PANCREATITIS

PANCREATITIS

DEFINITION:-

An inflammation of pancreas is called pancreatitis

CAUSES/AETIOLOGY:-

It is of two types:

  1. Acute pancreatitis:
    It is commonly described as an autodigestion of pancreas by exocrine enzymes (Trypsin).

  2. Chronic pancreatitis:
    It is an inflammatory disorder characterized by progressive anatomic and functional destruction of pancreas.


CAUSES:-

  • Excessive use of alcohol
  • Biliary duct disease (gall stones)
  • Trauma to pancreas
  • Hereditary
  • Infection of pancreas
  • Pancreatic tumour
  • Hypercalcemia
  • Pregnancy
  • Hyperlipidemia
  • Peptic ulcer.


CLINICAL MANIFESTATIONS:-

  • Pain in epigastrium region or in left upper quadrant
  • Constant pain
  • Low grade fever
  • Weight loss
  • Shock in severe condition
  • Nausea/Vomiting
  • Steatorrhoea (fatty stool)
  • ↓es bowel movement
  • Breathlessness
  • Weak pulse
  • Low body temperature
  • Bluish discolouration of skin.

According to this, two type of signs occur

  1. Cullen's sign:Skin discolouration in periumbilical region is known as Cullen's sign.
  2. Turner's sign:Skin discolouration in flank region is known as Turner's sign.

PATHOPHYSIOLOGY:-

    Premature activation of trypsin and lipase enzymes
    ↓
    Auto-digestion and inflammatory process produce
    ↓
    Fibrosis or nodules formation in pancreatic tissue
    ↓
    Pancreatitis

DIAGNOSTIC EVALUATION:-

  • By USG
  • ERCP (Endoscopic Retrograde Colangio-Pancreatography)
  • Serum bilirubin
  • AST, ALT, LDH Tests.
  • WBC.

COMPLICATIONS:-

  • Cholecystitis
  • Liver cirrhosis
  • Jaundice
  • Diabetes mellitus
  • Shock.

MEDICAL MANAGEMENT:-

  • Antibiotics
  • Analgesics, e.g., Morphine
  • H2 blocker, e.g., Ranitidine.

SURGICAL MANAGEMENT:-

  • Surgical incision done for drainage of accumulated fluid.
  • Subtotal Pancreatectomy.

NURSING MANAGEMENT:-

  • Maintain fluid and electrolyte balance
  • Provide comfort and rest to patient
  • Provide proper nutrition to patient
  • Provide psychological support
  • Avoid any injury to patient because there is more risk for infection
  • Provide pre-post operative care to patient
  • Health education
  • Restrict alcohol intake
  • Encourage for rest.

NURSING DIAGNOSIS:-

  • Pain related to inflammation of the pancreas and surrounding tissue.
  • Ineffective breathing pattern related to abdominal distension or ascites.
  • Altered nutrition less than body requirements related to Nausea and vomiting, nasogastric vomiting.
  • Risk for injury related to malfunction of pancreatic drains.
  • Knowledge deficit related to causes of pancreatitis, treatment, Possible complications and home health care.

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