A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body temperature, body weight, body height; further: Inspection (viewing). Skin, mucous membranes, and sclerae (white part of the eye) [possibly icterus (jaundice) – may also occur as a sequelae]. Abdomen (abdomen) Shape of the abdomen? … Inflammation of the Pancreas: Examination
1st-order laboratory parameters – obligatory laboratory tests in acute pancreatitis. CRP (C-reactive protein) [differentiate mild vs severe course: > 150 mg/dl 48 h] or PCT (procalcitonin) [indicator of severity]. Serum amylase Lipase [acute pancreatitis: ≥ 3-fold of upper normal] Trypsin Elastase in serum Small blood count [hematocrit: high negative predictive value (NPW) for a hematocrit … Inflammation of the Pancreas: Test and Diagnosis
Acute pancreatitis Therapeutic target Avoidance of complications Adequate pain management Healing of the disease Therapy recommendations Admit patients to a hospital as early as possible to avoid complications. Risk stratification using the Acute Physiology And Chronic Health Evaluation Score (APACHE II). In most patients (85 to 90%), acute pancreatitis is a self-limiting disease (“ending without … Inflammation of the Pancreas: Drug Therapy
Obligatory medical device diagnostics. Abdominal ultrasonography (ultrasound examination of the abdominal organs (in this case, pancreatic ultrasonography/ultrasound examination of the pancreas) – as a basic diagnostic test and method of choice in mild courses of disease [acute pancreatitis: edema (water retention), hypoechogenic (“echo-poor”) pancreatic enlargement, free fluid, possibly indication of biliary (gallbladder-related) cause Chronic pancreatitis: … Inflammation of the Pancreas: Diagnostic Tests
Pancreatitis may be associated with the risk of deficiency of the following vital nutrients (micronutrients): Vitamins A, C, E, K, and vitamin B12. Minerals calcium and magnesium Trace elements selenium and zinc Secondary plant substance beta-carotene The above vital substance recommendations (micronutrients) were created with the help of medical experts. All statements are supported by … Inflammation of the Pancreas: Micronutrient Therapy
Acute pancreatitis Biliary pancreatitis If the pancreatitis is caused by an impacted gallstone (= biliary pancreatitis), immediate ERCP (“endoscopic retrograde cholangiopancreatography”: radiographic imaging of the biliary system and pancreatic duct) with papillotomy (“incision” of the opening of the papilla Vateri/mucosal fold in the duodenum) and stone removal should be performed. If the clinical course permits, … Inflammation of the Pancreas: Surgical Therapy
To prevent pancreatitis (inflammation of the pancreas), attention must be paid to reducing individual risk factors. Behavioral risk factors Diet Malnutrition and undernutrition – low protein diet. Pleasure food consumption Alcohol* (abuse) Tobacco (smoking): Possibly increases the risk of acute pancreatitis Increases the risk for chronic pancreatitis and accelerates the progression of the disease Blunt … Inflammation of the Pancreas: Prevention
Acute pancreatitis (AP) The following symptoms and complaints may indicate acute pancreatitis (inflammation of the pancreas): Acute abdominal pain (abdominal pain) most important symptom. Typically, there is a severe, probing and persistent visceral pain in the upper abdomen (epigastrium), which may also radiate to the back (girdled), thorax (chest), flanks or lower abdomen and improves … Inflammation of the Pancreas: Symptoms, Complaints, Signs
The following are the most important diseases or complications that can be caused by pancreatitis (inflammation of the pancreas): Acute pancreatitis (AP) Local sequelae and complications of acute pancreatitis may include: Vascular erosion (Latin: arrodere – (to) gnaw) with acute bleeding into the abdominal cavity. Necrosis (tissue death; see below infections). Fistula formations due to … Inflammation of the Pancreas: Complications
When 2 of the following 3 criteria are met, a diagnosis of acute pancreatitis can be made: Typical abdominal pain: typically, there is severe, penetrating, and persistent visceral pain in the upper abdomen (epigastrium) that may also radiate to the back (girdled), thorax (chest), flanks, or lower abdomen and improves in a sitting or crouching … Inflammation of the Pancreas: Classification
Medical history (history of illness) is an important component in the diagnosis of pancreatitis (inflammation of the pancreas). Family history Are there any diseases of the digestive system in your family that are common? Social history Is there any evidence of psychosocial stress or strain due to your family situation? Current medical history/systemic history (somatic … Inflammation of the Pancreas: Medical History
All diseases leading to acute abdomen are differential diagnoses of pancreatitis. Only the most common differential diagnoses have been listed below for this purpose: Endocrine, nutritional, and metabolic diseases (E00-E90). Porphyria or acute intermittent porphyria (AIP); genetic disorder with autosomal dominant inheritance; patients with this disease have a 50% reduction in the activity of the … Inflammation of the Pancreas: Or something else? Differential Diagnosis
