How do patients with biliary pain typically describe their symptoms? Pain arising from the biliary tree is often localized to the epigastric or right upper quadrant. It may be precipitated by eating—classically by a fatty meal. The pain often radiates to the scapula, right shoulder, or lower abdomen. Patients may describe nausea and vomiting.
Differences between acute and chronic pancreatitis • Acute pancreatitis is almost always painful, whereas pain is not always present with chronic pancreatitis. • Patients with acute pancreatitis tend to have elevated amylase and lipase, whereas pancreatic enzyme levels are often normal in patients with chronic pancreatitis. • Pancreatic endocrine dysfunction, including diabetes and steatorrhea (diarrhea due to fat …
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What is chronic pancreatitis? How is chronic pancreatitis diagnosed? Chronic pancreatitis refers to progressive inflammation of the pancreas leading to irreversible structural damage. Similar to acute pancreatitis, the pain of chronic pancreatitis is typically epigastric, radiates to the back, is worse after eating and is improved with sitting forward. Early in the disease course, the …
Physical exam findings characteristic of severe acute pancreatitis • Grey Turner’s sign: flank bruising (can be unilateral or bilateral) • Cullen’s sign: periumbilical bruising Both findings are due to the presence of hemorrhagic pancreatic fluid that has tracked into these regions. The presence of these signs often portends a poor prognosis.
What are the two most common causes of acute pancreatitis? Name some additional causes of pancreatitis. The two most common causes of acute pancreatitis are gallstones and chronic alcohol abuse. Other causes of pancreatitis include hypertriglyceridemia, pancreatic cancer, medication side effects, genetic mutations, ischemia, and complications after an endoscopic retrograde cholangiopancreatography (ERCP).
What is acute pancreatitis? How is acute pancreatitis diagnosed? The term “pancreatitis” literally means inflammation of the pancreas. Acute pancreatitis, as the name implies, presents with sudden, severe, and persistent epigastric pain. Classically, pancreatitis pain radiates to the back, is worse after eating, and is relieved by sitting forward. The diagnosis of acute pancreatitis requires …
What complications can arise from chronic Helicobacter pylori infection? Although most patients are asymptomatic, approximately 10% to 15% of patients with chronic Hp infection will develop ulcers, gastric adenocarcinoma, or gastric lymphoma (“MALT lymphoma”). Early stages of MALT lymphoma may be cured by antibiotic and antisecretory therapy alone. More advanced stages, however, often require chemotherapy, radiation, or …
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