UMEM Educational Pearls

Category: Gastrointestional

Title: Pancreatitis

Keywords: Pancreatitis (PubMed Search)

Posted: 4/12/2008 by Michael Bond, MD (Updated: 10/28/2020)
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Some simple facts about Pancreatitis:

  1. Causes (First two are the most common in the United States)
    1. Gallstones
    2. Alcohol
    3. Hyperlipidemia
    4. Medications [azathioprine, corticosteroids, sulfonamides, thiazides, furosemides, NSAIDs, mercaptopurine, methyldopa, and tetracyclines]
    5. Peptic Ulcer Disease
    6. Scorpion and Snake Bites
    7. Trauma
    8. Infections [ ascaris, mumps, coxsackie virus, cytomegalovirus, Epstein Barr Virus, mycoplasma]
  2. Chronic Pancreatitis may not be associated with an elevation of lipase or amylase.
  3. Lipase is more specific for pancreatitis
  4. Amylase can be elevated in:
    1. pancreatitits
    2. salivary gland injury/disease
    3. ruptured ectopic pregnancy
    4. ovarian cysts
    5. salpingitis
    6. inflammation of the bowel [appendicitis, obstruction]
    7. end stage renal and liver disease [due to decreased clearance]
  5. Treatment:  mild cases can be discharged home with clear liquid diet and pain medications, more severe cases needed to be admitted for IV fluids and pain control.  Maintain NPO status.
  6. Complications:
    1. Pseudocyst
    2. Phlegmon
    3. Necrosis of the pancreas
    4. Hemorrhage
    5. Intestional obstruction
    6. fistula formation.