AcutePancreatitis.docx - Acute Pancreatitis Lena...

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Acute Pancreatitis Lena Cardinal/Katie Anderson Sorry this is so long, but it is a huge topic and really interesting, plus it has relevance to our case, and there are new labs and diagnostics in here. Definition There are two basic types of acute pancreatitis Edematous pancreatitis (80%); usually self-limiting and mild Necrotizing pancreatitis (20%); can lead to permanent endocrine & exocrine dysfunction; has a mortality rate of up to 30% More common in African Americans Acute pancreatitis is relatively common in the US Affects about 300,000 patients annually Mortality rate of 7% (20,000/year) Differential Diagnosis Perforated peptic ulcer Acute cholecystitis and biliary colic Acute intestinal obstruction Mesenteric vascular occlusion Renal colic MI Dissecting aortic aneurysm Connective tissue disorders with intraabdominal vasculitis Pneumonia Diabetic ketoacidosis Causes/Risk Factors 75% is caused by gallstones or alcohol Other causes include: Hypertriglyceridemia Associated w/extremely high (at least 1000 mg/dL & usually higher) levels of triglycerides Medication toxicity Trauma from endoscopic retrograde cholangiopancreatography (2%) Hypercalcemia Proposed pathophysiologic mechanisms include calcium deposition within the pancreatic duct or trypsinogen activation induced by calcium Abdominal trauma Various infections Autoimmune Sjogren’s syndrome, for one AIDS
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Certain medications (trimethoprim-sulfamethoxazole is one – AND – one we should currently be aware of for treating cystitis; tetracycline, and some unspecified oral contraceptives) Ischemia Pancreatic cancer Renal failure Hereditary causes Children with inherited disorders of metabolism; types I and V hyperlipidemia) Poorly controlled diabetics 15% cases are idiopathic Scorpion Venom (I just had to include this – scorpions in Brazil and Trinidad cause this – in case you are the adventurous type!) (Cool!). Presentation
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AcutePancreatitis.docx - Acute Pancreatitis Lena...

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