Morning Report: 9/5/2014

by Jay Khadpe MD • September 5, 2014 • Comments Off

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	1^st local inflammation 2^nd 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