Complications of acute pancreatitis

992 views

Published on

acute pancreatitis

Published in: Health & Medicine
0 Comments
4 Likes
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
992
On SlideShare
0
From Embeds
0
Number of Embeds
2
Actions
Shares
0
Downloads
55
Comments
0
Likes
4
Embeds 0
No embeds

No notes for slide

Complications of acute pancreatitis

  1. 1. Complications of acute pancreatitis
  2. 2. Local 1. Fluid collection (ascites/ pleural effusion) 2. Pancreatic pseudo cyst 3. Pancreatic necrosis 4. Infected pancreatic abscess 5. Hemorrhage and pseudo aneurysm
  3. 3. Regional 1. Venous thrombosis 2. Paralytic ileus 3. Intestinal obstruction 4. Intestinal ischemia/ necrosis 5. Cholestasis
  4. 4. Systemic 1. Systemic inflammatory response syndrome 2. Multiple organ dysfunction syndrome 3. ARDS/ pulmonary failure. 4. Renal failure 5. Cardiovascular complication 6. Hypocalcemia 7. hyperglycemia
  5. 5. 7. Disseminated intravascular coagulopathy 8. Protein energy malnutrition 9. Encephalopathy
  6. 6. Local fluid collection • Small collection – reactionary. • Massive ascites and pleural effusion due to internal panceatic fistula. • Treatment : 1. ERCP to detect site of leakage followed by stenting 2. Distal pancreatic resection or internal drainage in Roux en Y jejunostomy.
  7. 7. Pseudo cyst • Peripancreatic fluid collection contained by fibrous granulation tissue contrast to cystic neoplasm having epithelialized wall. • D’ Egidio classification: Type I Acute post necrotic cyst Type II Post necrotic cyst Type III Retention cyst
  8. 8. Complications of pseudocyst 1. Infection 2. Hemorrhage 3. Mass effect 4. Leaks
  9. 9. Management • Type I percutaneous drainage • Type II and III internal drainage
  10. 10. Pancreatic necrosis • May be sterile or infected. • Treated by debridement (necrosectomy).
  11. 11. Pancreatic abscess • Arise from infection of pancreatic collection. • Ideally should not contain necrotic debris. • Must be differentiated from infected necrosum radiologically.
  12. 12. Clinical features of pancreatic abscess 1. Fever 2. Tachycardia 3. Abdominal pain 4. leucocytosis
  13. 13. Management 1. Percutaneous drainage radiolgically 2. Endoscopic drainage with placement of double j stent
  14. 14. SIRS &MODS • SIRS : Tachypnea, tachychardia, leucocytosis and hyperthermia. • Sepsis could be there. • May progress to MODS • Treatment is supportive care.

×