Acute Pancreatitis (Summary) : DR Jeremy Jones Pancreas

Acute pancreatitis (summary)
Dr Jeremy Jones et al.
Acute pancreatitis refers to acute inflammation of the pancreas and is a potentially life-
threatening condition.
Reference article
This is a summary article; read more in our article on acute pancreatitis.
Summary
epidemiology
o epidemiology is dependent on the cause of pancreatitis
gallstones, idiopathic, alcohol, malignancy, metabolic conditions
presentation
o acute onset, severe central abdominal pain
o radiation through to the back
o raised lipase and amylase
pathophysiology
o obstruction of the pancreatic ducts is common
o pancreatic enzyme activation results in inflammation
o inflammation of the pancreas causes in interstitial oedema and swelling
o continued inflammation results in necrosis, and in some cases haemorrhage
investigation
o not required for diagnosis, but may help
o very useful for assessment of complications
treatment
o largely supportive, often requiring ICU care in severe cases
o respiratory and cardiovascular support
o careful management of glucose, calcium, and fluid balance
prognosis
o dependant on the severity of disease and rapidity of treatment
o complication include necrosis and cyst formation
Role of imaging
clarify the diagnosis when the clinical picture is confusing

assess severity and determine prognosis
detect complications
determine possible causes
Radiographic features
Imaging studies of acute pancreatitis may be normal in mild cases. Contrast-enhanced CT
provides the most comprehensive initial assessment, typically with a dual phase (arterial and
portal venous) protocol.
CT
Abnormalities that may be seen in the pancreas include:
typical findings
o focal or diffuse parenchymal enlargement
o changes in density because of oedema
o indistinct pancreatic margins owing to inflammation
o surrounding retroperitoneal fat stranding
necrosis of pancreatic parenchyma
o lack of parenchymal enhancement
infected necrosis
o difficult to distinguish from aseptic liquefactive necrosis
o the presence of gas is helpful
abscess formation
o circumscribed fluid collection
o little or no necrotic tissues
haemorrhage
o high-attenuation fluid in the retroperitoneum or peripancreatic tissues
Pankreatitis akut (ringkasan)
Dr Jeremy Jones et al.
Pankreatitis akut mengacu pada peradangan akut pada pankreas dan merupakan kondisi yang
berpotensi mengancam nyawa.
Artikel referensi
Ini adalah artikel ringkasan ; baca lebih lanjut dalam artikel kami pada pankreatitis akut .
Ringkasan
epidemiologi
o Epidemiologi tergantung pada penyebab pankreatitis
batu empedu, idiopatik, alkohol, keganasan, kondisi metabolik
presentasi
o onset akut, sakit perut bagian tengah yang parah
o radiasi sampai ke belakang
o mengangkat lipase dan amilase
patofisiologi
o Penyumbatan saluran pankreas sering terjadi
o aktivasi enzim pankreas mengakibatkan peradangan
o Peradangan pankreas menyebabkan edema interstisial dan pembengkakan
o Hasil peradangan berlanjut pada nekrosis, dan dalam beberapa kasus perdarahan
penyelidikan
o tidak diperlukan untuk diagnosis, tapi mungkin bisa membantu
o sangat berguna untuk penilaian komplikasi
pengobatan
o sangat mendukung, seringkali membutuhkan perawatan ICU pada kasus yang
parah
o dukungan pernafasan dan kardiovaskular
o pengelolaan keseimbangan glukosa, kalsium, dan cairan hati-hati
prognosa
o tergantung pada tingkat keparahan penyakit dan kecepatan pengobatan
o Komplikasi meliputi nekrosis dan pembentukan kista
Peran pencitraan
Klarifikasi diagnosis bila gambaran klinisnya membingungkan
menilai keparahan dan menentukan prognosis
mendeteksi komplikasi
tentukan kemungkinan penyebabnya
Fitur radiografi
Studi pencitraan pankreatitis akut mungkin normal pada kasus ringan. CT kontras kontras
memberikan penilaian awal yang paling komprehensif, biasanya dengan protokol dual phase
(arteri dan portal vena).
CT
Kelainan yang mungkin terlihat pada pankreas meliputi:
Temuan khas
o pembesaran parenkim fokal atau difus
o Perubahan kepadatan karena edema
o margin pankreas tidak jelas karena peradangan
o sekitar lemak retroperitoneal stranding
nekrosis parenkim pankreas
o kurangnya peningkatan parenkim
nekrosis yang terinfeksi
o Sulit dibedakan dari nekrosis liquefaktif aseptik
o Kehadiran gas sangat membantu
pembentukan abses
o koleksi cairan yang terbatas
o sedikit atau tidak ada jaringan nekrotik
pendarahan
o cairan atenuasi tinggi di jaringan retroperitoneum atau peripancreatic

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Acute pancreatitis (summary)

Dr Jeremy Jones et al.

This is a summary article; read more in our article on acute pancreatitis.

clarify the diagnosis when the clinical picture is confusing

Abnormalities that may be seen in the pancreas include:

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