Pancreatitis

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Summary 1)First Aid: USMLE Step 1 by Tao Le2)Fundamentals of Pathology by Hussain Sattar

Pancreatitis is the inflammation and hemorrhage of the pancreas that results from overwhelmingly activated zymogens and proenzymes within the pancreas, leading to self-digestion.

Pathophysiology 3) Cleveland Clinic

The pathogenesis of AP has been studied extensively using animal models. Although different etiologies produce distinct inciting events, the final common pathway is premature activation of enzymes within the acinar cell. Ordinarily, pancreatic proenzymes become activated on release within the duodenum. Pancreatitis results when activation of pancreatic enzymes occurs early within the acinar cells, producing autodigestion of the pancreas and surrounding tissues. Exposure of trypsinogen to lysosomal enzymes such as cathepsin B has been shown as a mechanism for early trypsin activation.

Causes 4)First Aid: USMLE Step 1 by Tao Le5)Wikipedia

  • Alcohol 
  • Gallstones
  • Medications – corticosteroids such as prednisolone, but also including the HIV drugs didanosine and pentamidine, diuretics, the anticonvulsant valproic acid, the chemotherapeutic agents L-asparaginase and azathioprine, estrogen by way of increased blood triglycerides, and antihyperglycemic agents like metformin, vildagliptin, and sitagliptin
  • Infectious agents  bacteria, viruses, fungi and parasites 
  • Trauma

Symptoms 6)USMLE Step 1 Secrets by Thomas Brown7)Wikipedia

  • Severe upper abdominal pain (epigastric pain) or left upper quadrant burning pain radiating to the back 
  • Nausea and vomiting that is worsened with eating

Acute hemmoragic pancreatitis

Diagnosis 8)Wikipedia9)Cleveland Clinic

  • Laboratory results elevated blood amylase and lipase levels  three times upper limit of normal 
  • Abdominal ultrasound – shows an inflamed pancreas clearly

Treatment 10) Cleveland Clinic

  • Morphine – suitable for pain control
  • Supportive Care – fluid resuscitation and nutritional support

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