goodduck

Acute Pancreatitis

[etiology]
 1. Alcohol
 2. Gallstone
 3. Hypertriglycemia

[PE]
Gereral appearance: ill-looking
T/P/R: increase  ; BP: decrease
HEENT
 Purtscher's retinopathy
 pale face
 diaphorsis
 icteric sclera
Chest
 basilar rale (left side)
Abdomen
 Grey-Turner sign
 Cullen sign
 distension
 rebounding pain
 muscle rigidity
 hypoactive bowel sound 
Extremity
 erythematous skin nodule
 cold

[X-ray] --according to anatomical location
1. duodenal distension w/ A-F level
2. sentinel loop sign in jujeunum(most)
3. colon cut off sign 
4. stomach displaced by pseudocyst
5. generalize ileus w/ A-F level

[Lab]
 leukocytosis (15000~20000)
 Hct >50% (plasma loss)
 amylase increase
 lipase increase
 hypocalcemia
 hyperglycemia
 metabolic acidosis-- hyperkalemia

[Complication] -- local / systemic
 
[Prognisis]
1. Ranson's criteria
2. CTSI

[Tx]
1. self-limiting (3~7 days)
2. NPO + fluid + meperidine