Pancreatitis And Pancreatic Cyst





Pancreatitis
Pancreatitis

Pancreatitis

Inflammation of the pancreas. It classified into :

1- Acute pancreatitis: caused by digestion of the pancreas by trypsin.

Aetiology:

Alcohol abuse, infection, ischemic vascular disease, abdominal blunt trauma, medication, surgery idiopathic.

Diagnostic Tests:

Serum amylase, serum lipase, serum electrolytes, CBC, urine analysis, stool analysis, X-ray, ultrasound, CT and ERCP.

Signs and Symptoms:

Abdominal pain, tenderness, epigastric pain radiated to the back, pain increase after meals, fever, leukocytosis, nausea and vomiting and respiratory distress.

Treatment:

- Keep the pt. NPO.

- Suctioning, biliary drainage.

- Vital signs monitoring.

- Monitor blood glucose.

- Analgesics.

- Antacid.

- Low fat and low protein diet.

- Alcohol cessation.

Chronic Pancreatitis:

It is an inflammatory disorder characterized by anatomic and functional destruction of the pancreas.
It caused by repeated attacks of pancreatitis which lead to protein secretion making the plug to the pancreatic duct that leads to obstruction of pancreatic secreting cells, common bile duct and pancreatic duct.

Causes:

Alcohol consumption and malnutrition.

Diagnosis:

CBC, serum amylase, glucose tolerance test, abdominal x-ray, ultrasound, CT and ERCP.

Treatment:

- Surgery: cholecystectomy with Oddi sphincter is cutting to improve pancreatic drainage. 

- Pancreatojejunostomy.

- Alcohol cessation, pancreatic enzyme replacement.

- Diabetic management.

Pancreatic Cyst:

Result from local necrosis of the pancreatic tissues due to acute pancreatitis causes collection of fluids, the tissue wall becomes fibrous called pancreatic cyst.

Management includes drainage of the cyst through skin or GI tract, or through surgery ( cholecystectomy and common bile duct exploration, or sphincterectomy).



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