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Pancreatic Pathology
Acute Pancreatitis Assessment
Mechanism
Heavy Alcohol Use and Gallstones
Signs and Symptoms
Abdominal Pain
Nausea/Vomiting/Anorexia
Abdominal Rigidity/Guarding
Decreased or Absent Bowel Sounds
Hypotension and Tachycardia
Jaundice
Increased White Blood Cells
2 mins
Acute Pancreatitis Disease
Autodigestion of Pancreas by Pancreatic Enzymes
Symptoms
Epigastric Abdominal Pain Radiating to Back
Anorexia
Nausea
Labs
Increased Amylase and Lipase
Complications
Disseminated Intravascular Coagulation (DIC)
Infection
Hypocalcemia
Systemic Inflammatory Response Syndrome (SIRS)
Acute Respiratory Distress Syndrome (ARDS)
Pancreatic Pseudocyst
Hemorrhage
3 mins
Acute Pancreatitis Causes
"GET SMASHHED" Mnemonic
Gallstones
(Ethanol) Alcohol
Trauma
Steroids
Mumps
Autoimmune
Scorpion Sting
Hypercalcemia
Hypertriglyceridemia > 1000
ERCP
Drugs
1 min
Acute Pancreatitis Interventions
NPO with NG Tube to Suction
Pain Management
Albumin
Lactated Ringers Solution
Proton Pump Inhibitor (PPI)
Antibiotics
Surgery
Nutrition
2 mins
Ranson's Criteria on Admission
Use
Mortality Predictor for Acute Pancreatitis
Criteria on Admission
GA LAW (Each is +1)
Glucose > 200 mg/dL
Age > 55 Years
LDH > 350 U/L
AST > 250 U/L
WBC Count > 16,000/mm3
2 mins
Ransons Criteria During First 48 Hours
Use
Mortality Predictor for Acute Pancreatitis
Criteria Present at 48 Hours
C HOBBS (Each is +1)
Calcium < 8.0 mg/dL
Hematocrit Decreased by > 10%
Oxygen (PO2) < 60 mmHg
BUN Increased by Greater or Equal to 5 mg/dL
Base Deficit > 4 mEq/L
Sequestered Fluid > 6 L
3 mins
Zollinger-Ellison Syndrome Disease
Pathophysiology
Gastrin-Secreting Tumor
Increased Gastric Acid
Recurrent Peptic Ulcers
MEN Type 1
Symptoms
Abdominal Pain
Heartburn (Pyrosis)
Diarrhea
3 mins
Zollinger-Ellison Syndrome Diagnosis and Treatment
Diagnosis
Gastrin > 1000 pg/mL
Positive Secretin Stimulation Test
Treatment
High-Dose PPI
Octreotide
Surgical Resection
3 mins
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