Pancreatitis and Pancreatic Cancer

Pancreatitis is really common in clinical surgical practice. Here we discuss everything that you need to know about.

 

Lecture by

Video Duration: 28 minutes

  • Acute Pancreatitis
    Created by Dr Ed Wallitt
    General
    Epidemiology

    Common on surgical take (1% surgical admissions). 10% mortality

    Pathology

    Insult leads to release of pancreated enzymes which causes 'internal autodigestion'

    Top three causes

    EtOH abuse, gallstones, idiopathic (20%)

    Clinical Features
    Symptoms

    Unwell patient +/- signs of shock. Epigastric tenderness. Absent bowel sounds (ileus), ecchymoses (Grey Turners, Cullens)

    Signs

    Generally unwell with vomiting and severe upper abdominal pain radiating to back (classically relieved by sitting forwards)

    Investigations
    Cultures

    Urine dipstick (everyone gets one)

    Bloods

    ABG

    FBC (elevated WCC), U&Es (dehydration and renal failure), LFT (elevated ALT and AST), reduced calcium, elevated glucose, CRP

    Imaging

    Ultrasound (? gallstones), Contrast CT

    Scopic/Biopsy

    None

    Functional

    None

    Treatment
    Conservative

    Support with analgesia and IV fluids (keep up urine output), NBM. NGT if vomiting

    Medical

    Antibiotics only if infection. ERCP if dilated pancreatic ducts.

    Surgical

    Rare. usually done for infected necrosis or pseudocyst.