Pancreatitis Diagnosis, Tests, Cause, Treatment and Nursing Management

Pancreatitis: Diagnosis, Tests, Cause, Treatment and Nursing Management

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What is Pancreatitis

The pancreas is a gland of the digestive system and endocrine systems. Pancreas endocrine and exocrine glands. The endocrine function of the pancreas secretes hormones and the exocrine function is a secret enzyme.

Pancreatitis Definition

Pancreatitis is acute and chronic inflammation of pancreas and is associated with injury to exocrine parenchyma. 80% of the exocrine gland of the pancreas is effective in pancreatitis. Pancreatitis is a disorder in which auto digestion of the pancreas.

Types of pancreatitis  

  1. Acute pancreatitis
  2. Chronic pancreatitis

Acute pancreatitis 

  • Acute, sudden, severe inflammation of pancreas.
  •  Common cause of acute pancreatitis is auto digestion of pancreas by its own enzymes.
  • Acute pancreatitis is associated with abdominal pain.
  • Acute pancreatitis is a reversible disorder.
  • 80% of acute pancreatitis is mild.

Chronic pancreatitis

  • Chronic pancreatitis is a chronic, ongoing, progressive and irreversible inflammation of pancreas.
  • Chronic pancreatitis causes destruction of fibrous tissue.
  • Chronic pancreatitis is more common in male patients, onset 40 years old.

Cause of Pancreatitis

  • Excessive drinking of alcohol.
  • Idiopathic.
  • Cholelithiasis  ( gall bladder stone)
  • Cholecystitis
  • Pancreatic tumour
  • Trauma to pancreas
  • Peptic ulcer
  • Hypercalcemia and hyperthyroidism
  • Ischemic vascular disease
  • Medication – Thiazide diuretics
  • Steroids.
  • Hyperlipidaemia.

Pathophysiology of Pancreatitis

Cause / risk factor

Auto activation of the pancreatic enzyme (trypsin and lipase enzyme)

Auto digestion of pancreas by activated enzymes

Inflammation, injury, destruction, fibrosis

Pancreatitis.

Pancreatitis symptoms

Acute pancreatitis symptoms

    • abdominal pain – mild epigastria pain
  • Upper left quadrant pain
  • Sudden severe pain.
    • Abdominal rigid and abdominal tenderness
    • Abdominal distension
    • Nausea and vomiting
    • Fever
    • Weight loss, weakness
    • Anxiety and palpitation
    • Hyperglycaemia
    • Elevated WBC
    • Tachycardia and dehydration
    • Cullen sign
    • Turner sign.

Chronic pancreatitis Symptoms

  • Abdominal pain and tenderness.
  • Steatorrhea (fatty stool)
  • In digestion, flatus
  • Weight loss, weakness, malnourished
  • Diabetes mellitus
  • Muscles wasting
  • Jaundice.

 Most signs of pancreatitis

Cullen sign – Discoloration of the abdomen and periumbilical area.

Turner’s sign – Bluish discoloration of the flanks.

Diagnosis of pancreatitis

  • History collection and physical examination.
  • Serum amylase and serum lipase (elevated).
  • Urinary amylase (elevated).
  • Abdominal USG.
  • Endoscopic retrograde cholangiopancreatography (ERCP).
  • CT- scan and MRI.
  • Blood glucose test (hyperglycemia).
  • Serum calcium (hypocalcemia).
  • LFT, AST, ALT.
  • X-ray.

Treatment of Pancreatitis

  • The Administrator prescribed IV therapy.
  • Maintain NPO.
  • Use NG Tube, when a client is vomiting or has paralytic ileus.

Drug use in Pancreatitis

– Analgesic (meperidine)

– Nitro-glycerine – relax smooth muscles.

– Antispasmodic – (Bus Copan)

– Carbonic anhydrase inhibitor (acetazolamide).

– Antibiotics – for inflammation

– Antiemetic – for vomiting.

– Antacids – for neutralization of gastric HCL.

– Proton pump inhibitors (pantocid)

– Calcium administer – for hypocalcemia.

– H2 blocker (ranitidine).

Surgical in Pancreatitis

  • Subtotal pancreatectomy
  • Cholecystectomy
  • Endoscopic retrograde cholangio pancreatogram.
  • Pancreato jejunostomy.
  • Necrosectomy.

Complication in Pancreatitis

  • Cirrhosis of the liver.
  • Cholecystitis.
  • Acute respiratory distress syndrome (ARDS).
  • Diabetes mellitus.
  • Haemorrhagic shock.
  • Jaundice
  • DIC.

Nursing management  

  • Monitor vital signs and body weight.
  • Nurses maintain fluid and electrolyte balance.
  • Nurse examines diagnostic procedures.
  • Provide IV fluid to maintain hydration status.
  • Nurses provide parenteral nutrition in server cases.
  • Provide comfort and rest to a patient.
  • Administer meperidine analgesic for relief pain. (Morphine is contraindicated in pancreatitis).
  • Instruct clients to avoid alcohol consumption.
  • Instruct the client to avoid heavy meals.
  • Insulin and hypoglycaemic agent administrator to treat DM.
  • Assess pancreatic signs (Cullen and Turner sign).
  • Provide low sugar food and vitamin A, D, E, K supplement.
  • Educate about the importance of follow-up care.

Key Points

  1. Sweat gland in the body – Pancreas.
  2. Exocrine and endocrine glands in the body – Pancreas.
  3. Pancreatitis loss which type function of pancreas – Enzymatic function.
  4. Acute pancreatitis is associated with – Abdominal pain.
  5. The most common cause of pancreatitis – Cholithiasis.
  6. Abdominal pain site in pancreatitis – Left upper quadrant.
  7. Pancreatitis common sign – Cullen sign or Turner sign.
  8. Bluish discoloration of the flanks – Turner’s sign.
  9. Administer analgesic in pancreatitis – Meperidine
  10. Morphine is contraindicated in pancreatitis because – Spasm of sphincter of Oddi.

What is Sweat Glands?

Pancreas

Which type of pancreas gland

Exocrine and endocrine glands in the body – Pancreas.

What is the Most Common Couse of Pancreatitis?

Cholelithiasis.

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