This document discusses acute pancreatitis, including its definition, classification, incidence, etiology, pathogenesis, and pathophysiology. Acute pancreatitis is an inflammatory disease of the pancreas with varying degrees of severity from mild self-limiting inflammation to critical illness. It commonly results from alcohol use or gallstone disease. The pathogenesis involves acinar cell events and cytokine activation that determine the clinical course. Incidence is approximately 50 per 100,000 population per year in India and 49.3 per 100,000 in the United States.

2. ACUTE
PANCREATITIS
DR ARPITA SINGH
INTRODUCTION
ETIOLOGY
PATHOGENESIS

3. DEFINITION & SPECTRUM
 Inflammatory disease of the pancreas
associated with little or no fibrosis
 Mild self limiting inflammation to critical
disease
 SIRS
 MODS

4. INCIDENCE :
WORLD SCENARIO
 49.3 PER 100000
POPULATION PER
YEAR IN USA
INDIAN SCENARIO
 50 PER 100000
POPULATION PER
YEAR

5. CLASSIFICATION
 MILD
 MODERATE
 SEVERE
 CRITICAL

6. ETIOLOGY I
METABOLIC
 ALCOHOL
 Hyperlipoproteinaemia
 Hypercalcaemia
 Drugs
 Genetics
 Scorpion venom

7. ETIOLOGY II
MECHANICAL
 CHOLELITHIASIS
 ERCP
 Post operative
 Pancreatic divisum
 Pancreatic duct obstruction
 Pancreatic ductal bleeding
 Post traumatic
 Duodenal obstruction

8. ETIOLOGY III
VASCULAR
 Post operative in
cardiopulmonary
bypass
 PAN
 Atheroembolism
INFECTIONS
 Mumps
 Coxsackie B
 CMV
 Cryptococcus

9. EVENTS IN
AP:
 ACINAR CELL
EVENTS
 CYTOKINE
ACTIVATION

11. ALCOHOLIC PANCREATITIS
 MOST COMMON cause
 AMOUNT & PATTERN is more important

12. BILIARY TRACT DISEASE
 HYPOTHESIS, not yet THEORY
1. OPIE’S COMMON CHANNEL
hypothesis
2. TRANSIENT incompetence of the
sphincter due to stone lodgement
3. DUCTAL HYPERTENSION

13. DRUG INDUCED PANCREATITIS
 AZATHIOPRINE
 SULPHONAMIDES
 Na VALPROATE
 FUROSEMIDE
 6 MERCAPTO PURINE
 TETRACYCLINE
 STATINS
 DIGOXIN

14. METABOLIC FACTORS
 HYPERTRIGLYCERIDAEMIA
 HYPERCALCAEMIA
 SCORPION VENOM

15. MISCELLANEOUS
 PANCREATIC TUMOUR
 IDIOPATHIC

16. PATHOPHYSIOLOGY WILL DETERMINE THE
COURSE OF CLINICAL FEATURES