- Causes – IGETSMASHED
- Idiopathic
- Gallstones
- EtoH
- Trauma
- Steroids
- mumps/malignancy
- autoimmune
- scorpion
- hypertriglycerides/calcaemi
- ERCP
- Drugs (HCTZ, bactrim, azathioprine)
Prognostic criteria
Ranson’s (valid for ETOH-induced pancreatitis only)
- Glasgow (includes gallstones and ETOH-induced)
- PaO2 <8kPa
- Age >55
- Neutrophils WCC >16
- Ca <2mmol/L
- Renal fx: Urea >16mmol/L
- Enzymes LDH > 600, AST >200
- Albumin >32g/L
- Sugar >10mmol/L
Mx
- Fluids, fluids, fluids (IV, both crystalloid + colloid + NBM)
- Intense monitoring
- Analgesia (meperidine, not morphine)
- Correct hypoxia
- Nutrition (pancreatitis is hypercatabolic) NG tube/TPN
- Antibiotic prophylaxis
- Surgery only if complications (e.g. pseudocyst drainage) or if gallstones cause.