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14 Cards in this Set
- Front
- Back
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How does a patient classically present with acute pancreatitis?
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Abdominal pain radiating to the back, nausea and vomiting
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What is the significance of amylase and lipase?
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Helpful for diagnosis, but does not correlate with the severity of the disease
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What ar ethe most common etiologies of acute pancreatitis?
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Alcohol consumption and gallstones
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How does severe acute pancreatitis cause system dysfunction?
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Increases microvascular permeability leading to large losses of intravascular fluid into the tissues, thereby decreasing perfusion of the lungs, kidneys and other organs
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What is the most important way to prevent multiple organ failure in pancreatitis?
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Fluid resuscitation
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What is the Ranson criteria in general?
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Prognostic systems to differentiate btwn mild and severe pancreatitis
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What is the Ranson criteria on admission?
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G - glucose > 200
A - age > 55 L - LDH > 350 A - AST > 250 W - WBC > 16,000 |
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What is the Ranson criteria in the next 48 hours?
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B - BUN increase > 5
O - Oxygen < 60mmHg B - base > 4mEq C - Calcium < 8 mg/dL H - Hematocrit decreases 10% F - Fluid requirement > 6 L |
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What is the imaging test of choice for acute pancreatitis?
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Contrast-enhanced CT imaging
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How do you treat patients with gallstone pancreatitis?
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Cholecystectomy once the pancreatitis has resolved
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What is the initial treatment of acute pancreatitis?
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1) NPO
2) Fluid resuscitation 3) Pain management 4) Maintain ventilation and adequate oxygenation |
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If biliary obstruction is causing the pancreatitis, what can be done?
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ERCP to clear the duct of stones and prevent biliary complications
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Why do patients with gallstone pancreatitis undergo cholecystectomy before discharge?
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Prevent recurrent attacks which occur up to a 1/3 of patients who do not undergo cholecystectomy
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How do you treat necrotic pancreatitis?
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Surgical debridement and drainage
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