Pancreatitis

Pancreatitis

1. anatomy of the pancreas

   • physiology
     • causes of pancreatitis
       • how does it happen? pathophysiology
         • Investigations
           • Management
             • Prognosis & Epidemiology
               • Acute pancreatitis can be very serious, even life threatening, but most patients can expect complete recovery.
               • Acute pancreatitis can become chronic if pancreatic tissue sustains damage and scarring occurs
             • fluid resuscitation
             • nutritional support
             • pain control
               • analgesics
           • pancreatic enzymes
             • Serum amylase
             • Serum lipase
               • Serum immunoreactive trypsin (SIT)
                 • Decreased fecal elastase
           • Radiologic Studies
             • Transabdominal ultrasound
             • MRI and magnetic resonance cholangiopancreatography (MRCP)
             • Endoscopic retrograde cholangiopancreatography (ERCP)
         • • leading to these signs and symptoms
             • Upper abdominal pain
             • Abdominal pain that radiates to your back
             • Abdominal pain that feels worse after eating
             • Fever
             • Nausea
             • Tenderness when touching the abdomen
               • ACUTE ABDOMEN
                 • causes
             • Rapid pulse
           • leading to these complications
             • SIRS (systemic inflammatory response syndrome)
             • Pseudocyst
               • surgical treatment
             • Infected pancreatic necrosis
             • Secondary DM
             • Septic shock
             • Peritonitis
       • " I get smashed "
         • Alcoholism
         • Gall stones
         • Medications (thiazides)
         • Hypertriglyceridemia hypercalcemia
         • Infections: mumps, coxackie, CMV
         • Acute ischemia (shock)
         • Trauma, blunt,
         • iatrogenic Genes: PRSS1, SPINK1
         • Idiopathic, 10-20%
     • controlled by CCK and vagal stimulation
       • neutralizes acid in lumen
         • digests fat and protein products
       • CO2 diffuses to the interior of the cell from blood (carbonic anhydrase).
         • CO2 combines water to form carbonic acid.
           • It, in turn, dissociates into bicarbonate ions and hydrogen ions.
             • H+ are exchanged for sodium which supplies the sodium ions → ductal lumen → electrical neutrality.
   • Histology

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