Acute Pancreatitis (Day 3)
- abdominal pain + ↑lipase
- ionized Ca++ ≈ 0.95 mmol/L
- mild AKI + ↑WCC + ↑bili + ↑BGL
Aetiology:
- Ethanol*
- Gallstones* : → {1+2} ≈ 85%
- Idiopathic ≈ 7%
- Traumatic
- Familial / hereditary
- Cystic fibrosis
- SIRS, ARDS, MODS → ?ischaemic pancreatitis
- Metabolic
- hyperlipidaemia
- hyperparathyroidism, hypercalcaemia
- renal failure
- acute fatty liver of pregnancy
- haemochromatosis
- Infections
- viral hepatitis, mumps
- Coxsackie, Echovirus and other viruses
- Mycoplasma, Ascariasis
- Autoimmune → "pancreatic vasculitis"
- SLE, TTP, necrotising vasculitis
- Drugs
- thiazides, frusemide, valproate
- vit D, oestrogens
- sulphonamides, tetracyclines, azathioprine
- possible associations : steroids, methyl-dopa, procainamide, chlorthalidone, ethacrynic acid, β-blockers, cimetidine, clonidine, rifampicin, phenformin, paracetamol
- Toxins
- methanol
- scorpion envenomation
- organophosphate poisoning
- Renal transplant
- surgery
- hypercalcaemia, steroids (?), diuretics
- viral infections, immunosuppressives
- GIT disease
- duodenal ulcer, penetration / perforation
- Crohn's disease
- obstruction of the Ampulla of Vater
- pancreas divisum
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