ACUTE PANCREATITIS

DR ARPITA SINGHINTRODUCTION

ETIOLOGY

PATHOGENESIS

DEFINITION & SPECTRUM

Inflammatory disease of the pancreas associated with little or no fibrosis

Mild self limiting inflammation to critical disease

SIRS MODS

INCIDENCE :

WORLD SCENARIO

49.3 PER 100000 POPULATION PER YEAR IN USA

INDIAN SCENARIO

50 PER 100000 POPULATION PER YEAR

CLASSIFICATION

MILDMODERATESEVERECRITICAL

ETIOLOGY I

METABOLIC

ALCOHOL Hyperlipoproteinaemia Hypercalcaemia Drugs Genetics Scorpion venom

ETIOLOGY IIMECHANICAL

CHOLELITHIASIS ERCP Post operative Pancreatic divisum Pancreatic duct obstruction Pancreatic ductal bleeding Post traumatic Duodenal obstruction

ETIOLOGY III

VASCULARPost operative in

cardiopulmonary bypass

PANAtheroembolism

INFECTIONSMumpsCoxsackie BCMVCryptococcus

EVENTS IN AP: ACINAR CELL

EVENTS

CYTOKINE ACTIVATION

ALCOHOLIC PANCREATITIS

ETHANOL METABOLICTOXINS

BRIEF SECRETORY BURST WITH

SPASM OF SOO

MOST COMMON cause

AMOUNT & PATTERN is more important

BILIARY TRACT DISEASE

HYPOTHESIS, not yet THEORY 1. OPIE’S COMMON CHANNEL

hypothesis 2. TRANSIENT incompetence of the

sphincter due to stone lodgement 3. DUCTAL HYPERTENSION

DRUG INDUCED PANCREATITIS AZATHIOPRINE SULPHONAMIDES Na VALPROATE FUROSEMIDE 6 MERCAPTO PURINE TETRACYCLINE STATINS DIGOXIN

METABOLIC FACTORS

HYPERTRIGLYCERIDAEMIAHYPERCALCAEMIASCORPION VENOM

MISCELLANEOUS

PANCREATIC TUMOUR IDIOPATHIC

PATHOPHYSIOLOGY WILL DETERMINE THE COURSE OF CLINICAL FEATURES

Thank you