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Acute Pancreatitis Assessment

Acute-angle Pancreas-on-fire with Assess-man
Picmonic
Acute pancreatitis is an acute inflammation of the pancreas commonly caused by gallbladder disease or chronic alcohol intake. Symptoms often include abdominal pain, nausea, vomiting, anorexia, abdominal guarding and rigidity, decreased or absent bowel sounds. Elevated WBCs, generalized jaundice, and hypotension and tachycardia may also be present. Smoking is considered a risk factor.
8 KEY FACTS
MECHANISM
Heavy Alcohol Use and Gallstones
Many Alcoholic-martinis and Gold-stones

In the majority of cases, acute pancreatitis is caused by heavy alcohol use and gallstones. Be sure to review our Picmonic on Acute Pancreatitis Causes for more etiologies.

SIGNS AND SYMPTOMS
Abdominal Pain
Abdominal Pain-bolt

Abdominal pain is usually epigastric and commonly radiates to the back because of the retroperitoneal location of the pancreas. This pain is due to distention of the pancreas, peritoneal irritation, and obstruction of the biliary tract. It typically has a sudden onset and is described as severe, deep, piercing, and continuous or steady. 

Nausea/Vomiting/Anorexia
Vomiting Anorexic-Rex

Patients may complain of nausea, vomiting, and anorexia, which can lead to weight loss.

Abdominal Rigidity/Guarding
Stone Abdomen being Guarded

Abdominal tenderness with muscle guarding is common as is a rigid, board-like abdomen.

Decreased or Absent Bowel Sounds
Down-arrow Bowel-bowl Stethoscope

Bowel sounds may become decreased or even absent, so be sure to perform a thorough gastrointestinal assessment.

Hypotension and Tachycardia
Hippo-BP with Tac-heart-card

Hypotension and tachycardia may be present in some patients. It is important to monitor for these symptoms, because life-threatening shock can occur as a result of pancreatic hemorrhage, excessive fluid volume shifts, or toxic effects of abdominal sepsis from enzyme damage.

Jaundice
Jaundice-janitor

Jaundice, or yellowing of the skin, can occur and is typically generalized. Additionally, other skin assessments to look for include Grey Turner’s spots or sign (a bluish flank discoloration on the flanks) and Cullen’s sign (a bluish periumbilical discoloration on the periumbilical area).

Increased White Blood Cells
Up-arrow White Mac-man

Elevated white blood cells, also known as leukocytosis, is another assessment finding. This may be accompanied by a low grade fever.

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