acute abdomen

stephen 47yr,
1. severe abdominal pain since 1 day
  1. chronic epigastric pain with mild-chronic diarrhea + bulky stools and steatorrhea
causes
1. perforating peptic ulcer
  1. intestinal obstruction
    1. ichemic bowel disease
      1. acute appendicites
        peritonitits
        acute pancreatitis
        anatomy
        embryology
        physiology
        endocrine
        exocrine
        causes
        alcohol
        gallstones
        drugs thiazides
        hypercalcimia
        infections
        mumps CMV
        shock
        trauma
        genes
        PRSS-1 SPINK-1
        idiopathic
        pathogenesis
        pancreatic duct obstruction
        edema
        compression of blood vessels
        ischemia
        acing cell damage
        release pancreatic enzyme
        auto digestion of pancreas
        C/P
        abdominal pain
        nausea
        retroperitoneal bleeding
        low hematocrit
        complications
        pseudocyst
        infected pancreatic necrosis
        SIRS
        chronic pancreatitis
        early complications
        biliary obstruction
        multi-organ failure
        peritonitis
        haemorrage
        wiring rupture
        infection of the necrosis
        management
        fluids for shock
        treat cause
        oxygen
        painkillers
        nutritional supplements
        surgical treatment
        remove bile duct obstruction
        cholecystectomy
        pancreas surgery
criteria of diagnosis and prognosis
1. ranson criteria
  1. 3 and less mild AP
    1. 4 and more severe AP
investigations
1. for AP
  1. severe abdominal pain
    1. amylase or lipase X3 higher
      1. abdominal imaging results
  2. also
    1. CBC
    2. LFTs
    3. serum Ca2+
    4. Hb
    5. pulse oximetry
    6. ABG
2. for chronic pancreatitis
  1. fecal fat
    1. fecal pancreatic elastase
3. ultrasound
  1. MRI
    1. CT scan
      1. ERCP
chronic pancreatitis
1. risk factors
  1. males
    1. alcohol
      1. cystic fibrosis
        gallstones
        hypercalcemia
        acute pancreatitis
        idiopathic
2. S&S
  1. abdominal pain
    1. nausea
      1. weight loss
        stools don't flush
        fever
        diabetic evidence
3. pathogenesis
4. C/P
  1. similar to AP plus
    1. calcification on pancreatis
      1. diabetes millitus
        pancreatic cancer
5. Differential Diagnosis
  1. ACUTE
  2. CHROIC

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acute abdomen

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	Creado por hassan abu juama hace más de 6 años