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Pancreatitis

Pancreatitis . Jarad Hopper 2/23/2014 University of Tennessee Health Science Center . The Basics . Definition: inflammation of the pancreas Secondary to activated digestive enzymes in pancreas May be acute (days) or chronic (years) . Anatomy.

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Pancreatitis

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  1. Pancreatitis Jarad Hopper 2/23/2014 University of Tennessee Health Science Center

  2. The Basics • Definition: inflammation of the pancreas • Secondary to activated digestive enzymes in pancreas • May be acute (days) or chronic (years)

  3. Anatomy http://www.emedicinehealth.com/pancreatitis/article_em.htm

  4. Signs and Symptoms • LUQ pain radiating to back • N/V that is worse with eating • Increased BP, HR, RR • Tender abdomen • Possible fever and jaundice

  5. Common Causes • Alcohol • Gallstones • Trauma • Steroids • Mumps • Autoimmune • ERCP • Hyperlipidemia

  6. Diagnosis • Characteristic abdominal pain • Elevated amylase and lipase • Characteristic CT scan

  7. http://health.shorehealth.org/imagepages/1145.htm

  8. Treatment • NPO (usually up to 5 days) • Oxygen via BNC • IVFs • Pain control – consider morphine

  9. Prognosis • Modified Glasgow criteria • Considered severe if 3 of the following are met: • Age > 55 years • Blood levels: • P02 Oxygen < 60mmHg or 7.9kPa • White Blood Cells > 15 • Calcium < 2 mmol/L • Urea > 16 mmol/L • LDH > 600iu/L • AST > 200iu/L • Albumin < 32g/L • Glucose > 10 mmol/L

  10. 62 y/o Caucasian male presents to the ED with complaints of nausea, vomiting, and LUQ pain that radiates to his back. The patient reports that his symptoms began 5 hours ago and noticed that it started after eating. The patient reports that he takes no medications and has no significant past medical history or family history. This is the first time that this has happened to the patient. Physical exam include tenderness to palpation in the mid-epigastrium. Labs include: CBC and CMP WNL and elevated amylase and lipase (5x normal). What is the most likely diagnosis? • Acute Pancreatitis • Cholecystitis • Duodenal Ulcer • Irritable Bowel Syndrome 30

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