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    Acute Pancreatitis

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    Choirina Qomariah
    1. Acute pancreatitis has various causes like gallstones, alcohol abuse, hyperlipidemia, and certain drugs. It presents with upper abdominal pain, vomiting, and elevated pancreatic enzymes. 2. Ranson's score and APACHE II score are used to classify pancreatitis severity based on clinical signs within 48 hours of admission. A Ranson's score of 3 or more indicates more severe disease. 3. Acute pancreatitis can lead to local complications like pancreatic abscesses or pseudocysts, and systemic complications including respiratory failure, renal failure, and shock. Management involves supportive care, ERCP for gallstone-related cases, and drainage of infected necrosis.

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    Acute Pancreatitis

    Uploaded by

    Choirina Qomariah
    768 views11 pages
    1. Acute pancreatitis has various causes like gallstones, alcohol abuse, hyperlipidemia, and certain drugs. It presents with upper abdominal pain, vomiting, and elevated pancreatic enzymes. 2. Ranson's score and APACHE II score are used to classify pancreatitis severity based on clinical signs within 48 hours of admission. A Ranson's score of 3 or more indicates more severe disease. 3. Acute pancreatitis can lead to local complications like pancreatic abscesses or pseudocysts, and systemic complications including respiratory failure, renal failure, and shock. Management involves supportive care, ERCP for gallstone-related cases, and drainage of infected necrosis.

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    1. Acute pancreatitis has various causes like gallstones, alcohol abuse, hyperlipidemia, and certain drugs. It presents with upper abdominal pain, vomiting, and elevated pancreatic enzymes. 2. Ranson's score and APACHE II score are used to classify pancreatitis severity based on clinical signs within 48 hours of admission. A Ranson's score of 3 or more indicates more severe disease. 3. Acute pancreatitis can lead to local complications like pancreatic abscesses or pseudocysts, and systemic complications including respiratory failure, renal failure, and shock. Management involves supportive care, ERCP for gallstone-related cases, and drainage of infected necrosis.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    768 views11 pages

    Acute Pancreatitis

    Uploaded by

    Choirina Qomariah
    1. Acute pancreatitis has various causes like gallstones, alcohol abuse, hyperlipidemia, and certain drugs. It presents with upper abdominal pain, vomiting, and elevated pancreatic enzymes. 2. Ranson's score and APACHE II score are used to classify pancreatitis severity based on clinical signs within 48 hours of admission. A Ranson's score of 3 or more indicates more severe disease. 3. Acute pancreatitis can lead to local complications like pancreatic abscesses or pseudocysts, and systemic complications including respiratory failure, renal failure, and shock. Management involves supportive care, ERCP for gallstone-related cases, and drainage of infected necrosis.

    Copyright:

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    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 11

    Acute Pancreatitis

    dr. Isbandiyah, SpPD FK UMM

    CAUSES OF ACUTE NECROTIZING PANCREATITIS.

    Most common

    Less common

    Choledocholithiasis Ethanol abuse Idiopathic Post Endoscopic retrograde cholangiopancreatography Hyperlipidemia hypercalcemia Drugs (azathioprine, sulfonamides, thiazide, methildopa, estrogen, NSAID) Pancreas divisum Abdominal trauma Hereditary (familial)

    Least common

    Clinical Manifestations

    Acute pancreatitis usually has a rapid onset Acute pancreatitis may be clinically mild or severe Manifested by upper abdominal pain, vomiting, fever, tachycardia, leukocytosis, and elevated serum levels of pancreatic enzymes

    Diagnose

    Clinical manifestations Lab. Finding USG CT-scan

    CLASSIFICATION

    Classifications for acute pancreatitis are used to identify patients at risk for complications. Ransons score is based on 11 clinical signs with prognostic importance; 5 are measured at the time of admission and the other 6 in the first 48 hours after admission Acute Physiology and Chronic Health Evaluation (APACHE II) score

    Ransons score

    Ransons score 3 (Ransons criteria of severity: at admission)


    Age >55 yr, white-cell count >16,000/mm3 blood glucose >200 mg/dl (11.1 mmol/liter), serum LDH >350 IU/liter serum AST >250 IU/liter

    During initial 48 hr

    absolute decrease in hematocrit >10%, increase in blood urea nitrogen >5 mg/dl (1.8 mmol/liter), serum calcium <8 mg/dl (2 mmol/liter), arterial PaO2 <60 mm Hg, base deficit >4 mmol/liter, fluid sequestration >6 liters

    APACHE II
    A. Acute physiology score Temperature-rectal Mean arterial pressure Heart rate Respiratory rate Oxygenation Arterial PH Serum sodium Serum potasium Hematocrit White blood count GCS Serum HCO3 B. Age points < 44 45-54 55-64 64-74 >75 0 2 3 5 6

    C. Chronic health points (history of severe organ system insufficiency)

    Complication

    Systemic complications
    Acute respiratory distress syndrome Acute renal failure, Shock, Coagulopathy, Hyperglycemia, and hypocalcemia.

    Local complications
    Gastrointestinal bleeding Infected necrosis, Adjacent bowel necrosis. pancreatic abscess Pancreatic pseudocysts.

    MANAGEMENT

    Supportive care

    Analgesics Antibiotics Fasting Nutritional support (parenteral nutrition, or enteral feeding by nasoenteric tube)

    Endoscopic retrograde cholangiopancreatography (ERCP) and biliary sphincterotomy in patients with acute gallstone pancreatitis and choledocholithiasis
    Dbridement of infected necrosis
    Operative management (explorative and drainage) Alternative techniques of dbridement (percutaneous or endoscopic)

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