Alimentary System: Acute and Chronic Pancreatitis (see note Anatomy of the Pancreas)

Inflammatory process with cascade of release of inflammatory cytokines (TNFA, IL2, IL6, platelet-activating factor (PAF)) & pancreatic enzymes (trypsin, lipases, co-lipases) initiated by pancreatic injury, but which may develop into full blown MODS or SIRS.
OHOCS

Causes of acute pancreatitis.

Clinical features of acute pancreatitis.

Classification/complications of acute pancreatitis.

Emergency Mx/resuscitation of suspected acute pancreatitis.

Glasgow Imrie criteria. Box from OHOCS.

Ix/Dx of acute pancreatitis.

Rx of acute pancreatitis.

Chronic pancreatitis - key facts:
* Characterized by recurrent or persistent abdo P arising from the pancreas
* Often associated with exocrine or endocrine pancreatic insufficiency
* Characterized by irreversible destruction & fibrosis of pancreatic parenchyma
* May arise following one or more episodes of acute pancreatitis or may be a chronic progressive process de novo
OHOCS

Pathological features of chronic pancreatitis:
* May affect all or part of gland (focal)
* Head tends to most severely involved part in chronic alcohol DS
* Features of acute pancreatitis may occur—oedema, acute inflammatory infiltrate, focal necrosis, intraparenchymal haemorrhage
* Chronic inflammatory changes cause progressive disorganization of the pancreas:
> Glandular atrophy & duct ectasia
> Microcalcification & intraductal stone formation with cystic changes secondary to duct occlusion
OHOCS

Causes of chronic pancreatitis.

Features of chronic inflammation, exocrine, & endocrine failure in chronic pancreatitis.

Rx of chronic pancreatitis.

What risks are associated with resectional SX?