© Springer International Publishing AG 2017
Dale A. Dangleben and Firas G. Madbak (eds.)Acute Care General Surgery 10.1007/978-3-319-52255-5_2424. Acute Pancreatitis
(1)
Department of Surgery, York Hospital, York, Pennsylvania, USA
(2)
Department of Surgery, Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania, USA
Keywords
Acute pancreatitisChronic pancreatitisRanson’s criteriaEUSERCPBuckle up and just ride out the storm
Learning Objectives
- 1.
Be able to diagnose acute pancreatitis and severe acute pancreatitis.
- 2.
Identify the different etiologies that cause acute pancreatitis.
- 3.
Recognize complications associated with acute pancreatitis and their management.
- 4.
Be able to recognize and diagnose chronic pancreatitis.
- 5.
Recognize the etiologies of chronic pancreatitis.
- 6.
Recognize complications of chronic pancreatitis and how to manage them.
- 7.
Become familiar with the surgical procedures and their indications for the treatment of chronic pancreatitis.
Case Scenario
A 45-year-old male presents to the emergency department complaining of severe abdominal pain, nausea, and vomiting. His medical history is unremarkable, and he denies a surgical history. He strongly denies alcohol use and does not take daily medications. His family history is only remarkable for cardiac disease. On physical examination, he has mid-epigastric tenderness to palpation. His laboratory studies reveal a leukocytosis, an elevated lipase, but a normal hepatic function panel. He is diagnosed with acute pancreatitis.
He is admitted, made NPO, and receives fluid resuscitation. His triglyceride levels come back as over 1000 mg/Dl, and he is diagnosed with hyperlipidemia. He is treated appropriately and discharged. However, 2 weeks later, he is brought by ambulance with altered mental status, hyperthermia, tachycardia, and tachypnea. A CT scan of his abdomen reveals findings associated with pancreatic necrosis. He undergoes percutaneous drainage successfully. He recuperates and is discharged with fenofibrate and high-dose lovastatin to prevent future pancreatitis episodes.