Pancreatitis - Pancreatitis Dr Karan Wadhwa Mr JP 49 Sudden...

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Pancreatitis Dr Karan Wadhwa
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Mr JP 49 ♂ Sudden onset epigastric pain Radiates to back Relieved by sitting forward Nausea and Vomiting Fever
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PMH Known gallstones Heavy drinking (80-120 u a week) FH hypertriglyceridemia
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Examination Shocked : BP 90/50 HR 120 Cold, clammy, sweating profusely RR 35 Epigastric tenderness + guarding BS sluggish/tinkling
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Differential Diagnosis •Pancreatitis •Acute cholecystitis •Ascending cholangitis Perforated viscus •Intestinal obstruction •Ruptured AAA •Diverticulitis •Bowel Ischaemia •MI •Severe pneumonia •Appendicitis •Caecal perforation Ruptured ectopic
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Pancreas
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Function Exocrine precursor digestive enzymes lipases Endocrine metabolic hormones Insulin from β cells Glucagon from α cells
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Pancreatitis Inflammatory Destructive Self-perpetuating ‘third space’ fluid loss Rapidly progressing Can progress to haemorrhagic or necrotising pancreatitis
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Get Smashed! allstones
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Pancreatitis - Pancreatitis Dr Karan Wadhwa Mr JP 49 Sudden...

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