Pancreatitis (inflammatory disease of pancreas) Signs and Symptoms Diagnostic Tests

Pancreatitis (inflammatory disease of pancreas) Signs and Symptoms Diagnostic Tests

Pancreatic Diseases

Pancreatitis is inflammatory disease of pan­creas

Various presentations of Pancreatitis :

Pancreatitis Prognosis:

  • Several techniques are used to determine how well (or how poorly) patients with pancreatitis will progress during their illness and whether they may benefit from intensive care.
  • The best of these is the APACHE II system; it grades patients with pancreatitis on the basis of 14 measurable physiological parameters, including the patient’s

pancreatitis

Pancreatitis (inflammatory disease of pancreas) Signs and Symptoms Diagnostic Tests


Pancreatitis Classic presentation

  • Pancreatitis Signs and Symptoms
  • Pancreatitis History
Pancreatitis Etiology
  • · Unknown
  • · Alcohol abuse
  • · Biliary tract disease
  •  Drugs
  • · Trauma
  • · Viral infections
  • · Metabolic and connective tissue disorders.

Pancreatitis Diagnostic Tests and Interpretation

Lab

  • •No test is 100% sensitive or specific
  • AcuteBronchiectasis Signs and Symptoms Diagnosis Treatment. Read more ... » pancreatitis:
    • Elevated serum amylase (amylase P)
    • Elevated serum lipase
    • Liver function tests (LFTs): Hyperbilirubinemia and elevated (mild) ALT, AST, and/or alkaline phosphatase when associated with alcoholic hepatitis or choledocholithiasis
    • Glucose increased in severe disease
    • Calcium decreased in severe disease
    • White blood cells (WBCs): 10,000–25,000/µL

Other Tests

Tests for Pancreatic Structure X-ray: shows

Ultrasound: shows

  • · Edema
  • · Inflammation
  • · Calcification
  • · Pseudocyst
  • · Mass lesions
  • · Gall stones.
  • In acuteBronchiectasis Signs and Symptoms Diagnosis Treatment. Read more ... » pancreatfti~ pancreas is enlarged. Pancreatic pseudocyst – echo-free smooth round fluid collection.
  • In pancreatic carcinoma – distortion of normal struc­tures.
  • If more than 3 cm localized echo-free solid lesion seen, it is usually carcinoma.
  • In obesity and gas in large bowel, pancreas difficult· to see.

CT is best for:

Endoscopic ultrasonography (EUS)

  •  is done to see pancreatic parenchyma and pancreatic duct, common bile duct stones, pseudo cyst.
  • Endoscopic ultrasound (EUS) is better than Endoscopic retrograde cholepancreatography (ERCP).
  • EUS is also for:
  • Biopsy
  • Nerve blocks through EUS Dilatation of main pancreatic duct.

Magnetic Resonance Cholepancreatography (MRCP)

  • To see –
  • Pancreatic duct Bile duct
  • It is useful in elderly as it is a dure.
  • Selective catheterization
    • of celiac and superior mesenteric arteries, and hepatic, splenic, and gas­trgduodenal arteries for angiography.
    • Percutaneous aspiration biopsy of pancreatic mass is done to differentiate between inflammatory swelli’ng and neoplasm.
  • Exocrine pancreatic function
    • 1. Direct stimulation of pancreas by IV infusion of secretin, or secretin plus CCK (cholecystokinin), then measurement of duodenal contents.
    • 2. Study of digestion products from lumen like un­digested meat fibers, stool fat, fecal nitrogen.
    • 3. Measurement of pancreatic enzymes like elastase.