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15 Cards in this Set
- Front
- Back
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What is it?
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Injury to pancreatic acinar cells from a number of causes, leading to impaired zymogen granule secretion, leading to increased permeability, oedema, haemorrhage and necrosis.
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Incidence
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20-70 per 100,000
0.0002 - 0.0007% |
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Age
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Aetiology related
Gallstones - 69 Alcohol - 39 |
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Sex ratio
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Slightly Male Dominant (alcohol)
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Geography
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Alcohol
?Black 3x |
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Causes
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Idiopathic (20%)
Gallstones (40%) Ethanol (35%) Trauma (1.5%) Steroids (<1%) Mumps, Coxsackie, Measles, (<1%) Autoimmune - PAN, SLE (<1%) Scorpion Venom - Tityus Trinitatis (<1%) Hypercalcaemia, Hypercholesterolaemia, Hypothermia (<1%) ERCP (4%) Drugs : Azothioprine, Sulphonamides, Valproic Acid, Tetracycline, Furosemide (2%) |
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Classical Symptom
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Dull achy steady abdo pain which radiates to back (50%)
Relieved by leaning forward - worse lying flat |
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Symptoms (2)
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Jaundice
Dypsnoea (10%) from diaphragmatic irritation |
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Special Signs
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GC(S)E
Grey-Turner Cullen's Erythematous skin nodules |
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Grey-Turner Sign
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Reddish-brown flanks
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Cullen's sign
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Bluish periumbilical
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Erythematous Nodules
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focal subcutaneous fat nodules
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Investigations (9 = 7 blood, 2 imaging)
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FBC (neutropenia)
ABG (paO2 <8) Lipase / Amylase (3x) LFTs U+E's; Ca, Mg Lipids Glucose Erect Chest XR USS for gallstones |
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Treatment
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ERCP
CT guided needle aspiration to determine if infected |
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Prognosis Score system
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Glasgow Severity Score (>3 to ITU)
PaO2 Age Neutrophils Calcium Renal function Enzymes Albumin Sugar |
