ACUTE PANCREATITIS.

Dr. Zachary Lahlou

DEFINITION

  • Inflammatory disease of the pancreas characterized by abdominal pain and elevated serum amylase and lipase.

ETIOLOGY/ PATHOGENESIS

  • Leakage of pancreatic enzymes into the peri-pancreatic tissue
  • Often secondary to gallstones or alcoholism
  • 85% self-limiting
  • Other causes include: trauma, drugs, hyperlipidemia, and genetics, post-surgery (ECRP), infection, hypercalcemia, pancreatic tumor.

PERTINENT HISTORICAL FINDINGS/ CLINICAL SYMPTOMS

  • Abrupt constant epigastric pain often radiating to the back
  • Nausea, vomiting

PERTINENT PHYSICAL EXAM FINDINGS

  • Fever and shock (hypotension when severe)
  • Pain aggravated by walking and lyin
  • Improved by sitting and leaning forward
  • If associated with severe necrotizing pancreatitis, flank discoloration (Gray-Turner sign) may be present

DIFFERENTIAL DIAGNOSIS

  • Gall stones
  • Perforated duodenal ulcers
  • Chronic pancreatitis
  • Leaking aortic aneurysm
  • Mesenteric ischemia

DIAGNOSTIC EVALUATIONS Cancer

  • Elevated amylase
  • Elevated lipase, remains elevated longer than amylase
  • Decreased Ca if very severe
  • CT is useful in diagnosis
  • Plain abdominal x-rays may show signs of obstruction due to Ileus, “sentinel loop” or “colon…

View original post 141 more words

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

w

Connecting to %s