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Pancreatitis_Study_Notes

Pancreatitis is the inflammation of the pancreas due to premature activation of enzymes, leading to autodigestion. It can be classified into acute and chronic forms, with acute pancreatitis commonly caused by gallstones and chronic pancreatitis often linked to alcohol use. Diagnosis involves increased serum amylase and lipase levels, while management includes pain control, IV fluids, and addressing underlying causes.

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2 views4 pages

Pancreatitis_Study_Notes

Pancreatitis is the inflammation of the pancreas due to premature activation of enzymes, leading to autodigestion. It can be classified into acute and chronic forms, with acute pancreatitis commonly caused by gallstones and chronic pancreatitis often linked to alcohol use. Diagnosis involves increased serum amylase and lipase levels, while management includes pain control, IV fluids, and addressing underlying causes.

Uploaded by

shoaibfarooqui418
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd

PANCREATITIS - STUDY NOTES (Exam & Clinical

Focused)

Definition:
Pancreatitis is inflammation of the pancreas caused by premature activation of pancreatic enzymes,
leading to autodigestion of pancreatic tissue.

Types:
1. Acute Pancreatitis
2. Chronic Pancreatitis

Etiology (Causes of Acute Pancreatitis – I GET SMASHED):


I – Idiopathic
G – Gallstones (Most common)
E – Ethanol (Alcohol)
T – Trauma
S – Steroids
M – Mumps
A – Autoimmune
S – Scorpion sting
H – Hypertriglyceridemia / Hypercalcemia
E – ERCP
D – Drugs (Azathioprine, Thiazides)

Chronic Pancreatitis Causes:


• Alcohol (Most common)
• Tropical pancreatitis
• Smoking
• Genetic (CFTR mutation)
• Autoimmune

Pathophysiology:
Premature activation of trypsin inside the pancreas leads to autodigestion, inflammation, edema,
necrosis, and systemic inflammatory response.

Clinical Features:
Acute:
• Severe epigastric pain radiating to back
• Nausea and vomiting
• Fever
• Abdominal tenderness
• Pain relieved by leaning forward

Signs:
• Cullen’s sign – Periumbilical discoloration
• Grey Turner’s sign – Flank bruising

Chronic:
• Recurrent abdominal pain
• Weight loss
• Steatorrhea (fatty stools)
• Diabetes mellitus

Diagnosis:
Laboratory:
• Increased Serum Amylase
• Increased Serum Lipase (Most specific)
• Increased CRP
• LFT (if gallstones suspected)
• Serum Calcium and Triglycerides

Imaging:
• USG Abdomen – Gallstones
• CECT Abdomen – Gold standard for severity
• MRCP – Ductal anomalies

Severity Assessment:
• Ranson’s Criteria
• BISAP Score
• APACHE II

Complications:
Local:
• Pancreatic pseudocyst
• Necrosis
• Abscess
• Hemorrhage

Systemic:
• Shock
• ARDS
• Acute Kidney Injury
• Sepsis
• DIC

Management of Acute Pancreatitis (PANCREAS):


P – Pain control (Opioids)
A – Aggressive IV fluids (Ringer’s lactate)
N – NPO (Nil per oral)
C – Correct electrolytes
R – Remove cause (ERCP for gallstones)
E – Enteral feeding (early)
A – Antibiotics (if infection)
S – Surgery (if complications)

Chronic Pancreatitis Management:


• Stop alcohol and smoking
• Pancreatic enzyme supplements
• Analgesics
• Insulin if diabetic
• Fat-soluble vitamin supplements
• Surgery if severe

Difference Between Acute and Chronic Pancreatitis:


Acute – Sudden onset, reversible, severe pain, high enzymes, diabetes rare
Chronic – Gradual onset, irreversible, recurrent pain, normal/slightly high enzymes, diabetes
common

Exam Pearls:
• Most common cause of acute pancreatitis – Gallstones
• Most specific test – Serum Lipase
• Gold standard imaging – CECT Abdomen
• Steatorrhea indicates chronic pancreatitis

Quick Revision Box:


Pancreatitis pain is relieved by leaning forward and worsened in supine position.

Prepared for:
MBBS | FMG | Nursing | Clinical Revision

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