Acute Pancreatitis

• What are the 3 main causes of acute pancreatitis?

  Gallstones

  Alcohol

  Post-ERCP
• What are the causes of acute pancreatitis?

  Mnemonic = I GET SMASHED

  Idiopathic

  Gallstones

  Ethanol (alcohol consumption)

  Trauma

  Steroids

  Mumps

  Autoimmune

  Scorpion sting

  Hyperlipidaemia

  ERCP

  Drugs (furosemide, thiazide diuretics & azathioprine)
• What are the signs & symptoms of acute pancreatitis?

  Abdo pain (classically epigastric)

  Radiation to back

  Vomiting

  Abdo tenderness

  Low grade fever

  Tachycardia

  May be peritonism
• What are the Inx of acute pancreatitis?

  Obs

  Full Hx & examination

  BM

  Bloods (FBC, U&Es, LFTs, CRP, calcium, ABG, amylase/lipase)

  USS

  CT abdo
• What can be used to score the severity of acute pancreatitis?

  Glasgow score

  PANCREAS mnemonic

  PaO2 < 8 kPa

  Age > 55

  Neutrophils (WCC > 15)

  Calcium < 2

  uRea > 16

  Enzymes (LDH > 600 or AST/ALT > 200)

  Albumin < 32

  Sugar (glucose > 10)

  • 0 - 1 = mild
  • 2 = moderate
  • 3 or more = severe
• What are the DDx of acute pancreatitis?

  Perforated peptic ulcer

  Ruptured AAA

  Bowel obstruction
• What is the management of acute pancreatitis?

  Resus

  IV fluids

  Analgesia

  Nutritional support (by mouth or parenteral)

  Treatment of underlying cause

  Abx (if evidence of infection)

  Monitoring & treat complications

  Most pts will improve within 3-7 days
• What are the possible complications of acute pancreatitis?

  Necrosis

  Infection

  Abscess

  Chronic pancreatitis