Acute Pancreatitis

Causes
  • G – Gallstones
  • E – ETOH
  • T – Trauma
  • S – Steroids
  • M – Mumps
  • A – Autoimmune
  • S – Scorpion Stings
  • H – Hypertriglyceridemia
  • D – Drugs
    • Immunosuppressants
    • HIV medication
    • Diuretics
    • Seizure medications
    • Antibiotics
Treatment
  • Analgesics
    • Do not use MS, as it causes spasms in the sphincter of oddi
  • Normal Saline
  • Replace lost electrolytes
  • Bowel Rest
  • Possible NG tube
  • TPN if bowel rest is prolonged
  • Antibiotics
Symptoms
  • Severe midepigastric pain
  • Pain which radiates to the flanks
  • Nausea / Vomiting
  • Grey Turner’s Sign (Bruising on the flanks)
  • Cullen’s Sign (Bruising around the umbilicus)
Labs
  • Elevated Lipase (specific to pancreatitis)
  • Elevated Amylase (also found in the mouth and esophagus, not specific to pancreas)
  • Hypocalcemia
Imaging
  • Abdominal X-Ray (sentinel loop)
  • CT Scan
  • Ultrasound (for possible obstruction)
Pancreatic Pseudocyst

Can form after an episode of acute pancreatitis; cyst often times fills with copious amounts of Amylase. Labs may show elevated Amylase but a normal Lypase, this can indicate that a pancreatic pseudocyst may of formed. This cyst is considered “pseudo” as its lining does not consist of epithelial cells. The cyst forms a sac which forms off of the pancreas.