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Some simple facts about Pancreatitis:
- Causes (First two are the most common in the United States)
- Gallstones
- Alcohol
- Hyperlipidemia
- Medications [azathioprine, corticosteroids, sulfonamides, thiazides, furosemides, NSAIDs, mercaptopurine, methyldopa, and tetracyclines]
- Peptic Ulcer Disease
- Scorpion and Snake Bites
- Trauma
- Infections [ ascaris, mumps, coxsackie virus, cytomegalovirus, Epstein Barr Virus, mycoplasma]
- Chronic Pancreatitis may not be associated with an elevation of lipase or amylase.
- Lipase is more specific for pancreatitis
- Amylase can be elevated in:
- pancreatitits
- salivary gland injury/disease
- ruptured ectopic pregnancy
- ovarian cysts
- salpingitis
- inflammation of the bowel [appendicitis, obstruction]
- end stage renal and liver disease [due to decreased clearance]
- 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.
- Complications:
- Pseudocyst
- Phlegmon
- Necrosis of the pancreas
- Hemorrhage
- Intestional obstruction
- fistula formation.