What are examples of pancreatic disease?
What is acute pancreatitis?
Acute inflammation of the pancreas
Where is the pain usually due to acute pancreatitis?
Upper abdominal pain
How does acute pancreatitis change serum levels of amylase?
Elevation of serum amylase (4x upper limit of normal)
What can acute pancreatitis be associated with in severe cases?
What is the incidence of acute pancreatitis?
What is the mortality of acute pancreatitis?
What is the aetiology of acute pancreatitis?
Alcohol abuse (60-75%)
Trauma (blunt/postoperative/post ERCO)
Miscellaneous (drugs, viruses, pancreatic carcinoma, metabolic, autoimmune)
Idiopathic (about 10%)
What are examples of drugs that can cause acute pancreatitis?
What are examples of viruses that can cause acute pancreatitis?
What are metabolic changes that can cause acute pancreatitis?
Explain the pathogenesis of acute pancreatitis?
1) Primary insult
2) Release of activated pancreatic enzymes
3) Autodigestion causing pro-inflammatory cytokines, reactive oxygen species, oedema, fat necrosis and haemorrhage
What are the clinical features of acute pancreatitis?
Hypoxia (respiratory failure in most severe cases)
Hyperglycaemia (occsaionally diabetic coma)
What is paralytic ileus?
Obstruction of the intestine due to paralysis of the intestinal muscles
What is oligouria?
Urine output less than:
1mL/kg/h in infants
0.5mL/kg/h in children
400ml or 500ml per 24 hours in adults
What is strange about ERCP and acute panceatitis?
ERCP is a cause and a treatment of acute pancreatitis
What investigations are done for acute pancreatitis?
Abdominal and chest x-ray
CT scan (contrast enhanced)
What is being looked for in an abdominal ultrasound for acute pancreatitis?
What blood tests are done for acute pancreatitis?
Arterial blood gases
What is used to assess the severity of acute pancreatitis?
Using the glasgow criteria, what is considered to be severe pancreatitis?
A score of 3 or more
What is the white cell count for the glasgow criteria?
>15 x 109/L
What is the blood glucose for the glasgow criteria?
What is the blood urea for the glasgow criteria?
What is the AST for the glasgow criteria?
What is the LDH for the glasgow criteria?
What is the serum albumin for the glasgow criteria?
What is the serum calcium for the glasgow criteria?
What is the arterial PO2 for the glasgow criteria?
What is assessed with the glasgow criteria?
White cell count