First Things First (assess & treat for the following)

  • Pancreatitis has a wide array of disease severity & should always be taken very seriously. An initially mild case can progress rapidly to fatal disease. It is easy to underestimate the fluid requirements & need for resuscitation.
    • Does pt have evidence of hypovolemia or shock?
      • SBP < 90 mmHg, MAP < 60 mmHg, urine output < 0.5 cc/kg/hr
    • Does pt have electrolyte abnormalities or glucose abnormalities that require immediate attention?
    • Does pt have evidence of the potential hemorrhagic complications of pancreatitis (flank hematoma, decreasing hemoglobin)?
    • Does pt demonstrate evidence of systemic complications?
  • Pt w/ 3 or more initial Ranson’s criteria should be monitored & cared for in the ICU (see below).
  • Terminology of acute pancreatitis
    • Acute interstitial pancreatitis
    • Necrotizing pancreatitis
      • Sterile necrosis
      • Infected necrosis
    • Pancreatic fluid collection
      • Sterile
      • Infected
    • Pancreatic pseudocyst
      • Sterile
    • Pancreatic abscess

There's more to see -- the rest of this topic is available only to subscribers.

Last updated: May 10, 2010