Pancreatitis

Pancreatitis

Definition:

Inflammation of the pancreatic cells.

Types of the Pancreatitis:

Acute Pancreatitis:

Definition:

Acute inflammatory process of pancreas, degree of inflammation varies from mild edema to severe hemorrhage necrosis, often in middle aged males.

Etiology:

  1. Primary etiology:
  2. Billiary tract disease
  3. Alcoholism
  4. Other less common causes:
  5. Viral infection (mumps, coxsakier Virus B)
  6. Abscesses
  7. Cystic fibrosis
  8. Certain drugs (cortisol, diuretics, NSAIDS)
  9. Metabolic disorder
  10. Idiopathic may be

Clinical features:

  1. Pain
  2. Vomiting
  3. Fever
  4. Tenderness
  5. Distension
  6. Decreased & absent peristalsis
  7. Hypo-volumic shock
  8. Ascites
  9. Jaundice Investigations:
  10. Serum amylase, Lipase & urinary amylase level (elevated)
  11. Blood Glucose
  12. CTS
  13. Serum Calcium
  14. Complications:
  15. Pseudo cyst
  16. Abscesses
  17. Pleural effusion
  18. Atelectasis
  19. Pneumonia

Medical Management:

  1. Analgesic
  2. Antipyretic
  3. Anti-inflammatory
  4. IV maintains

Nursing Management

  1. Control of fluid & electrolyte imbalance
  2. NPO with NG tube to suction & reduce secretion
  3. Teach patient to avoid alcohol
  4. Bed rest
  5. Ringer lactate for fluid & electrolyte & bed rest & proper diet, good oral hygiene should be maintained & take measures to treat complications accordingly.

Chronic Pancreatitis

Definition:

A progressive destruction of the pancreas with fibrolite replacement of pancreatic tissue structure & calcification may also occur in the pancreas.

Etiology:

  1. Recurrent of acute Pancreatitis
  2. Types of Chronic Pancreatitis:
  3. Chronic Obstructive Pancreatitis due to the Billiary disease

Chronic Calcifying Pancreatitis due to the alcohol (alcohol induced Pancreatitis)

Clinical features:

  1. Abdominal pain
  2. Pancreatic fibrosis
  3. Burning
  4. Weight loss
  5. Constipation
  6. Mild jaundice
  7. Dark urine
  8. Tenderness

Investigations:

  1. Serum amylase, lipase & urinary amylase laser (elevated)
  2. Blood Glucose
  3. CTS
  4. Serum calcium

Medical Management:

  1. Analgesic
  2. Antacids
  3. Anticholensing drug
  4. H-2 receptors antagonists
  5. Cimetidine
  6. Ranitidine
  7. For diabetic patient insulin therapy included

Nursing Management

  1. Advised for low fiber diet, high carbohydrate & high protein diet
  2. Alcohol should be avoided totally
  3. Control on clinical features
  4. Care of the mouth
  5. Observe for stool and urine coloration.

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