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.



Episoder(1149)

Podcast 886: Cough in Kids

Podcast 886: Cough in Kids

Contributor: Ricky Dhaliwal, MD Educational Pearls: Croup Caused by: Parainfluenza, Adenovirus, RSV, Enterovirus (big right now) Age range: 6 months to 3 years Symptoms: Barky cough ...

15 Jan 20246min

Podcast 885: Penetrating Neck Injuries

Podcast 885: Penetrating Neck Injuries

Contributor: Ricky Dhaliwal MD Educational Pearls: Three zones of the neck with different structures and risks for injuries: Zone 1 is the most caudal region from the clavicle to the cricoid cart...

10 Jan 20244min

Laboring Under Pressure Episode 2: Postpartum Hemorrhage with Dr. Kiersten Williams

Laboring Under Pressure Episode 2: Postpartum Hemorrhage with Dr. Kiersten Williams

Contributor: Kiersten Williams MD, Travis Barlock MD, Jeffrey Olson MS2 Summary: In this episode, Dr. Travis Barlock and Jeffrey Olson meet in the studio to discuss a clip from Dr. Williams' talk at t...

8 Jan 202425min

Podcast 884: Nerve Blocks

Podcast 884: Nerve Blocks

Contributor: Meghan Hurley MD Educational Pearls: What is a nerve block? A nerve block is the medical procedure of injecting anesthetic into the area around a nerve to block pain signals. They ar...

1 Jan 20246min

Podcast 883: Migraine Treatment in Cardiovascular Disease

Podcast 883: Migraine Treatment in Cardiovascular Disease

Contributor: Jorge Chalit, OMS II Educational Pearls: Migraine pathophysiology Primarily mediated through the trigeminovascular system Serotonin, dopamine, and calcitonin gene-related peptide (...

25 Des 20233min

Podcast 882: Thrombolytics for Minor Strokes

Podcast 882: Thrombolytics for Minor Strokes

Contributor: Aaron Lessen MD Educational Pearls: How is the severity of a stroke assessed? Strokes are assessed by the NIH Stroke Scale (NIHSS), this scale has different tasks, such as asking the pe...

20 Des 20232min

Podcast 881: Pediatric Readmissions

Podcast 881: Pediatric Readmissions

Contributor: Nick Tsipis MD Educational Pearls: The review article assessed 16.3 million patients across six states to identify those at high-risk for critical revisit Criteria for critical revis...

12 Des 20233min

Podcast 880: OB Delivery in the ED

Podcast 880: OB Delivery in the ED

Contributor: Meghan Hurley MD Educational Pearls: Pearls about labor: Labor is split into 3 stages. Stage 1 starts when the first persistent contractions are felt and goes up until the cervix is ...

4 Des 20238min

Populært innen Vitenskap

fastlegen
tingenes-tilstand
rekommandert
forskningno
rss-nysgjerrige-norge
sinnsyn
rss-rekommandert
vett-og-vitenskap-med-gaute-einevoll
smart-forklart
pod-britannia
fjellsportpodden
liberal-halvtime
jss
villmarksliv
nevropodden
aldring-og-helse-podden
rss-overskuddsliv
psykopoden
tomprat-med-gunnar-tjomlid
dekodet-2