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29 Cards in this Set
- Front
- Back
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Where does the main pancreatic duct enter the duodenum? |
At the ampulla of Vater, usually with the CBD NB- There may be an accessory duct |
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What is the function of the pancreas? |
Enzyme recreation for GIT function |
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What is Acute Pancreatitis? |
Inflammation of the Pancreas |
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How common is morality in pancreatitis? |
20%, but less than 5% if aggressive management |
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What is the pathogenesis of Acute Pancreatitis? |
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How does pathogenesis compare to the pathology? |
In first week, 50% mortality due to: Systemic Inflammatory Response Syndrome leads to Multi-organ dysfunction syndrome (Ex. ARDS resulting in respiratory failure) From 2nd week, Mortality due to peri-pancreatic necrosis with sepsis. |
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What are the pathological features of acute pancreatitis? |
Gross changes vary from: 1) Swollen and oedematous, but preserved pancreas (10-15% mortality rate) to 2) Haemorrhage and necrotic mass (50% RIP) with extensive necrosis extending to the mesentery Commonly- Pancreas has yellow-white plaques and nodules from fat necrosis and within the pancreas and mesentery with inflammation and neutrophils |
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How else can Acute Pancreatitis present? |
80% as mild, self-limiting disease 20% as the severe, fulminating disease w/ SIRS and necrosis of the peri-pancreatic fat with risk of local complications |
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What are some consequences of SIRS? |
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How would you manage Acute Pancreatitis? |
Supportive Management
Treatment of Necrotic Tissue Treatment of Infection |
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Briefly, comment on the epidemiology of Pancreatitis |
32/100,000 people and 3% of admissions with abdominal pain Overall mortality is 10%, with 80% of cases being mild and self-limiting |
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What are causes of Acute Pancreatitis? |
GET SMASHED Gallstones EtOH Trauma Steroids Mumps Autoimmune Scorpion Hyperlipidaemia/Hypercalcaemia ERCP Drugs - Thiazide, Azothriprin |
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How is Acute Pancreatitis determined to be mild or severe |
If Mild, minimal organ dysfunction If Severe, Organ failure or local sequelae including
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What are symptoms of Acute Pancreatitis? |
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What are signs of Acute Pancreatitis? |
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How is diagnosis of Acute Pancreatitis made? |
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What is the Ranson Criteria? |
Think Ranson for a rancid pancreas Ranson 0-2 --> Minimal Mortality Ranson 3-5 --> 10-20% mortality Ranson >5 ---> more than 50% mortality |
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What is the Imrie score? |
WCC > 15e9 cells/L (High) Glucose > 10 mmol/L (High) Urea > 16 mol/L (High) PaO2 < 8.6 kPa (Low) Calcium < 2 mmol/L (Low) Albumin < 32 g/L (Low) LDH > 600 units/L (High) AST > 100 units/L (High) |
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Pancreatitis is a two-phase disease, describe the two phases. |
Phase 1 (1-2 weeks), severe SIRS due to cytokine release Phase 2 (2+ weeks), sepsis-related complications due to peri-pancreatic necrosis |
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What are investigations that should be ordered for Acute Pancreatitis? |
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How can future episodes of Acute Pancreatitis by prevented? |
1) Cholecystectomy 30% gallstone-causing risk recurrence 2) Avoid aggravating factors (EtOH) |
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What are complications of Acute Pancreatitis? |
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What is chronic pancreatitis? |
Inflammation go the pancreas that does not heal or improve and becomes worse over time, leading to permanent damage. |
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What are causes of Chronic Pancreatitis? |
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What is the pathogenesis of Chronic Pancreatitis? |
1) Obstruction go major pancreatic ducts by a gallstone or carcinoma 2) Extensive parenchymal calcification (95%)
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What are the signs and symptoms or Chronic Pancreatitis? |
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Management of Chronic Pancreatitis |
Treat Complications
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What is a Pancreatic Pseudocyst? |
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How is a Pancreatic Pseudocyst managed, and what complications may occur? |
Management
Complications
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