What is acute pancreatitis?
Sudden inflammation + haemorrhaging of the pancreas due to autodigestion
REVERSIBLE
What are the 2 main causes of acute pancreatitis?
Alcohol abuse
Gallstones
What are the clinical presentations of acute pancreatitis? (5)
- Epigastric pain that radiates to the back
- N+V
- Fever
- Abdominal tenderness
- Distension
What signs are present in late-stage acute pancreatitis? (2)
Haemorrhagic
- Grey-Turner’s sign (bruised flank)
- Cullen’s sign (bruising around umbilicus)
How do you investigate acute pancreatitis? (2)
- Raised serum amylase/ lipase
- CT abdomen
How would you treat acute pancreatitis? (2)
- Treat underlying cause
- Supportive: fluids, analgesia, IV nutrition
What can cause acute pancreatitis?
GET SMASHED!
Gallstones Ethanol abuse Trauma Steroids Mumps Autoimmune eg SLE Scorpion bites Hypercalcemia, hyperlipidemia ERCP Drugs - metronidazole, azathioprine, tetracycline, furosemide
What is chronic pancreatitis?
Persistent inflammation leading to fibrosis, atrophy and calcification of the pancreas
IRREVERSIBLE
What causes of acute pancreatitis often lead to chronic pancreatitis?
- Alcohol
- Trauma
- Tumours
- Cystic fibrosis [main cause in children]
How would you diagnose chronic pancreatitis? (2)
Abdominal x-rays: calcifications
ERCP: chain-of-lakes
How would you treat chronic pancreatitis? (4)
- Control pain
- Manage risk factors: less alcohol, meat, lose weight)
- Replace digestive enzymes, nutritional supplements
What should you suspect in a pt w painless jaundice with weight loss?
Cancer of head of pancreas
