Acute Pancreatitis Assessment
- Heavy Alcohol Use and Gallstones
- Abdominal Pain
- Nausea/Vomiting/Anorexia
- Abdominal Rigidity/Guarding
- Decreased or Absent Bowel Sounds
- Hypotension and Tachycardia
- Jaundice
- Increased White Blood Cells
Acute Pancreatitis Disease
- Autodigestion of Pancreas by Pancreatic Enzymes
- Epigastric Abdominal Pain Radiating to Back
- Anorexia
- Nausea
- Increased Amylase and Lipase
- Disseminated Intravascular Coagulation (DIC)
- Infection
- Hypocalcemia
- Systemic Inflammatory Response Syndrome (SIRS)
- Acute Respiratory Distress Syndrome (ARDS)
- Pancreatic Pseudocyst
- Hemorrhage
Acute Pancreatitis Causes
- "GET SMASHHED" Mnemonic
- Gallstones
- (Ethanol) Alcohol
- Trauma
- Steroids
- Mumps
- Autoimmune
- Scorpion Sting
- Hypercalcemia
- Hypertriglyceridemia > 1000
- ERCP
- Drugs
Acute Pancreatitis Interventions
- NPO with NG Tube to Suction
- Pain Management
- Albumin
- Lactated Ringers Solution
- Proton Pump Inhibitor (PPI)
- Antibiotics
- Surgery
- Nutrition
Ranson's Criteria on Admission
- Mortality Predictor for Acute Pancreatitis
- GA LAW (Each is +1)
- Glucose > 200 mg/dL
- Age > 55 Years
- LDH > 350 U/L
- AST > 250 U/L
- WBC Count > 16,000/mm3
Ransons Criteria During First 48 Hours
- Mortality Predictor for Acute Pancreatitis
- C HOBBS (Each is +1)
- Calcium < 8.0 mg/dL
- Hematocrit Decreased by > 10%
- Oxygen (PO2) < 60 mmHg
- BUN Increased by Greater or Equal to 5 mg/dL
- Base Deficit > 4 mEq/L
- Sequestered Fluid > 6 L
Zollinger-Ellison Syndrome Disease
- Gastrin-Secreting Tumor
- Increased Gastric Acid
- Recurrent Peptic Ulcers
- MEN Type 1
- Abdominal Pain
- Heartburn (Pyrosis)
- Diarrhea
Zollinger-Ellison Syndrome Diagnosis and Treatment
- Gastrin > 1000 pg/mL
- Positive Secretin Stimulation Test
- High-Dose PPI
- Octreotide
- Surgical Resection
Pancreatic Adenocarcinoma Diagnosis and Treatment
- CA 19-9
- Liver Function Tests for Cholestasis
- Serum Lipase
- Ultrasound if Cholestasis Suspected
- CT Abdomen
- FNA Biopsy if Diagnosis or Resectability Uncertain
- Whipple if Resectable
- Palliative Care if Not Resectable
Pancreatic Adenocarcinoma Symptoms and Risk Factors
- Abdominal Pain
- Anorexia and Weight Loss
- Migratory Superficial Thrombophlebitis
- New-Onset Diabetes
- Jaundice
- Steatorrhea
- White Stool
- Palpable but Non-tender Gall Bladder
- Elderly
- Chronic Pancreatitis
- Smoking
- Alcoholism
- Diabetes
VIPoma
- Pancreatic Neuroendocrine Tumor
- Secretes Vasoactive Intestinal Polypeptide (VIP)
- GI Distress
- Watery Diarrhea
- Hypokalemia
- Achlorhydria
- Octreotide
- Surgical Resection
- Multiple Endocrine Neoplasia Type 1 (MEN 1)
Somatostatinoma
- Pancreatic Neuroendocrine Tumor
- Originates from Delta Cells
- Steatorrhea
- Gallstones
- Hyperglycemia
- Increased Somatostatin
- Abdominal CT or MRI
- Octreotide
- Surgical Resection
- Chemotherapy
Glucagonoma
- Pancreatic Neuroendocine Tumor
- Originates from A Cells
- Weight Loss
- Necrolytic Migratory Erythema
- Depression
- Diarrhea
- Deep Vein Thrombosis
- Diabetes Mellitus
- Increased Glucagon
- Abdominal CT
- Octreotide
- Surgical Resection
Insulinoma
- Pancreatic Neuroendocrine Tumor
- Benign
- Associated with MEN-1
- Whipple Triad
- Symptoms of Hypoglycemia
- Hypoglycemia During Episode
- Relief with Glucose
- Increased C-peptide
- Surgery
- Octreotide
- Diazoxide
Annular Pancreas
- Congenital Anomaly
- Fusion of Ventral and Dorsal Pancreatic Buds
- Circumferential Duodenal Compression
- Down Syndrome
- Polyhydramnios
- Poor Feeding
- Vomiting
- Double Bubble Sign
- Surgery