Podcast #399: Hunting for pancreatitis

Podcast #399: Hunting for pancreatitis

Author: Michael Hunt, MD

Educational Pearls:

  • Alcohol and gallstones are most common causes of pancreatitis
  • Diagnosis is not simply based on lipase alone - must have at least two the the three criteria:
    • Elevated lipase (greater than 3x upper limit of reference range)
    • Typical pain (epigastric pain, radiating to back, etc.)
    • Radiographic findings suggestive of pancreatitis (CT, MRI, US)
  • BISAP criteria can help risk stratify mortality in pancreatitis. You get 1 point for each of the following:
    • BNP > 25
    • Impaired mental status
    • SIRS criteria, more than 2
    • AGE > 60
    • Pleural effusion
  • BISAP score of 0 has < 1% mortality

Editor's note: The severity of pancreatitis does not correlate with serum lipase levels - notice how it is not used in the BISAP criteria, as an example. Even a mild elevation in serum testing can result in severe pancreatitis.

References:

Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD, Sarr MG, Tsiotos GG, Vege SS; Acute Pancreatitis Classification Working Group.. Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013 Jan;62(1):102-11. doi: 10.1136/gutjnl-2012-302779. Epub 2012 Oct 25. PubMed PMID: 23100216.

Papachristou GI, Muddana V, Yadav D, O'Connell M, Sanders MK, Slivka A, Whitcomb DC. Comparison of BISAP, Ranson's, APACHE-II, and CTSI scores in predicting organ failure, complications, and mortality in acute pancreatitis. Am J Gastroenterol. 2010 Feb;105(2):435-41; quiz 442. doi: 10.1038/ajg.2009.622. Epub 2009 Oct 27. PubMed PMID: 19861954.

Wu BU, Johannes RS, Sun X, Tabak Y, Conwell DL, Banks PA. The early prediction of mortality in acute pancreatitis: a large population-based study. Gut. 2008 Dec;57(12):1698-703. doi: 10.1136/gut.2008.152702. Epub 2008 Jun 2. PubMed PMID: 18519429.



Jaksot(1145)

Episode 928: Neutropenic Fever

Episode 928: Neutropenic Fever

Contributor: Taylor Lynch, MD Educational Pearls: What is neutropenic fever? Specific type of fever that is seen in cancer patients and other patients with impaired immune systems These patients a...

28 Loka 20245min

Episode 927: Functional Gallbladder Syndrome

Episode 927: Functional Gallbladder Syndrome

Contributor: Jorge Chalit-Hernandez, OMS3 Typically presents with biliary colic Right upper quadrant abdominal pain lasting more than 30 minutes and subsiding over several hours Often associate...

22 Loka 20245min

Episode 926: Supraventricular Tachycardia

Episode 926: Supraventricular Tachycardia

Contributor: Taylor Lynch MD Supraventricular tachycardias (SVTs) arise above the bundle of His The term SVT includes AV nodal reentrant tachycardia (AVNRT), atrioventricular reentrant tachycardi...

21 Loka 20246min

Episode 925: Table Sugar for Tongue Entrapment

Episode 925: Table Sugar for Tongue Entrapment

Contributor: Aaron Lessen, MD Educational Pearls: Pediatric case study where the child's tongue was stuck in the opening of a hard plastic drink lid Entrapment restricts circulation which causes f...

14 Loka 20241min

Episode 924: Pregnancy Cold Remedies

Episode 924: Pregnancy Cold Remedies

Contributor: Megan Hurley, MD Educational Pearls: Fevers Tylenol Up until 20 weeks NSAIDs are ok but after 20 weeks they are contraindicated Can limit the amount of amniotic fluid produced Ca...

7 Loka 20245min

Episode 923: Blunt Cerebrovascular Injury

Episode 923: Blunt Cerebrovascular Injury

Contributor: Travis Barlock MD Educational Pearls: Assessment of head and neck vascular injury due to blunt trauma Symptomatic patients require screening head and neck CT angiography EAST guid...

30 Syys 20243min

Episode 922: Chest Tube Irrigation

Episode 922: Chest Tube Irrigation

Contributor: Aaron Lessen, MD Educational Pearls: Hemothorax: blood in the pleural cavity, most commonly due to chest trauma Treatment: thoracostomy tube for blood drainage helps to avoid clott...

23 Syys 20242min

Episode 921: Pediatric Hypoglycemia

Episode 921: Pediatric Hypoglycemia

Contributor: Taylor Lynch, MD Educational Pearls: When it comes to hypoglycemia, the age dictates possible causes Neonate: Hormonal deficiency Congenital Adrenal Hyperplasia (21-hydroxylase de...

22 Syys 20244min

Suosittua kategoriassa Tiede

tiedekulma-podcast
rss-mita-tulisi-tietaa
rss-poliisin-mieli
docemilia
rss-duodecim-lehti
rss-sosiopodi
radio-antro
filocast-filosofian-perusteet
rss-ammamafia
utelias-mieli
mielipaivakirja
rss-bios-podcast
rss-astetta-parempi-elama-podcast
rss-tiedetta-vai-tarinaa
rss-luontopodi-samuel-glassar-tutkii-luonnon-ihmeita