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    PANCREATITIS

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    VEDHIKAVIJAYAN
    The pancreas is an organ located in the abdomen that produces enzymes to digest food and hormones to regulate blood sugar. Pancreatitis is inflammation of the pancreas that can be acute or chronic. Acute pancreatitis causes sudden inflammation and symptoms include severe abdominal pain, nausea, and vomiting. The inflammation is usually treated with pain medications and intravenous fluids while avoiding food to rest the pancreas. Complications can include infection, bleeding, or formation of cysts.

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    PANCREATITIS

    Uploaded by

    VEDHIKAVIJAYAN
    99 views38 pages
    The pancreas is an organ located in the abdomen that produces enzymes to digest food and hormones to regulate blood sugar. Pancreatitis is inflammation of the pancreas that can be acute or chronic. Acute pancreatitis causes sudden inflammation and symptoms include severe abdominal pain, nausea, and vomiting. The inflammation is usually treated with pain medications and intravenous fluids while avoiding food to rest the pancreas. Complications can include infection, bleeding, or formation of cysts.

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    The pancreas is an organ located in the abdomen that produces enzymes to digest food and hormones to regulate blood sugar. Pancreatitis is inflammation of the pancreas that can be acute or chronic. Acute pancreatitis causes sudden inflammation and symptoms include severe abdominal pain, nausea, and vomiting. The inflammation is usually treated with pain medications and intravenous fluids while avoiding food to rest the pancreas. Complications can include infection, bleeding, or formation of cysts.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    99 views38 pages

    PANCREATITIS

    Uploaded by

    VEDHIKAVIJAYAN
    The pancreas is an organ located in the abdomen that produces enzymes to digest food and hormones to regulate blood sugar. Pancreatitis is inflammation of the pancreas that can be acute or chronic. Acute pancreatitis causes sudden inflammation and symptoms include severe abdominal pain, nausea, and vomiting. The inflammation is usually treated with pain medications and intravenous fluids while avoiding food to rest the pancreas. Complications can include infection, bleeding, or formation of cysts.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 38

    PANCREATITIS

    PANCREAS

     Elongated and tapered organ


     Pale grey gland weighing about 60gms and 12-15cm long
     Situated in epigastric and left hypochondriac region of abdominal cavity
    FUNCTIONS OF PANCREAS

    EXOCRINE
    ENDOCRINE • Pancreatic juices
    • Islet of langerhens • Amylase
    • Alpha cells • Lipase
    • Beta cells • Trypsin
    • Delta cells • Chymotrypsin
    • Carboxypeptidase
    PANCREATITIS

     Pancreatitis is inflammation of the pancreas


     Also described as autodigestion of pancreas
    ACUTE CHRONIC
    PANCREATITIS PANCREATITIS

    TYPES
    ACUTE PANCREATITIS
     It is an acute inflammatory process of the pancreas.
     The degree of inflammation varies from mild edema to severe
    hemorrhagic necrosis
     Acute pancreatitis is defined as an acute condition presenting with
    abdominal pain and associated with raised pancreatic enzymes levels in
    the blood or urine as a result of pancreatic inflammation
    Incidence

     Most common in middle age men and women


     Equally affect both genders
    ETIOLOGY
    CLINICAL FEATURES
     The cardinal symptom of AP is epigastric or periumbilical pain that
    radiates to the back
     Some patients may gain relief by sitting or leaning forward

     Nausea, repeated vomiting and retching are usually marked


    accompaniments
     Tachypnea, tachycardia and hypotension may be present
     Features of shock
     Hypovolemia and hypokalemia
     In gallstone pancreatitis mild icterus may be present

     Bleeding into fascial planes can produce bluish discoloration of the flanks
    (GreyTurner sign) or umbilicus (Cullen sign)
     Usually muscle guarding in the upper abdomen
     Pleural effusion is present in 10-20% patients
    DIAGNOSTIC FINDINGS
    PRIMARY TEST

    Serum Amylase : Increased more than 200IU

    Serum lipase : Elevated

    Urinary amylase : Elevated

    SECONDARY TESTS

    Blood Glucose : Hyperglycemia

    Serum Calcium : Hypocalcemia

    Serum Triglcerides : Hyperlipedemia


    MRI
    Ranson Prognostic Criteria for Non-
    Gallstone Pancreatitis
     At presentation
     Age > 55 yrs
     Blood glucose level > 200 mg/dl
     White blood cell count > 16,000 cells/ mm3
     Lactate dehydrogenase level > 350 IU/L
     Aspartate Aminotransferase level > 250 IU/L
     After 48 hours of admission
     Hematocrit : decrease > 10%
     Serum calcium level < 8mg/dl
     Base deficit > 4 mEq/L
     Blood urea nitrogen level : increase > 5 mg/dl
     Fluid requirement > 6 L
     PaO2 < 60 mm Hg
    ** Ranson score ≥ 3 defines severe pancreatitis
    MANAGEMENT
    RELIIEF OF
    PAIN

    REMOVAL OF PREVENTION
    PERCIPITATING OR
    CAUSE ALLEVIATION
    OF SHOCK

    GOALS

    PREVENTION REDUCTION
    AND OF
    TREATMENT OF CONTROL PANCREATIC
    INFECTIONS OF FLUID SECRETIONS
    AND
    ELECTROLYTE
    IMBALANCE
    CONSERVATIVE MANAGEMENT
     Focussed on supportive care
     Pain management
     Correction of hypovolemia using saline and colloids
     Continuous NG aspiration
     Keep the patient NPO
     Decreased Stimulation of pancreas
     Avoidance of alcohol or other percipitating factor
     Oxygen for hypoxic patients
    Pharmacological therapy

     Morphine- Relive pain


     Nitroglycerine or papaverine : Relaxation of smooth muscles and
    relive pain
     Antispasmodics : decrease vagal stimulation, motility and
    pancreatic outflow ‘
     Carbonic anhydrase inhiblitor ( eg: Acetazolamide) reduction in
    volume and bicarbonate concentration of pancreatic secretion
    cntd…
     Antacids : neutralization of gastric acidic content
     Histamine Receptor antagonist
     Proton pump inhibitors :Decrease HCl content and stimulates pancreatic secretion
     Prophylactic antibiotics
     Calcium to treat hypocalcemia
     Pancreatic enzyme replacement
     MCT oil
    Surgical Management

     Done in case
     Abscess
     Severe Peritonitis
     Acute pseudocyst
    Nutritional therapy
     “Rest the pancreas” by avoiding enteral nutrition is no longer acceptable

     There are evidences for nutritional support in acute pancreatitis

     Enteral nutrition should be commenced after initial fluid resuscitation and

     within the first 24 hrs of admission

     Can be introduced through NG tube and increased in stepwise fashion in 2-3 days

     Delay in commencing enteral nutrition may contribute to the development

     of intestinal ileus and feeding intolerance


    Complication
    NURSING ASSESSMENT
     Past health history
     Medications
     Surgery or other treatment
     Vital monitoring
     Objective symptoms of the disease
    NURSING DIAGNOSIS
     Acute pain related to inflammatory process at pancreas and surrounding tissues

     Ineffective breathing pattern related to reduced diaphragm movement or fluid

    accumulation

     Fluid electrolyte imbalance related to altered metabolic process

     Infection related to inflammatory process

     Hyperthermia related to infective process


     Imbalanced nutrition less than body requirement

     Constipation related to decreased oral intake

     Disturbed sleeping pattern related to pain

     Activity intolerance related to pain

     Knowledge deficit related to prognosis

     Anxiety related to prognosis and disease progression

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