Acute pancreatitis history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2]
Overview
Patient history should include the evaluation of risk factors for pancreatitis, such as heavy alcohol use, certain medications, family history, history of autoimmune diseases, and history of gallstone diseases. Common symptoms of acute pancreatitis include severe epigastric abdominal pain (which worsens on eating) radiating to the back and and the shoulder blades, anorexia, nausea, vomiting, diarrhea, fever and chills. There may also be symptoms of indigestion and abdominal bloating.
History
Obtaining the right history assists in making a precise diagnosis in acute pancreatitis. The following history should be obtained from a patient presenting with acute abdominal pain:[1][2][3]
- Onset, duration, location, radiation, aggravating and relieving factors of abdominal pain
- Alcohol abuse
- Gall stone disease
- Diabetes mellitus
- Morbid obesity
- Hyperlipidemia
- Steroid abuse
- History of medication intake (which are known to cause pancreatitis)
- Autoimmune diseases like SLE
- Family history of pancreatitis, hyperlipidemia
Symptoms
Common Symptoms
Common symptoms include:[1][2][3]
- Severe upper abdominal pain. The pain:
- May be worse within minutes after eating or drinking at first, especially if foods have a high fat content;
- Becomes constant and more severe, lasting for several days;
- May be worse when lying flat on the back;
- May spread (radiate) to the back, or below the left shoulder blade.
- Nausea, vomiting, diarrhea and loss of appetite
- Fever / Chills
- Shock, hemodynamic instability
- Mild yellowing of the skin
- Hiccups
Less Common Symptoms
Other symptoms that may occur with this disease:[1][2][3]
- Indigestion
- Clay-colored stools
- Gaseous abdominal fullness
- Hiccups
- Skin rash or lesion
- Swollen abdomen
References
- ↑ 1.0 1.1 1.2 Dellinger EP, Forsmark CE, Layer P, Lévy P, Maraví-Poma E, Petrov MS; et al. (2012). "Determinant-based classification of acute pancreatitis severity: an international multidisciplinary consultation". Ann Surg. 256 (6): 875–80. doi:10.1097/SLA.0b013e318256f778. PMID 22735715.
- ↑ 2.0 2.1 2.2 Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD, Sarr MG; et al. (2013). "Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus". Gut. 62 (1): 102–11. doi:10.1136/gutjnl-2012-302779. PMID 23100216.
- ↑ 3.0 3.1 3.2 Forsmark CE, Vege SS, Wilcox M (November 17,2016). "Acute Pancreatitis". The New England Journal of Medicine: 1972–1981. doi:10.1056/NEJMra1505202. Retrieved November 25,2016. Check date values in:
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