Pancreatitis Flashcards
(27 cards)
Inflammatory condition of the pancreas characterized by the sudden onset and involvement of other organs
Acute pancreatitis
_____ persons per 100,000 person per year have pancreatitis
19.5
Approximately _____ cases/year, with 20-30% of those being severe
800,000
Frequency (increase / decreases) with age
Increases
Acute pancreatitis is more common in which race?
African Americans
Alcoholism accounts for _____ of cases, and are usually male patients
65%
Gallstones account for _____ of cases, but is the usual cause for females
10%
Other causes of acute pancreatitis include which factors? (5)
- Genetics
- Surgery or Trauma
- Congenital abnormality
- Cystic fibrosis
- Medications
Pancreas has two main parts known as
Exocrine and endocrine
What is the exocrine system responsible for?
Secrete digestive enzymes to break down food
What is the endocrine system responsible for?
Insulin and glucagon regulate glucose
The pancreas is made up of mostly which tissue?
Exocrine tissue arranged in clusters connected via a series of ducts
How does the pancreas go about its main action of helping to digest food?
Digestive juices and enzymes collect in ducts and mix with food in duodenum
How does alcohol contribute to the initiation of pancreatic inflammation?
Affect the sphincter of Oddi, causing it to spasm which prematurely releases enzymes and increases duct permeability
How do gallstones contribute to the initiation of pancreatic inflammation?
Causes a direct physical obstruction or overdistention of the ducts
What are the 5 steps of pancreatic pathophysiology
- Initiation of pancreatic inflammation
- Premature activation of digestive enzymes
- Leakage of pancreatic enzymes
- Autodigestion, inflammation, cell death (pancreatic necrosis)
- Mild, localized damage or severe necrosis (not able to produce exocrine or endocrine functions)
What is the issue with repeated acute episodes of pancreatitis?
Inflammation is usually able to resolve itself, but when it is repeated, the damage can result in the forming excessive fibrin and scar tissue (fibrosis)
Clinical presentation of pancreatitis includes what symptoms? (5)
- Upper abdominal/left upper quadrant pain - sudden onset, unremitting, gradually worsening
- Pain may improve by sitting or leaning forward
- Nausea and vomiting
- Tender, distended abdomen with decreased BS
- Fever, tachycardia, tachypnea, hypotension, pallor, clammy skin
What values can increase by up to 3-fold, with one specific value being most specific to pancreatitis?
Serum amylase and lipase; lipase most specific
What happens to WBC values?
Increase
What happens to glucose levels?
Increase (hyperglycemia)
What levels may increase if damage extends to the liver?
Elevated bilirubin and liver enzymes (AST)
What is the staging method used for diagnosing severity of acute pancreatitis?
CT-determined grade (A is best, E is worst)
What are more severe complications that can arise from acute pancreatitis? (4)
- Hypovolemic or septic shock
- Acute renal failure
- Pancreatic necrosis
- Multisystem organ failure
