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Pancreatitis

Pancreatitis is a topic covered in the 5-Minute Emergency Consult.

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Emergency Central

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Basics

Description

  • Inflammation of pancreas due to activation, interstitial liberation, and digestion of gland by its ownenzymes
  • Acute pancreatitis:
    • Exocrine and endocrine function of gland impaired for weeks to months
    • Glandular function will return to normal.
  • Chronic pancreatitis:
    • Exocrine and endocrine function progressively deteriorates with resultant steatorrhea and malabsorption.
    • Dysfunction progressive and irreversible
  • Pancreatic pseudocyst:
    • Cystic collection of fluid with high content of pancreatic enzymes surrounded by a wall of fibrous tissue lacking a true epithelial lining
    • Localized in parenchyma of pancreas or adjacent abdominal spaces (lesser peritoneal sac)
    • Requires 4–6 wk to form from onset of acute pancreatitis

Etiology

  • Gallstones and alcohol abuse most common causes of acute pancreatitis (75–80%)
  • Alcohol abuse accounts for 70–80% of chronic pancreatitis.
  • Acute:
    • Biliary tract disease
    • Chronic alcoholism
    • Obstruction of pancreatic duct
    • Ischemia
    • Medications
    • Infectious
    • Postoperative
    • Post-ERCP
    • Metabolic diseases
    • Trauma
    • Scorpion venom
    • Penetrating peptic ulcer
    • Hereditary
  • Chronic:
    • Chronic alcoholism
    • Obstruction pancreatic duct
    • Tropical
    • Hereditary
    • Shwachman disease
    • Enzyme deficiency
    • Idiopathic
    • Hyperlipedemia
    • Hypercalcemia
  • Pancreatic pseudocyst:
    • Complication in 5–16% of acute pancreatitis; 20–40% of chronic pancreatitis

Pediatric Considerations
Causes mainly viral, trauma, and medications

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Citation

Rosen, Peter, et al., editors. "Pancreatitis." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307076/all/Pancreatitis.
Pancreatitis. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307076/all/Pancreatitis. Accessed April 23, 2019.
Pancreatitis. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307076/all/Pancreatitis
Pancreatitis [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 23]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307076/all/Pancreatitis.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Pancreatitis ID - 307076 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307076/all/Pancreatitis PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -