Acute Pancreatitis

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Acute Pancreatitis

• Aaron Hui
• Surgical Resident RMH

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Objectives

• Why learn about it?
• Clinical presentation
• Causes
• Diagnosis
• Treatment

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Why learn about it?

• It kills people!!!!

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Clinical Presentation

• Symptoms
• Abdominal pain (80-90)
• Nausea
• Vomiting
• Signs
• Abdominal tenderness/ peritonitis
• Fever
• Shock

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Causes

• Gallstones
• Alcohol
• other

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Diagnosis

• Blood tests
• (ABG)
• Abdominal xray
• Chest xray
• Abdominal U/S
• CT
• MRI/MRCP

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Severity

• Atlantic (moderate/severe)
• Ransons Criteria
• APACHE II

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Traumatic pancreatitis
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Pancreatic necrosis
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MRI- necrotising pancreatitis Day 7 after
admission. (A) Contrast-enhanced T1-weighted
axial MRI sections showing areas of hypoperfusion
in the head and body of the pancreas appearing as
zones of decreased signal intensity (arrow) and
peripancreatic acute fluid collection
(arrowhead). (B) T2-weighted coronal MRI sections
after secretin injection showing main pancreas
duct rupture (arrow).
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Treatment

• Dont underestimate severity
• Diagnosis
• ERCP/Cholecystectomy
• Moderate/severe
• Aggressive Fluid resuscitation
• Pain relief
• Look for complications
• Haemorrhage
• SIRS
• Multi-organ failure