Acute pancreatitis resident survival guide

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vidit Bhargava, M.B.B.S [2]

Definition

It is an acute inflammation of the pancreas characterized by elevated pancreatic enzymes and severe abdominal pain.

Causes

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated. Acute pancreatitis from any cause may be life-threatening especially if it progresses to necrotizing pancreatitis. However, in last several years it has come down due to advances in diagnosis and treatment strategies.

Common Causes

  • Gallstones
  • Alcohol
  • Smoking[1]
  • Pancreatic tumor[2]
  • Medication such as 5-Mercapto-purine, azathioprine, 5-DDI[4]
  • Hypertriglyceridemia
  • Post - ERCP
  • Metabolic - Hypercalcemia and hyperphosphatemia.
  • Infections
  • Toxins such as venom of brown recluse spider, certain arachnids etc.
  • Pregnancy
  • Idiopathic
  • Ischaemic necrosis of pancreas from vascular sources such as vasculitis and atherosclerosis.

Management

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

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References


Template:WikiDoc Sources

  1. Rebours, V.; Vullierme, MP.; Hentic, O.; Maire, F.; Hammel, P.; Ruszniewski, P.; Lévy, P. (2012). "Smoking and the course of recurrent acute and chronic alcoholic pancreatitis: a dose-dependent relationship". Pancreas. 41 (8): 1219–24. doi:10.1097/MPA.0b013e31825de97d. PMID 23086245. Unknown parameter |month= ignored (help)
  2. Köhler, H.; Lankisch, PG. (1987). "Acute pancreatitis and hyperamylasaemia in pancreatic carcinoma". Pancreas. 2 (1): 117–9. PMID 2437571.
  3. Bleichner, JP.; Guillou, YM.; Martin, L.; Seguin, P.; Mallédant, Y. (1998). "-Pancreatitis after blunt injuries to the abdomen-". Ann Fr Anesth Reanim. 17 (3): 250–3. PMID 9750738.
  4. Yi, GC.; Yoon, KH.; Hwang, JB. (2012). "Acute Pancreatitis Induced by Azathioprine and 6-mercaptopurine Proven by Single and Low Dose Challenge Testing in a Child with Crohn Disease". Pediatr Gastroenterol Hepatol Nutr. 15 (4): 272–5. doi:10.5223/pghn.2012.15.4.272. PMID 24010098. Unknown parameter |month= ignored (help)