GENERAL SURGERY
GENERAL SURGERY
Embedded Files
ACUTE PANCREATITIS
ACUTE PANCREATITIS
ABOUT THIS SESSION
ABOUT THIS SESSION
This is a self-directed learning resource designed to be worked through in the clinical environment.
Learning objectives:
Learning objectives:
- Discuss three differentials of epigastric pain and three causes of pancreatitis
- Understand the key investigations required for the diagnosis and severity-stratification of someone with pancreatitis
- Prescribe appropriate management for a patient diagnosed with pancreatitis
Total time:
60 minNumber of students:
1-5Grade of students:
3rd to 5th year medical studentsCreated by:
Dr Beth BrockbankUploaded:
19th September 2019Last updated:
19th September 2019Resources needed for this session:
Resources needed for this session:
Prescription chart, pen, paper
Resources linked to this session:
Resources linked to this session:
Activity 1: History Taking Skills
15 minActivity 1: History Taking Skills
Take a focused history from a patient with suspected pancreatitis. Ask about past medical history, drug history, social history and relevant family history. Consider the key symptoms of pancreatitis and identifying clues to possible causes.
Following this, perform a focused abdominal examination.
Activity 2: Diagnostic Reasoning
10 minActivity 2: Diagnostic Reasoning
Consider three key differential diagnoses for the patient's problem. For each one, suggest two features from the history/examination that support each one. Answer the following questions:
- What are the most common causes of pancreatitis?
- What initial investigations would be helpful to determine severity of pancreatitis and identify the underlying cause?
- What are you expecting them to show?
Activity 3: Initial Investigations and Risk-Stratification
10 minActivity 3: Initial Investigations and Risk-Stratification
Review the patient’s own results or if none are available, use the example below. Calculate a Glasgow Score for the patient.
Hb 123
MCV 102
WCC 23
CRP 98
Urea 8.0
Creat 67
ALT 65
ALP 440
LDH 780
Calcium 2.3
Albumin 61
pH 7.45
O2 11.2
CO2 4.5
Lactate 3.0
Activity 4: Prescribing
10 minActivity 4: Prescribing
Find a blank drug chart. Imagine you are the junior doctor assessing the patient on presentation to the emergency department. The patient is stable, but looks dehydrated and unwell, with a blood pressure of 95/60mmHg ad heart rate of 100bpm.
Prescribe the following treatments.
- IV fluids for resuscitation and 24 hours of maintenance
- appropriate analgesia
- an appropriate antiemetic
Consider the circumstances in which antibiotics may be indicated in acute pancreatitis.
Activity 5: Further Management
10 minActivity 5: Further Management
Find the local hospital policy on management of patients with acute pancreatitis. Compare this with the treatment the patient you have seen received.
Consider:
- Were any treatments missed, or done differently? Why might this be?
- When might it be appropriate to move the patient to a high dependency unit or intensive care?
- Summarise the key aspects of management of a patient with acute pancreatitis.
- What further tests might be required to determine the underlying cause of acute pancreatitis?
Summary and Feedback
Summary and Feedback
Highlight three key things you have learned today. Summarise them on a post-it note and keep it somewhere you will find in a week or two.
Found this useful? Please leave some feedback.
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