Category: Fundamentals
Gastroenteritis is an inflammation of the stomach and small/large bowel intestines. Most cases present as a self-limited illness, and most patients have nausea, vomiting and diarrhea, often with diarrhea being the predominant symptom.
Category: Fundamentals
Pancreatic cancer is a particularly lethal form of cancer because it often goes undetected until the later stages. The survival rate is less than 10%, with only about 5% of patients surviving 5 years from the time of diagnosis.
Category: Fundamentals
The treatment of acute pancreatitis is mainly supportive. Volume replacement is important because patients with pancreatitis are often volume-depleted from decreased oral intake, emesis, diaphoresis or third-spacing of fluids.
Category: Fundamentals
Lipase plays a major role in fat metabolism and is produced predominantly by the pancreas. Elevated lipase levels can also be seen in certain extrapancreatic disease processes, but it is more specific for pancreatitis than amylase.
Category: Fundamentals
Amylase levels rise in pancreatitis, but elevations can also be seen in many other conditions, such as malignancy, trauma, burns, salivary and liver disease, cholecystitis, renal failure, HIV and pregnancy.
Category: Fundamentals
Laboratory diagnosis of pancreatitis is based on serum amylase and lipase levels. Amylase is an enzyme that functions in carbohydrate digestion that is produced by the pancreas and salivary glands, as well as several other organs.
Category: Fundamentals
Patients with acute pancreatitis typically complain of the rapid onset of constant epigastric or left upper quadrant pain. The pain may radiate to the back or flanks, with bandlike distribution and may be accompanied by nausea and vomiting.
Category: Fundamentals
Acute pancreatitis can be classified by type, interstitial edematous versus necrotizing pancreatitis, and by local complications. Most patients have the interstitial edematous type, which usually resolves within the first week of illness.
Category: Fundamentals
Acute pancreatitis begins with an initial inciting event, such as exposure to a toxin or duct obstruction by gallstones. Cellular injury disrupts normal membrane trafficking and triggers the activation of trypsinogen and other enzymes.
Category: Fundamentals
The exocrine function of the pancreas is carried out by the excretion of various digestive enzymes, such as trypsinogen. The endocrine function of the pancreas includes secretion of the regulatory hormones insulin, glucagon and somatostatin.
Category: Fundamentals
The pancreas is a retroperitoneal organ with endocrine and exocrine functions. It contains three segments that span across the abdomen. A large main pancreatic duct (duct of Wirsung) courses within the pancreas from the tail to the head.
Category: Fundamentals
There are numerous causes of acute pancreatitis. However, the most common causes in the United States are gallstones and chronic alcohol consumption. Other causes include infection, hypertriglyceridemia, hypercalcemia and tumors.
Category: Fundamentals
Acute pancreatitis is an inflammatory condition that occurs when enzymatic autodigestion and an inflammatory cascade result in destruction of pancreatic tissue. Presentation ranges widely from mild to sepsis and multiorgan failure.
Category: Fundamentals
The current standard of care for patients with hepatic encephalopathy is treatment with nonabsorbable disaccharides (lactulose). Lactulose decreases the absorption of ammonia through osmotic cathartic effects and by altering the colonic pH.
Category: Fundamentals
Hepatic encephalopathy is a state of altered cerebral function from the diseased liver’s failure to perform its metabolic functions adequately. Clinical manifestations range from mild cognitive dysfunction, irritability and confusion to coma.
Category: Fundamentals
Removal of very large quantities of ascitic fluid can result in body fluid and electrolyte abnormalities, intravascular volume depletion and hemodynamic instability, commonly known as paracentesis-induced circulatory dysfunction.
Category: Fundamentals
Ascites occurs as a consequence of portal hypertension, impaired hepatic lymph flow, hypoalbuminemia and renal salt retention. When severe, it can cause respiratory compromise or significant discomfort.
Category: Fundamentals
The clinical manifestations of cirrhosis are related to loss of hepatocytes, leading to metabolic and synthetic dysfunction, or to fibrosis and altered hepatic architecture, resulting in impaired portal vein blood flow and portal hypertension.
