...Pathophysiology of Pancreatitis The pancreas contains enzymes which have potential to cause extensive tissue damage. Under normal circumstances several mechanisms protect the pancreas from damage by these enzymes; however, inappropriate activation of the enzyme systems leads to extensive damage by auto digestion. Some proposed mechanisms by which auto digestion begins are: reflux of duodenal contents, reflux of bile into pancreatic duct when CBD blocked, and activation of complement system and overstimulation of pancreatic secretions. Epidemiology Acute pancreatitis is a potentially lethal disease that is increasing in incidence. Its mortality has improved as a result of a better understanding of the natural history of the disease and improvement of critical care. Approximately 210,000 patients are admitted to hospitals each year with acute pancreatitis with approximately 20% meeting criteria for severe pancreatitis alone in the US. Alcoholic pancreatitis is seen more frequently in men. Manifestation Acute pancreatitis is an important cause of acute upper abdominal pain. Because its manifestations are similar to a number of other acute illnesses, it is difficult to base a diagnosis only on symptoms and signs. The two most common causes of acute pancreatitis in adults are gallstones and alcoholism. Treatment The main goal of initial treatment is to prevent complications of severe pancreatitis by reducing pancreatic secretory stimuli. Initially, the patient should be...
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...Unit 2 Assignment, Yvonne McAlpin For this week’s assignment covering disease research, I chose pancreatitis. I chose this because my friend was just recently diagnosed with this. She is a very healthy person, in fact healthier than I and a little younger. I thought it would be a perfect research topic. Pancreatitis means inflammation of the pancreas that can appear in two very different ways. Acute pancreatitis is sudden while chronic pancreatitis is recurring or persistent. Some cases of pancreatitis may be mild and go away on their own and do not require treatment. However, severe cases can lead to potentially fatal complications. Although pancreatitis is mainly caused by gallstones, the rise in alcohol misuse in several countries has led to an increase in incidence. Alcohol now accounts for over one third of all acute pancreatitis cases in the USA. The patient will experience a sudden onset of pain in the center of the upper abdomen, below the breastbone. The pain is first felt in the lower abdomen. It will then gradually become more intense until it is a constant ache. The ache may intensify further and become severe, and also spread into the back in 50% of cases. Eating may exacerbate the pain. If it is caused by gallstones everything will happen and develop very fast. When it is caused by alcohol, symptoms will typically develop more slowly, over a number of days. These symptoms may also be present; vomiting, nausea, diarrhea, loss of appetite, coughing...
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...chemical formula given directly into the patient’s bloodstream. Central venous access located in the chest; the digestive system is bypassed. The TPN catheter is used only for nutrients; medications are not added to the solution. Often the placement is done in an operating room under local anesthesia and sterile conditions to decrease the chance of infection. Once the catheter is in place, a chest x ray is done to make sure the placement is correct. The outside tubing leading from the bag of solution to the catheter is changed daily, and special dressings covering the catheter are changed every other day. Some diseases and conditions where TPN is indicated include short bowel syndrome, GI fistulas, bowel obstruction, Crohn’s disease, pancreatitis, some stages of ulcerative colitis, critically ill patients, anorexia, advanced cancer patients, individuals with severe burns, multiple fractures, and in malnourished individuals to prepare them for major surgery. TPN can also create a multitude of complications such as infection, osteoporosis, osteomalacia, fluid and electrolyte imbalance, cholelithiasis, cholecystitis, pneumothorax, thrombosis, dyspnea, nausea, headache, back pain, sweating and dizziness, and could lead to major organ failure. Other adverse reactions of TPN can be hepatomegaly, splenomegaly, thrombocytopenia, and leukopenia. Nonuse of the gut leads to intestinal mucosal atrophy. Hyperglycemia, Hypoglycemia are common but could be corrected by regular monitoring and...
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...According to Carroll (2007), laboratory evaluation are done in assessing and evaluating acute pancreatitis. She mentioned that initially many biological markers such as amylase and lipase levels, complete blood count with differential metabolic panel, urinalysis and triglyceride levels were being used. However recent studies have found other potential means of concluding the severity and prognosis of pancreatitis. Such promising markers include the use of trypsinogens and pancreatic protease which are used in the auto digestive process of acute pancreatitis. Additional markers that are now being investigated include trypsinogen activation peptide, C-reactive protein, procalcitonin, phosphalipase A2 and the cytokines; interleukin 6 and...
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...NATIONAL CENTER FOR CASE STUDY TEACHING IN SCIENCE A Case of Acute Pancreatitis by David F. Dean Department of Biology, Spring Hill College Case Presentation George Hendrix is a 38-year-old man who has abused alcohol his entire adult life. Recently, following an episode of binge drinking, George experienced a gradual onset of pain in his upper abdomen that radiated to his back. The pain persisted for several hours and worsened each time that he ate. He also felt nauseous and experienced repeated episodes of vomiting. The pain grew more intense and George decided to drive himself to the emergency room of his local hospital. The physician who examined George in the ER noted the following findings when she performed a physical exam: Intense pain upon palpation of the upper left quadrant of the abdominal cavity, gaseous distension of the intestinal tract, and tachycardia. The physical exam findings, together with the history of alcohol abuse and the results of a CBC, serum chemistry panel, and abdominal ultrasound, led the physician to conclude that George was suffering from a case of acute pancreatitis. The doctor immediately initiated the appropriate medical therapy. Questions 1. Describe the anatomic location of the pancreas relative to the other organs in the upper portion of the abdominal cavity. 2. Describe the functional anatomy of the duct system that conveys bile from the liver and digestive juice from the pancreas to the lumen of the duodenum...
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...Acute pancreatitis is a sudden and serious swelling of the pancreas. The amount of inflammation ranges from mild swelling/fluid buildup to extreme tissue death. This disease usually and equally affects middle-aged men and women; however, the percentage of African Americans with acute pancreatitis is three times higher than in Caucasians. Many factors make up the etiology of acute pancreatitis; gallbladder disease being the number one cause (most common in women) followed by chronic alcohol intake as the second most common cause (most common in men). Other causes of acute pancreatitis include vascular diseases, viral infections, abscesses, cystic fibrosis, trauma, penetrating duodenal ulcers, metabolic disorders, certain drugs, Kaposi sarcoma,...
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...body to use food for energy (Pancreatitis Causes, Symptoms, 2013). Pancreatitis is a serious disease in which the pancreas becomes inflamed. This occurs when the protein and lipid digesting enzymes become activated before they are released into the small intestine and begin attacking and digesting the pancreas itself (Zelman, 2010). This results in severe necrosis and edema of the pancreas. There are two types of pancreatitis: chronic and acute, which occur more often in women than in men (Zelman, 2010). In men, pancreatitis is often associated with alcoholism or peptic ulcers, while in women it’s associated with gallbladder disease (Zelman, 2010). Acute pancreatitis is a sudden inflammation that only last a short time and most people recover completely after receiving proper treatment. If severe pancreatitis occurs, it may cause damage to vital organs such as the heart, lungs, and kidneys due to infection, serious tissue damage, and cyst formation (Pancreatitis Causes, Symptoms, 2013). Chronic pancreatic is a long lasting inflammation of the pancreas usually after an episode of acute pancreatitis. It may also occur due to heavy alcohol drinking, but damage to the pancreas may not cause symptoms for many years (Cuhna, 2014). Symptoms of chronic pancreatitis include: pain in the upper abdomen that radiates to the back, weight loss due to malabsorption of food, nausea, vomiting, diarrhea, oily stools, and diabetes (Cuhna, 2014). Chronic pancreatitis is caused by long time alcohol...
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...Digestive Case Study: A Case Of Acute Pancreatitis Describe the Anatomical location of the Pancreas relative to the other organs in the upper portion of the abdominal cavity. The pancreas is an “elongated, tapered” organ that sits behind the stomach, across the back of the abdomen. The widest part of the pancreas is called the head and lies in the curve of the duodenum (1st section of s. intestine). The body of the pancreas extends slightly upward, and the tail of the pancreas ends near the spleen. (n.d.). Retrieved from http://medicalcenter.osu.edu/patientcare/healthcare_services/liver_biliary_pancreatic_disease/pancreas_anatomy_function/Pages/index.aspx Describe the functional anatomy of the duct system that conveys bile from the liver and digestive juice from the pancreas to the lumen of the duodenum. Pancreatic juice is a mixture of sodium bicarbonate and digestive enzymes that travel through the pancreatic ducts directly into the lumen of the duodenum. Chyme is partially digested food that travels from the stomach into the duodenum, and trypsm, amylase, and lipase are the digestive enzymes which break down proteins, starches, and fats and are carried to the duodenum from the stomach. The liver manufactures and secretes Bile, which is a fluid released into the duodenum that aids in digestion of fat. (n.d.). Retrieved from http://www.visualhistology.com/products/atlas/VHA_Chpt14_Pancreas_Liver_And_Gallbladder.html Briefly outline the endocrine and exocrine...
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...disease that can affect it. Function of the Pancreas The pancreas is a hollow organ located behind the stomach with two primary functions are (Digestive Disorder Health Center, 2013): to secrete enzymes into the small intestine and to release the hormones insulin and glucagon into the bloodstream. What can prevent the pancreas from functioning properly? There are several diseases that can affect the pancreas but I want to focus mainly on one. What is Pancreatitis? Pancreatitis occurs when the pancreas is inflamed (Pancreatitis, 1988-2014). Damage occurs when the digestive enzymes are activated before they are secreted and begin attacking the pancreas (Digestive Disorder Health Center, 2013). There are two types of pancreatitis: acute and chronic (Digestive Disorder Health Center, 2013). Anyone can get this but it only happens to certain people with certain risk factors. Acute risk factors include: gallstone disease and heavy alcohol consumption (Digestive Disorder Health Center, 2013). Chronic pancreatitis risk factors may include prolonged alcohol use; certain hereditary conditions and gallstones (Digestive Disorder Health Center, 2013). What can we do? Controlling or Prevention Lifestyle Changes Understanding the disease and risk factors involved is important and as you can see some of the risk factors we can avoid but some it is difficult. The treatment always involves being hospitalized and...
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...Philippine Christian University Mary Johnston College of Nursing 415 Morga St. Tondo, Manila A Case Study on Acute Pancreatitis Secondary to Cholelithiasis Submitted by: Abad, Edryan Calara, Sharika Loradel Casul Mark Jury Corpuz, Trisha Dela Cruz, Marjori Gamboa, Jonalyn Lebico, Elmarie Lopez, Anica Tapawan, Ansherina Tuazon, Serleen March 09, 2012 Acknowledgement We would like to thank the following to the development of this case study. Mrs. Edna Oraye-Imperial, Dean, PCU – Mary Johnston College of Nursing, for her support and for allowing us to have our related learning experiences in the clinical area that hone our knowledge skills and attitude to be a competent, caring, Christian nurses. Ms. Ma. Lourdes Galima, Clinical Instructor, for continually guiding and supporting us throughout our duty at the Surgery ward, for helping us in enhancing and improving our skills in the area. For the patience that she showed us despite of our attitude and mistakes. Ms. Loreto Vicarme, School Librarian, for allowing us to utilize the library books and references for our case study. To the staff nurses on duty at the Surgery Intensive Care Unit and Ward of Mary Johnston Hospital for the support and providing us with enough information about the routines in the area which we were able to apply. To our fellow group members for their continuous support and sharing their knowledge and experiences for polishing this case study...
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...22. Occasionally, following a cholecystectomy, undetected cholesterol stones are retained in the common bile duct. How can these stones be treated? Does it mean more surgery will have to be performed? These stones be treated by administering a solubilizing agent through a catheter into the bile duct, which may dissolve the remaining stones. This prevents the necessity to perform more surgery. 23. Discuss the conditions that pancreatitis is associated with in men and in women. How does this affect prognosis? In men it is often associated with alcoholism or peptic ulcers. In women it is more commonly associated with gallbladder disease. The prognosis is good if pancreatitis is associated with gallbladder disease but is very poor if it is related to alcoholism. 24. Discuss how pancreatitis is diagnosed and treated. The procedures to diagnosis pancreatitis include blood and urine tests for elevated pancreatic enzymes (lipase and amylase), fecal fat test, and an abdominal CT scan or ultrasound. The treatment requires hospitalization, a few days of fasting,fluid replacement, intravenous fluids (IV) nutrients, and...
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...migrate into the pancreas, causing pancreatitis. The pancreas is in the upper abdomen and lies behind the stomach and intestines. It makes a fluid that contains enzymes that are needed to digest food. The enzymes are made in the pancreatic cells and are passed into tiny tubes. These tubes join together to form the main pancreatic duct. This drains the enzyme-rich fluid into the duodenum. The enzymes are in an inactive form in the pancreas, they are 'activated' in the duodenum to digest food. Groups of special cells called 'Islets of Langerhans' are scattered throughout the pancreas. These cells make the hormones insulin and glucagon. The hormones are secreted directly into the bloodstream to control the blood sugar level. The bile duct carries bile from the liver and gallbladder. This joins the pancreatic duct just before it opens into the duodenum. Bile also passes into the duodenum and helps to digest food. Pancreatitis occurs when the pancreas becomes inflamed. When pancreatitis occurs, it's largely due to digestive enzymes attacking and digesting the pancreas, which produced them in the first place. There are two types of pancreatitis: Acute pancreatitis - when the inflammation develops quickly, over a few days or so. It often goes away completely and leaves no permanent damage. Sometimes it is serious. Chronic pancreatitis - when the inflammation is persistent. The inflammation tends to be less intense than acute pancreatitis but as it is ongoing it can cause...
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...concern, history of concern, allergies. O – VS appear to be erratic with fever, the PR is high, and PT has extremely low BP. CBC done with WBC very high. Jaundice is evident on PT. Lungs clear. Pain in LUQ obvious when examined. PT is also C/O swelling in ankles and dizziness. Denies dysuria. Infection is obvious. This is the objective data. It contains the observations made by the doctor during examination. Some of the information included in this area is the patient’s vital signs, general appearance and mental status. Laboratory results may also be included in this area. A – This 47 YO male has been found to be symptomatic of possible pancreatitis that has been occurring off and on for about a month. Patient is feverish and is showing signs of malaise. Findings suggest possible gall stone pancreatitis or acute pancreatitis. This is due to the occurrence of pain and nausea after...
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...Brief research into pancreatitis reveals that this disease is a dangerous inflammation and swelling of the blood vessels in the pancreas that prevents proper digestion. The immune system is the next part of the body that receives extensive damage from persistent alcohol use. Drinking leads to reduced function of the immune system which exposes the user to a greater risk of disease. Alcoholics have a much higher chance of contracting pneumonia and tuberculosis than even their counterparts who drink moderately. While these diseases are very serious for even the heathiest of individuals, often when an alcoholic contracts one of these it can be considered life threatening. Something I didn’t know prior to reviewing some published medical reports was that even drinking...
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...pear-shaped organ is a hollow sac that stores the digestive element bile, which is produced by the liver. Bile moves from the liver into the gallbladder for storage. When food is eaten, the gallbladder contracts and pushes the stored bile into the cystic duct and down the common bile duct into the duodenum of the small intestine where bile will help to break down food. Typical symptoms of gallbladder conditions include epigastric pain, abdominal pain, right upper quadrant pain, and/or pain that radiates around the right rib cage and into the back. Some people with gallbladder conditions may have no symptoms or problems at all. However, in some cases, gallbladder conditions can result in serious, even life-threatening complications, such as pancreatitis, biliary cirrhosis, and jaundice. The most common complication of the gallbladder however is cholecystitis. Which is a condition when calcifications and stones build up in the gallbladder lumen potentially causing blockage at any point in the biliary tree. The rarest condition is carcinoma of the Gallbladder. Gallbladder cancer is known to be most common in women and in people who have had a history of gallstones or other gallbladder conditions. Early gallbladder cancer often causes no symptoms and is usually discovered unexpectedly when someone has surgery to remove gallstones. About 1 in 5 gallbladder cancers are found in this way. Most tumors are unfortunately only discovered at an advanced stage. The stage of a cancer describes...
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