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.
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.
Patients may complain of nausea, vomiting, and anorexia, which can lead to weight loss.
Abdominal tenderness with muscle guarding is common as is a rigid, board-like abdomen.
Bowel sounds may become decreased or even absent, so be sure to perform a thorough gastrointestinal assessment.
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, 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).
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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