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Inflammation of the Pancreas

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Presentation on theme: "Inflammation of the Pancreas"— Presentation transcript:

1 Inflammation of the Pancreas
Pancreatitis Inflammation of the Pancreas

2 Acute Pancreatitis Function of the pancreas is to release proteolytic enzymes that assist in the breaking down food products so that nutrients can be absorbed.

3 Acute Pancreatitis Etiology and Pathophysiology
Pancreatic Ducts become obstructed Hypersecretion of the exocrine enzymes of pancreas These enzymes enter the bile duct, where they are activated and with bile back up into the pancreatic duct Pancreatitis

4 Acute Pancreatitis Etiology and Pathophysiology
Trypsinogen- (a proteolytic enzyme) Normally released into the small intestine, where it is activated to trypsin In AP, activated to trypsin in the pancreas causing autodigestion of pancreas

5 Progression of Disease
Autodigestion Acute Inflammation of Pancreas Necrosis of Pancreas Digestion of vascular walls Thrombus and Hemorrhage Death

6 Precipitating Factors
Trauma Use of alcohol * Biliary tract disease Viral or Bacterial disease Cholelithiasis * Peptic Ulcer Disease *most common causes

7 Acute Pancreatitis Clinical Manifestations
Severe Abdominal pain is predominant symptom Pain located in LUQ and mid-epigastrium Commonly radiates to the back Sudden onset Severe, deep, piercing, steady Aggravated by fatty meal or lying recumbent position Not relieved by vomiting

8 Acute Pancreatitis Clinical Manifestations
Cyanosis, Dyspnea Bowel sounds decreased or absent Low-grade fever, Leukocytosis Hypotension, Tachycardia Jaundice Flushing Abnormal lung sounds - Crackles Discoloration of abdominal wall – Turner’s or Cullen’s sign SIGNS OF SHOCK

9 Acute Pancreatitis Diagnostic Studies
History and physical examination Laboratory tests Serum amylase- hallmark test Serum lipase – also elevated Blood glucose Serum calcium Triglycerides

10 Acute Pancreatitis Diagnostic Studies
Flat plate of abdomen Abdominal/endoscopic ultrasound Endoscopic retrograde cholangiopancreatography (ERCP) Chest x-ray CT of pancreas Magnetic resonance cholangiopancreatography (MRCP)

11 Acute Pancreatitis Can be a medical emergency associated with a risk for life-threatening complications

12 What do they die of?

13 Acute Pancreatitis Complications
Two significant local complications Pseudocyst Abscess

14 Acute Pancreatitis Complications
Pseudocyst Cavity surrounding outside of pancreas filled with necrotic products and liquid secretions Abdominal pain Palpable epigastric mass Nausea, vomiting, and anorexia Elevated serum amylase

15 Acute Pancreatitis Complications
Pancreatic abscess A large fluid-containing cavity within pancreas Results from extensive necrosis Upper abdominal pain Abdominal mass High fever Leukocytosis

16 Acute Pancreatitis Complications
Main systemic complications are? Pulmonary Cardiovascular Electrolyte imbalance – Hypocalcemia

17 Acute Pancreatitis Goals of Care
Relief of pain Prevention or alleviation of shock Decrease respiratory failure ↓ of pancreatic secretions Maintain Fluid/electrolyte balance

18 Treatment and Nursing Care
1. Pain management IV morphine or Dilaudid Antispasmodic agent Bentyl Pro-Banthine Spasmolytics – Nitroglycerine Positioning – sitting up and leaning forward Why is it important to relieve pain?

19 Treatment 2. Prevention of Shock – hemodynamic stability
* Administer Blood, Plasma expanders, Albumin * LR solution

20 What is the cause of shock?

21 Treatment and Nursing Care
3. Suppress pancreatic enzymes * NPO * NG suction * Antacids, H2 receptor antagonists, antispasmotics 4. Decrease respiratory distress * Oxygen; check O2 saturation levels * Semi-fowlers position, knees flexed, position changes * C, DB; incentive spirometer 5. Antibiotics

22 Treatment and Nursing Care
6. Correction of electrolyte imbalance/ hypocalcemia 7. Maintain Hydration / Nutrition

23 Treatment and Nursing Care
Surgical therapy – if related to gallstones ERCP Endoscopic sphincterotomy Laparoscopic cholecystectomy

24 Treatment - Home Care Follow up care Dietary teaching
High-carbohydrate, low-fat diet Abstinence from alcohol, Patient/family teaching * Signs of infection, high blood glucose, steatorrhea

25 The End

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