Morning Report: 9/5/2014

Here’s Dr. Aldokhi with today’s Morning Report!

 

Pancreatitis

Epidemiology –       Annual incidence of acute pancreatitis range from 4.9 to 35 per 100,000

–       Mortality1.5 percent in mild pancreatitis & 17 percent in severe pancreatitis

–       Alcoholic pancreatitis is more common in men than in women

Classification –       Acute and Chronic

–       Mild and Severe

Pathophysiology 1st local inflammation

2nd release of digestive enzymes and auto digestion

Etiology 1-    Mechanical (Gall stone)

2-    Toxic (alcohol)

3-    Metabolic (Ca, Trig)

4-    Infectious

5-    Trauma

6-    idiopathic

Diagnosis –       Sx and Sx

–       Labs (lipase), LFT, LDH, CBC,

–       US

–       CT

Criteria –       Ranson                                   – APACHE

–       Atlanta Criteria for Predicting Severe Acute Pancreatitis

Management Supportive

IV fluid  5-10ml/kg monitor UOP

NPO?

Opioid

ICU Or Floor Pulse <40 or >150 beats/minute

  • Systolic arterial pressure <80 mmHg or mean arterial pressure <60 mmHg or diastolic arterial pressure >120 mmHg
  • Respiratory rate >35 breaths/minute
  • Serum sodium <110 mmol/L or >170 mmol/L
  • Serum potassium <2.0 mmol/L or >7.0 mmol/L
  • PaO2 <50 mmHg
  • pH <7.1 or >7.7
  • Serum glucose >800 mg/dL
  • Serum calcium >15 mg/dL
  • Anuria
  • Coma

 

 

 

The views expressed on this blog are the author's own and do not reflect the views of their employer. Please read our full disclaimer here. Any references to clinical cases refer to patients treated at a virtual hospital, Janus General Hospital.
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Jay Khadpe MD

Editor in Chief of "The Original Kings of County" Assistant Professor of Emergency Medicine Assistant Residency Director SUNY Downstate / Kings County Hospital

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