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Binge Brings Pain, Due to, image, image, f9adf32adbf2b66 150x58, image -…

- - - - 2nd Duodenum
    - - Where SMA/SMV run
    - - Part of splenorenal ligament
- - - - 2 Types
        
        Alcoholism
        
        Defined as
        
        Consumption of > 14 drinks per week or > 4 drinks per day for men < 65 y
        
        Consumption of > 7 drinks per week or > 3 drinks per day for women of any age and men > 65 years of age
        
        Heavy drinker
        
        Defines as
        
        Consume large amount of alcohol but does not met the AUD criteria
      - Effect of alcohol on GI
        
        Ductal obstruction
        
        Fatty liver
        
        Cirrhosis
        
        Oxidative stress
  - - - Anxiety
    - - Seizure and hallucination
    - - Delirium
- - - - Vagal Ach activity stimulation
        
        Stimulate Ductal cells
        
        secerte HCO3-
        
        Stimulate Acinar cells
        
        digestive enzymes
  - - - Vagus stimulation
        
        Gastrin stimulation
        
        Acinar cells activation through gasterin and cck
        
        ACH receptors activation
        
        acinar cells activation though ach
  - - - vagovegal reflex
        
        ACH receptors activation
        
        stimulation of acinar cells and ductal cells
      - I cells activation
        
        CCK
        
        stimulate acinar cells
        
        digestive enzymes seceretion
      - H+ in lumen
        
        S cells activation
        
        Secertin
        
        Stimulate ductal cells
        
        Bicarbonate seceretion
  - - - Intestinal distension or irritation can also trigger local reflexes that can influence pancreatic
        secretion
- - - - Nausea and vomiting
      - Dyspnea
      - Fever
      - Severe persistent pain in epigastric region
    - - Gallstones
      - Alcohol
    - - Inappropriate activation of pancreatic enzyme
        
        Auto-digestion
        
        Necrosis and Adipose tissue
- - - - Amylase
      - Lipase
      - C-reactive protein
    - - Abdominal ultrasound
      - Abdominal CT
  - - - Means that there is excessive amount of fat in stool
    - - Exocrine pancreatic insufficiency
        
        Bile duct and liver disease
- - - - IV opiates;
        
        Morphine/ Fentanyl
      - 3: Nutritional support:
        
        Avoid oral feeding
        
        Nasogastric or nasojejunal tube
        
        4: Detailed personal history
        
        5: Physical examination
        
        6: Laboratory serum tests
        
        7: Imaging
        
        Delay it for day 2/3
        
        Look for the cause of AP
    - - Ringer's lactate