Smitha Abraham Case 1.

3 Helen Bartlett Pancreatitis Definition: Inflammation of the pancreas can be acute or chronic

from: aca emic.!ello"".e u #he pancreas is a lar"e "lan behin the stomach an close to the uo enum$the first part of the small intestine. #he pancreas secretes i"esti%e &uices' or en()mes' into the uo enum throu"h a tube calle the pancreatic uct. Pancreatic en()mes &oin *ith bile $a li+ui pro uce in the li%er an store in the "allbla er$to i"est foo . #he pancreas also releases the hormones insulin an "luca"on into the bloo stream. #hese hormones help the bo ) re"ulate the "lucose it ta!es from foo for ener").

Acute Pancreatitis: - inflammation of the pancreas that occurs su enl) an usuall) resol%es in a fe* a)s *ith treatment - #he most common cause of acute pancreatitis is the presence of "allstones$small' pebble-li!e substances ma e of har ene bile$that cause inflammation in the pancreas as the) pass throu"h the common bile uct - Chronic' hea%) alcohol use is also a common cause - ,ther causes of acute pancreatitis inclu e ab ominal trauma' me ications' infections' tumors' an "enetic abnormalities of the pancreas S)mptoms: Acute pancreatitis usuall) be"ins *ith "ra ual or su en pain in the upper ab omen that sometimes e-ten s throu"h the bac!. #he pain ma) be mil at first an feel *orse after eatin". But the pain is often se%ere an ma) become constant an last for se%eral a)s. ,ther s)mptoms ma) inclu e:

o a s*ollen an ten er ab omen o nausea an %omitin" o .e%er o a rapi pulse Se%ere acute pancreatitis ma) cause eh) ration an lo* bloo pressure. #he heart' lun"s' or !i ne)s can fail If blee in" occurs in the pancreas' shoc! an e%en eath ma) follo*

Dia"nosis: - the bloo contains at least three times the normal amount of am)lase an lipase' i"esti%e en()mes forme in the pancreas - ,ther metho s to ia"nose pancreatitis: o Ab ominal ultrasoun -Soun *a%es are sent to*ar the pancreas throu"h a han hel e%ice that "li es o%er the ab omen. #he soun *a%es bounce off the pancreas' "allbla er' li%er' an other or"ans' an their echoes ma!e electrical impulses that create a picture$calle a sono"ram$on a %i eo monitor. If "allstones are causin" inflammation' the soun *a%es *ill also bounce off them' sho*in" their location o Computeri(e tomo"raph) /C#0 scan. #he C# scan is a nonin%asi%e - ra) that pro uces three- imensional pictures of parts of the bo ). #he person lies on a table that sli es into a onut-shape machine. #he test ma) sho* "allstones an the e-tent of ama"e to the pancreas o 1n oscopic ultrasoun /12S0. After spra)in" a solution to numb the patient3s throat' insertion of an en oscope$a thin' fle-ible' li"hte tube$ o*n the throat' throu"h the stomach' an into the small intestine. An ultrasoun attachment to the scope pro uces soun *a%es to create %isual ima"es of the pancreas an bile ucts o 4a"netic resonance cholan"iopancreato"raph) /45CP0. 45CP uses ma"netic resonance ima"in"' a nonin%asi%e test that pro uces cross-section ima"es of parts of the bo ). After bein" li"htl) se ate ' the patient lies in a c)lin er-li!e tube for the test. In&ection of a )e into the patient3s %eins helps sho* the pancreas' "allbla er' an pancreatic an bile ucts #reatment: intra%enous /I60 flui s' antibiotics' an me ication to relie%e pain Chronic Pancreatitis: inflammation of the pancreas that oes not heal or impro%e$it "ets *orse o%er time an lea s to permanent ama"e often e%elops in people *ho are bet*een the a"es of 37 an 87 #he most common cause of chronic pancreatitis is man) )ears of hea%) alcohol use #he chronic form of pancreatitis can be tri""ere b) one acute attac! that ama"es the pancreatic uct. #he ama"e uct causes the pancreas to become inflame . Scar tissue e%elops an the pancreas is slo*l) estro)e . ,ther causes of chronic pancreatitis are:

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o o o o S)mptoms: - upper ab ominal pain' althou"h some people ha%e no pain at all - #he pain ma) sprea to the bac!' feel *orse *hen eatin" or rin!in"' an become constant an isablin" - In some cases' ab ominal pain "oes a*a) as the con ition *orsens' most li!el) because the pancreas is no lon"er ma!in" i"esti%e en()mes - ,ther s)mptoms inclu e: o nausea o %omitin" o *ei"ht loss o iarrhea o oil) stools - People *ith chronic pancreatitis often lose *ei"ht' e%en *hen their appetite an eatin" habits are normal. #he *ei"ht loss occurs because the bo ) oes not secrete enou"h pancreatic en()mes to i"est foo ' so nutrients are not absorbe normall) - Poor i"estion lea s to malnutrition ue to e-cretion of fat in the stool #reatment: - 4a) re+uire hospitali(ation for pain mana"ement' I6 h) ration' an nutritional support - 9aso"astric fee in"s for those *ho continue to lose *ei"ht - S)nthetic pancreatic en()mes' if pancreas cannot secrete enou"h of its o*n Complications: - Diabetes ma) e%elop because beta cells' *hich pro uce insulin' is ama"e . Pancreatitis in chil ren is rare. #rauma to pancreas an here itar) pancreatitis ma) be some causes of pancreatitis in chil ren. Chil ren *ith c)stic fibrosis ma) be at ris! for e%elopin" pancreatitis. 51.1519C1S: :umar' Cotran' 5obbins' Basic Patholo") ;th e . P"s <<=-<;> 4cPhee' Papa a!is' >711 Current 4e ical Dia"nosis ? #reatment' p"s. ;=8-;@>

here itar) isor ers of the pancreas c)stic fibrosis$the most common inherite isor er lea in" to chronic pancreatitis h)percalcemia$hi"h le%els of calcium in the bloo h)perlipi emia or h)pertri"l)ceri emia$hi"h le%els of bloo fats some me icines certain autoimmune con itions