enzymes- AST >200 or LDH >600
Albumin <32
Sugars >10
3 or more= severe pancreatitis
What is the management of acute pancreatitis?
IV fluids
Strict input output
Analgesia
Treat underlying cause
Abx only if infection or necrosis
What are features of pancreatic necrosis?
Ischaemic infarction with severe inflammation
Persistent inflammation >1 week post pancreatitis onset
Diagnosed via CT
Consider prophylactic abx to prevent secondary infection
What are features of pancreatic pseudocysts?
Fluid colletion containing pancreatic enzymes, blood and debris
Often asymptomatic may cause biliary obstruction if large
Found incidentally on CT/US
Management
- conservative
- drain if persists >6 weeks or symptomatic
What are features of chronic pancreatitis?
Chronic inflammation leads to fibrosis and loss of function
Often caused by alcohol
Symptoms
- chronic epigastric pain worse after meals
- steatorrhoea
- diabetes mellitus
What are the investigations for chronic pancreatitis?
Amylase/lipase often normal
Low faecal elastase
Imaging
- AXR: pancreatic calcifications
- CT: atrophy, calcification and pseudocyst
What is the management of chronic pancreatitis?
Lifestyle modification e.g. alcohol cessation
Exocrine supplements e.g. CREON
Analgesia
Control diabetes if present
