Pancreatitis - Revision history

Aidan at 16:30, 10 April 2026

2026-04-10T16:30:05Z

← Older revision		Revision as of 16:30, 10 April 2026
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	==~~Definition~~==		==Background==

	*Inflammation of the pancreas		*Inflammation of the pancreas

	==~~Etiology~~==		=== Etiologies ===

	*'''[[Gallstone]]'''		*'''[[Gallstone]]'''
	*'''Alcohol'''		*'''Alcohol'''

Aidan: /* Management */

2026-04-10T16:29:38Z

Management

← Older revision		Revision as of 16:29, 10 April 2026
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	**Walled-off necrosis, which develops over the course of illness, and is usually an organized collection		**Walled-off necrosis, which develops over the course of illness, and is usually an organized collection
	*Both are sterile and both can become infected		*Both are sterile and both can become infected
	*No antibiotics warranted in acute necrotizing pancreatitis		**No antibiotics warranted in acute necrotizing pancreatitis
	*Infection usually develops after about 10 days		**Infection usually develops after about 10 days
			*For patients with walled-off pancreatic necrosis, either sterile collections with severe symptoms, or suspected infection, they should be assessed for drainage[[CiteRef::baron2020am]]
⚫	*If necrosectomy is indicated, it should be delayed by at least 4 weeks
			**Options include IR-guided drainage, EUS-guided drainage, or endoscopic necrosectomy
		⚫	**In general, if necrosectomy is indicated, it should be delayed by at least 4 weeks for the collection to mature
			**Percutaneous drainage has a risk of pancreatocutaneous fistula (about 30% if done without some form of surgical debridement)[[iteRef::ross2014du]][[CiteRef::van brunschot2018en]]

	===Splenic Vein Thrombosis===		===Splenic Vein Thrombosis===

	*Monitor		*Monitor

			== Further Reading ==

			* American Gastroenterological Association Clinical Practice Update: Management of Pancreatic Necrosis. ''Gastroenterology''. 2020;158(1):67-75.e1. doi: [https://doi.org/10.1053/j.gastro.2019.07.064 10.1053/j.gastro.2019.07.064]. PMID: [https://pubmed.ncbi.nlm.nih.gov/31479658/ 31479658].

	[[Category:Gastroenterology]]		[[Category:Gastroenterology]]

Aidan: /* Clinical Manifestations */

2020-08-24T13:41:39Z

Clinical Manifestations

@@ Line 38: / Line 38: @@
 ==Clinical Manifestations==
-*Acute abdominal pain, usually epigastric, sometimes radiating to the back
+*[[Causes::Acute abdominal pain]], usually [[Causes::epigastric pain|epigastric]], sometimes radiating to the back
-*Nausea, vomiting
+*[[Causes::Nausea]] and [[Causes::vomiting]]
-*Dyspnea
+*[[Causes::Dyspnea]]
-==Management==
+=== Prognosis ===
-===Pancreatic necrosis===
+====Ranson's Criteria====
 *On presentation
@@ Line 77: / Line 62: @@
 **Fluid needs &gt; 6L within 48 hours
-===BISAP===
+====BISAP====
 *BUN &gt; 8.9
@@ Line 84: / Line 69: @@
 *Age &gt; 60
 *Pleural effusion
 [[Category:Gastroenterology]]

Aidan: /* Etiology */

2020-08-24T13:37:06Z

Etiology

@@ Line 10: / Line 10: @@
 *Scorpion sting (Trinidadian)
 *Microbiological
 *Surgery: [[ERCP]]
 *[[Hyperlipidemia]]
@@ Line 46: / Line 28: @@
 **H<sub>2</sub> blockers
 **[[Valproic acid]]
 **[[Acetaminophen]]
 **[[Salicylates]]

Aidan: /* Etiology */

2020-08-24T13:10:22Z

Etiology

Show changes

Aidan: Text replacement - "Clinical Presentation" to "Clinical Manifestations"

2020-07-15T14:48:33Z

Text replacement - "Clinical Presentation" to "Clinical Manifestations"

← Older revision		Revision as of 14:48, 15 July 2020
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	** Organophosphates		** Organophosphates

	== Clinical ~~Presentation~~ ==		== Clinical Manifestations ==

	* Acute abdominal pain, usually epigastric, sometimes radiating to the back		* Acute abdominal pain, usually epigastric, sometimes radiating to the back

Maintenance script: Imported from text file

2020-07-04T01:17:48Z

Imported from text file

New page

== Definition ==

* Inflammation of the pancreas

== Etiology ==

* Gallstones
* Ethanol
* Tumour/Trauma
* Scorpion sting (Trinidadian)
* Microbiological
** Viral
*** Mumps
*** Rubella
*** Varicella
*** Viral hepatitis
*** CMV/EBV/HIV
*** Coxsackie virus/Echovirus/Adenovirus
** Bacterial
*** Mycoplasma
*** Campylobacter
*** Mycobacterium tuberculosis
*** Mycobacterium avium intracellular
*** Legionella
*** Leptospirosis
** Parasitological
*** Ascariasis
*** Clonorchiasis
*** Echinococcus
* Autoimmune
** SLE
** Polyarteritis nodosa
** Crohn's disease
* Surgery: ERCP
* Hyperlipidemia
* Hypercalcemia
* Hypothermia
* Emboli/Ischemia
* Drugs
** Steroids
** Azathioprine
** Furosemide
** Mercaptopurine
** Estrogen
** Methyldopa
** H2 blockers
** Valproic acid
** Antibiotics
** Acetaminophen
** Salicylates
** Methanol
** Organophosphates

== Clinical Presentation ==

* Acute abdominal pain, usually epigastric, sometimes radiating to the back
* Nausea, vomiting
* Fevers
* Dyspnea

== Management ==

=== Pancreatic necrosis ===

* Two forms
** Acute necrotizing pancreatitis, which is present at the start, and is usually phlegmonous
** Walled-off necrosis, which develops over the course of illness, and is usually an organized collection
* Both are sterile and both can become infected
* No antibiotics warranted in acute necrotizing pancreatitis
* Infection usually develops after about 10 days
* If necrosectomy is indicated, it should be delayed by at least 4 weeks

=== Splenic vein thrombosis ===

* Monitor

== Prognosis ==

=== Ranson's criteria ===

* On presentation
** Sugar > 10
** WBC > 16k
** Elderly > 55 years
** LDH > 350
** AST > 250
* After 48h
** Hct drop >10% from admission
** BUN increase >5 mg/dL (>1.79 mmol/L) from admission
** Ca <8 mg/dL (<2 mmol/L) within 48 hours
** Arterial pO2 <60 mmHg within 48 hours
** Base deficit (24 - HCO3) >4 mg/dL within 48 hours
** Fluid needs > 6L within 48 hours

=== BISAP ===

* BUN > 8.9
* Impaired LOC
* SIRS
* Age > 60
* Pleural effusion

[[Category:Gastroenterology]]