Pancreatitis Flashcards
what is pancreatitis
self perpetuating pancreatinc inflammation by enzyme autodigestion
causes
GET SMASHED
gallstones
ethanol
trauma (incl ERCP)
sx pancreatitis
gradual/sudden severe epigastric pain or central abdo pain radiating to back
vomiting++ fever tachycardia jaundice rigid abdo
2 signs in pancreatitis
cullen’s sign (periumbilical bruising)
grey turner’s sign (flank bruising)
how to diagnos
serum amylase 3 or more times normal
what would raised bilirubin and/or serum aminotransferase suggest
gallstones
other causes of raised amylase
renal fialure
ectopic
DKA
perforated duodenal ulcer
prognostic scores in pancreatitis
galsgow prognostic score
ranson’s criteria
Acute Physiology and Chronic Health Evaluation II (APACHE II) Score
treatment pancreatitis
analgesia \+//- IV benzos IV fluids nil b mouth NG tube for severe vomiting abx if infection
complications
pancreatic necrosis
what analgesia is given in pancreatitis
pethidine or buprenorphine
Morphine is relatively contra-indicated because of possible spastic effect on the sphincter of Oddi
sx chronic pancreatitis
epigastric pain radiating to back n+v reduced appetite exocrine dysfunction endocrine dysfunction
what is the endocrine dysfunction of chronic pancreatitis
DM
what is exocrine dysfunction of chronic pancreatitis
malabsorption weight loss diarrhoea steatorrhoea (because fat soluble vitamins can't be absorbed bc lipase isn't produced) protein deficiency
causes of chronic pancreatitis
ALCOHOL!
CF
haemochromatosis
