This document discusses pancreatitis, including its definition, types, causes, pathophysiology, signs and symptoms, diagnostic studies, complications, and management. Pancreatitis is inflammation of the pancreas that can damage the organ through premature activation of digestive enzymes. It can be acute, with rapid onset but potential reversibility, or chronic, resulting from irreversible structural changes over many years. Gallstones and alcohol are major causes. Diagnostic tests include blood tests, imaging like CT scans, and procedures like ERCP. Complications involve infection, pancreatic cancer, or nutritional issues. Treatment involves managing pain, treating underlying causes, and surgery in some cases. Nursing care focuses on pain management, fluid and nutrition management, and addressing related risks

1. Presenter
Meha
M.Sc (N)
PRACTICE TEACHING
ON
PANCREATITIS

2. Definition
Anatomy and physiology of pancreas
Types of pancreatitis
Main causes of pancreatitis
Pathophysiology
Sign and symptoms
Diagnostic studies
Complications
Medical management
Surgical management
Nursing management
Research abstract 2

3. Inflammation of the pancreas that can lead to digestion of the
pancreas by its own enzymes and/or irreversible structural damage to
the organ.
Or
Pancreatitis is a painful inflammatory condition in which the
pancreatic enzymes are prematurely activated resulting in auto
digestion of the pancreas.
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DEFINITION

4. ANATOMY
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6. PHYSIOLOGY
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7. Acute pancreatitis:Epidemiology
 Incidence about 50 per 100,000 population per year
 80%have mild disease
 40%with severe disease dev. infected pancreatic
necrosis
 The mortality ass. with infected necrosis is about 40%
 This usually occurs in the absence of local
complications
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8. CONSENSUS CLASSIFICATION
(Revisionof theAtlanta 1992classification)
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9. Types of
Pancreatitis

10. • Sudden inflammation of the pancreas due to something
that has triggered the digestive enzymes to become
activated inside the organ (there will be a high amylase
and lipase level in the blood).
• It comes on quickly and if treated promptly it can be
reversed. Typically there is limited structural damage to
the pancreas because it can be reversed with proper
treatment 10

11. Chronic inflammation of the pancreas (can be from
repeated episodes of acute pancreatitis but most
commonly due to years of alcohol abuse) that has
led to irreversible damage to the structure of
pancreas.
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12. PHASES


EARLYPHASE
Occurs within1stweek
Involves early inflammation with

variable degree ofpancreatic
edema & ischemia
Leads toresolution / permanent

necrosis & liquefaction
Severity isentirely based onclinical
parameters
LATE PHASE
Begins after the first week,
can extend toweeks or
months
Characterized by increasing
necrosis, infection
Imaging becomes moreI
important for detecting local
complications & directing
treatment
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13. PHASES
EARLY PHASE
Occurs within 1st week
Involves early inflammationwith
variable degree ofpancreatic
edema &ischemia
Leads toresolution / permanent
necrosis & liquefaction
Severity isentirely based on
clinical parameters
LATE PHASE
Begins after the first week, can
extend to weeks or months
Characterized by increasing necrosis,
infection
Imaging becomes more important
for detecting local complications &
directing treatment
13

14. Grades of Severity
Mild acute pancreatitis
Moderately severe acute pancreatitis
Severe acute pancreatitis
 No organ failure
 No local orsystemiccomplications
 Organ failure that resolves within 48 h
(transient organ failure) and/or
 Local or systemic complications without
persistent organ failure
Persistent organ failure (>48 h)
–Single organ failure
–Multiple organ failure

15. CAUSES OF PANCREATITIS
ACUTE PANCREATITIS
Main causes gallstones and high alcohol consumption
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16. CHRONIC PANCREATITIS
Main cause is heavy-long term alcohol
consumption
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19. PATHOPHYSIOLOGY

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24. Fox's sign : The sign is named after George Henry Fox.

25. DIAGNOSTIC STUDIES

26. Abdominal ultrasound
Computerized tomography (CT) scan.
Endoscopic ultrasound (EUS).
Magnetic resonance cholangiopancreatography (MRCP)
Endoscopic retrograde cholangiopancreatography (ERCP),
CT–guided needle aspiration
Abdominal x-rays:
Upper GI series:
Serum amylase
Serum bilirubin:
Alkaline phosphatase:
Serum albumin and protein
Serum calcium:
CBC:
Serum glucose 26

27. Baseline CT scanning is indicated in the
following situations:(1) the diagnosis is in
doubt;(2) severe pancreatitis is suspected
because of high fever (higher than 38.8°
C[102°F]), distension and leukocytosis
CT Severity Index (Balthazar Score) in Acute
Pancreatitis
Helpful in assessing complications related to
acute pancreatitis or as a follow-up study in
patients who are clinically deteriorating

29. CT Scan of acute pancreatitis
CT shows significant swelling
and inflammation of the
pancreas
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30. Gall stone pancreatitis by ERCP
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31. Infection
Pancreatic
cancer
Breathing
problems
Diabetes.
Malnutrition
Pseudocyst COMPLICATIONS

32. MANAGEMENT
Mild pancreatitis
-Fasting
-Fluid restriction
-Analgesia
-Treat underlying
cause
-No role for antibiotic
Severe pancreatitis
-Admission to ICU
-Monitoring
-Supportive therapy
-Nutritional support
-CTscan
-ERCP (in 72hours )
Enzymes to improve digestion
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33. SURGICAL MANAGEMENT
Sphincterotomy. Cholecystectomy Stent placement
Balloon
dilatation
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34. ERCP : Endoscopic retrograde cholangiopancreaticography 34

35. NURSING MANAGEMENT

36. NURSING DIAGNOSIS
• Ineffective Breathing Pattern related to severe pain and pulmonary
complications
•Acute Pain May be related to Obstruction of pancreatic, biliary ducts,
Chemical contamination of peritoneal surfaces by pancreatic exudate/
auto digestion of pancreas ,Extension of inflammation to
the retroperitoneal nerve plexus Possibly evidenced by Reports of pain
Self-focusing, grimacing, distraction/guarding behaviors, Autonomic
responses, alteration in muscle tone.
• Chronic Pain related to chronic and unrelenting insult to pancreas
36

37. • Deficient Fluid Volume related to vomiting, self-
restricted intake, fever, and fluid shifts
• Imbalanced Nutrition: Less Than Body Requirements
related to fear of eating, mal absorption, and glucose
intolerance
• Impaired skin integrity related to poor nutritional status,
bed rest, and multiple drains and surgical wound
• Anxiety related to surgical intervention
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38. RESEARCH ABSTRACT
99 patients with pancreatitis are discussed, 95 of whom had pancreatitis
induced by cane spirits. One quarter of the patients had pancreatic
calcification (more Indians than Africans) and 13% had pancreatic
pseudocysts (32% Indians, 6% Africans). Over 50% of the African patients
were in the lower dietary group, consuming meat less than twice weekly.
Pancreatic function tests (secretin-cholecystokinin) disclosed a low
bicarbonate and amylase secretion in 84 patients and a lowered
concentration associated with a large volume of secretion in 15 patients.
Triple-lumen intestinal perfusion with sucrose or glucose revealed a
diminished absorption of both sugars in pancreatitis with diabetes and
other groups tested. Water and sodium absorption were increased, and
potassium secretion was increased in pancreatitis with diabetes. 38

39. SUMMARIZATION
39
Definition
Anatomy and physiology of pancreas
Types of pancreatitis
Main causes of pancreatitis
Pathophysiology
Sign and symptoms
Diagnostic studies
Complications
Medical management
Surgical management
Nursing management
Research abstract

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