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pancreatitis (chronic (signs and symptoms (episododic abdo pain, radiates…
pancreatitis
acute
definition: inflammation and hemorrhaging caused by pancreatic enzyme activation. Usually reversible
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Signs and symptoms
upper abdo pain, radiates to back (50%). Sudden pain in gall stone pancreatitis, slower in alcoholic pancreatitis
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Shallow breathing, nausea, vomitting
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investigations
Serum markers - amylase 3x more than upper limit, lipase (specific for pancreatitis)
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management
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NBM if severe, hospitalisation, analgesia (no morphine - increases pressure on sphinchter of Oddi - makes pancreatitis worse
aetiology - alcohol abuse, gall stones, biliary tract disease, IGETSMASHED
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chronic
definition - persistent inflammation due to structural damage (fibrosis, calcification or atrophy) and ductal strictures (or due to continuous acute pancreatitis) - usually irreversible
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aetiology - 15-20% idiopathic, less commonly caused by alcohol. Hereditary, autoimmune, obstruction of pancreatic duct, CF (most common cause in children), topical pancreatitis
risk factor - acute pancreatitis, CF especially in children, alcohol, obesity
signs and symptoms
episododic abdo pain, radiates to back, epigastric- some have no pain but have malabsorption, weight loss, vitamin deficiency- A, D, E and K(fat soluble that cannot be digested - pass straight to stool) - steatorrhea
investigations - Elevated lipase and amylase, abdo X ray and CT to show structural changes, ERCP, MRCP
management - managing pain and controlling risk factors, replace digestive enzymes, nutritional supplements
Complications - Diabetes mellitus, pseudocysts, pancreatic cancer
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