CHAPTER 7 Gastrointestinal System^315
Pancreatitis
WHAT WENT WRONG?
Pancreatitis is an inflammation of the pancreas which causes destructive cellular
changes. It may be an acute or a chronic process. Acute pancreatitis involves auto-
digestion of the pancreas by pancreatic enzymes and development of fibrosis. Blood
glucose control may be affected by the changes to the pancreas. Chronic pancreatitis
results from recurrent episodes of exacerbation, leading to fibrosis and a decrease in
pancreatic function. Presence of gallstones blocking a pancreatic duct, chronic use
of alcohol, post-abdominal trauma or surgery, or elevated cholesterol are associated
with an increased risk of pancreatitis.
PROGNOSIS
Acute pancreatitis may be life-threatening. Pleural effusion may develop as a com-
plication of acute pancreatitis; older patients have a greater risk of also developing
pneumonia. Disseminated intravascular coagulation is another complication that
may occur, affecting the body’s ability to clot due to depleted clotting factors in
the development of small thrombi.
HALLMARK SIGNS AND SYMPTOMS
- Epigastric pain due to inflammation and stretching of pancreatic duct
- Boring abdominal pain may radiate to back or left shoulder in acute pan-
creatitis - Gnawing continuous abdominal pain with acute exacerbations in chronic
pancreatitis - Patient in knee-chest position for comfort—reduces tension on abdomen
- Nausea and vomiting
- Bluish-gray discoloration of periumbilical area and abdomen (Cullen’s sign)
- Bluish-gray discoloration of flank areas (Turner’s sign)
- Ascites
- Weight loss
- Blood glucose elevation
- Fatigue
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