AN UPDATE ON ACUTE PANCREATITIS 11.01.2017

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