3. PANCREATITIS
3.1 ACUTE PANCREATITIS
The majority of patients of
pancreatitis (80%)
have
associated gallstones
or
history of excess
alcohol
intake. The
relative
inportance of
these two
principal causes is variable.
CLINICAL MANIFESTATIONS
In
most cases the patients
give history of a heavy meal
or
an acute excess alcohol
intake episode preceding the
attack
*
Pain usually begins
suddenly
*
Is located in midepigast-
rium and may radiate to
the
back
*
It may range
in intesity and
is steady knife
like or
penetrating pain
*
Accompaning vomiting and/or retching is common
Examination usually shows:
*
Upper abdominal tenderness
*
Guarding
*
In addition, there is fever
*
Tachycardia
*
Leukocytosis
*
Shock may be profound because of
loss of fluid or blood into
retroperitoneum or abdominal cavity
*
Fluid deficiency is also a result of persistent vomiting
*
Ileus soon develops with extracellular fluid deficit
*
Renal insufficiency often occur as the ultimate outcome
*
Carpopedal spasms appear
due to loss of large
amount of
calcium from the blood
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