Acute pancreatitis

external

• Causes

  • Cholelithiasis
  • Alcohol
  • Endoscopic retrograde cholangiopancreatography
  • Mumps
  • Hypercalcaemia
  • Hypothermia
  • Hypertriglyceridaemia
  • Coxsackie virus
  • Thiazide
  • Corticosteroid
  • Azathioprine
  • Oral contraceptive pill
  • Tetracycline
  • Frusemide
  • 5-aminosalicylic acid
  • Systemic lupus erythematosus
  • Polyarteritis nodosa
  • Mycoplasma pneumoniae
  • Familial hypertriglyceridaemia
  • Type I hyperlipoproteinaemia
  • Nucleoside reverse transcriptase inhibitor
  • Azidothymidine
  • Didanosine
  • Alpers syndrome
  • Reye syndrome

• Effects

  • Acute abdominal pain
  • Nausea and vomiting
  • Epigastric pain
  • Guarding
  • Grey Turner's sign
  • Cullen's sign
  • Peripheral vasodilatation
  • Hypocalcaemia
  • Acute kidney injury
  • Adult respiratory distress syndrome
  • Disseminated intravascular coagulation
  • Pseudocyst
  • Chronic pancreatitis
  • Total parenteral nutrition
  • Pancreatic insufficiency
  • Splenic vein thrombosis

• Parents

  • Pancreatitis
  • Gastrointestinal disease

• Treatments

  • Intravenous fluid
  • Aspiration of gastric contents
  • Total parenteral nutrition
  • Ventilatory support

• Description

  • "Differential Diagnosis: 1.Perforated peptic ulcer 2. Acute Cholecystitis 3.Aortic aneurysm 4. Acute mesenteric ischemia 5. High intestinal obstruction 6. Myocardial infarction INVESTIGATIONS: 1. Serum Amylase- Normal= upto 200 SU Pancreatitis = 5 times normal Peak values - 5hr after onset Falls to normal after 48 hrs 2. Hypocalcemia 3. Glycosuria 4. FBC & Clotting screen 5. Renal Function 6. Liver function 7. Blood Gas 8. ECG - to exclude MI TREATMENT: 1. Pain Relief - avoid morphine 2. Keep Stomach empty a. Nil by mouth b. NG Aspiration 3. Correct Hypovolemia 4. Correct Electrolyte Imbalance 5. ARDS(Ventilation) 6. Renal Failure (Dialysis)"