Acute Pancreatitis
Hello my name is dr tiwan s raja today i will discuss about acute pancreatitis acute pancreatitis is the acute inflammation of the pancreas acute pancreatitis is a reversible inflammatory disorder of the pancreas associated with activation of pancreatic enzymes we know that pancreas is exhibiting part and endocrine part and the part secret some enzyme that goes
Through the pancreatic duct united with that of the common bile duct and opens into the second part of the duodenum so there will be activation of pancreatic enzyme like pancreatic lipase amylase there will be auto digestion of pancreas that may happen if the passage is blocked then there will be collection of the pancreatic juice rich in pancreatic enzyme
That will start auto digestion of pancreas and there will be some of the surrounding tissue fat necrosis to hemorrhagic necrosis deposition of calcium soap over the pancreas sometimes formation of acidosis pseudosyst because this cyst is blood not lying by epithelium rather it is lined by the pancreatic parenchyma covered by fibrous tissue incidence of acute
Pancreatitis is 10 to 20 per 100 000 in western world so in that case it is not uncommon so 10 to 20 per 100 000 people in the western world suffer from equipment get diets what are the causes of egg white and pancake diet is alcoholic gallstone obstructing the pancreatic duct usually small gallstones okay hereditaries pancreatitis trauma abdominal surgery
Ercp endoscopic retrograde colon geo pen protocol medication like that of anti-cancer drug anti-gout drug as well as the diuretic drug may cause may cause a good pancake dietitians moms a viral infection that affects the period gland that affects the pancreas that affects the gonads okay metabolic digital like hypocalcemia ischemia it may be idiopathic we
Don’t know the cause of acute pancreatitis sometimes okay this is the pathogenesis that is taken from robin’s pathology we have dark oxygen this is the common bile duct this is the pancreatic type so there may be some blockage here and there will be stagnation of fluid here and these are the assign of the pancreatic pancreas so that may be damaged or destroyed
Okay here snr cell injury alcohol drug trauma ischemic virus condition release of interstellar pro-enzymes and lysosomal hydrolysis ultimately you have snr 73 like defective intercellular transport okay so they all lead to snr cell injury activated enzyme this is the enzyme they’ll be acute pancreatitis okay if we go to the equipped pancake that is what are the
Clinical features acute abdominal pain radiating to the back it is a severe pain guarding and hypoactive bowel sound this may be the sign of peritonitis the beginning shock and confusion fever tachycardia respiratory distress journeys is there is collection of fluid in the petroleum cavity hypocalcemia because calcium has been utilized around the pancreas so
First take sign so if we if you tap here facial muscle will react and that trousers sign if you add a blood pressure calf and if you hold it just above the system blood pressure for three minutes then there will be there will be flexion of the wrist flexion of the metacarpal phalangeal joint will happen okay and also you get a good pancreatitis into abdominal
Bleeding like colon sign around the anglicans umbilicus will get bluish side great arnold sign okay that is present around the loin area we’ll get some ecommerce is a bluish color these are indicative of some inter abdominal bleeding these are two features okay in acute pancreatitis what should be the diagnostic workout certainly pancreatic enzyme study serum
Myelin serum lipids imaging study like abdominal plain film ct scan of the abdomen mri of abdomen treatment nothing by mouth npo nastic suction allergic for pain analgesic for pain like even morphine ethidine correction of metabolic abnormality like the calcium antibiotic if there is any infection surgery in gallstone perforated peptic ulcer necrosis or
Infected foci if we have that over the pancreas then we need surgery surgery has very limited role role is this patient is managed through this surgery is secondary it has minimum role in pancreatitis chronic pancreatitis progressive fibrosis of the pancreatic panchema classification shito cyst again that cyst is not lined by the epithelium it is lined by the
Fibrous tissue and pancreatic cells history of alcoholism history of abdominal and back pain pancreatic insufficiency diabetes mellitus tutorial fair there is fat male absorption like vitamin a d e k is not able to absorb deficiency of fat soluble vitamin okay vitamin a deficiency causes what night blindness osteomalacia yes vitamin d is not absorbed properly
Then there will be osteomalacia hemorrhage it is related to vitamin k mostly you
Transcribed from video
Acute and Chronic Pancreatitis By Dewan Raja