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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