Pancreatitis

Sherry L. Knowles, RN, CCRN, CRNIOrlando Regional Medical Center

Orlando Health

Pancreatitis Can Be Fatal

Anatomy & Physiology

• The Pancreas secretes digestive enzymes into the duodenum via the pancreatic duct.

(Lipase, Amylase, Trypsin)

• The Pancreas also secretes bicarbonate, water, and lytes into the duodenum.

• The Pancreas produces and secretes insulin as needed.

Definition of Pancreatitis

• Inflammation of the pancreas associated with autodigestion

• An autodigestive process resulting from premature activation of pancreatic enzymes.

• May be acute or chronic

Physiology of Pancreatitis

• Inactive pancreatic enzymes are activated outside of the duodenum

•The swelling pancreas causes fluids to shift into the retro peritoneum and bowel

•Fluid shifts can cause severe hypovolemia and hypotension

Causes of Pancreatitis

• Alcoholism• Biliary Disease• Infections• Hyperparathyroidism• Hypertriglyceridemia• Hypercalcemia• Peptic Ulcer Disease• Cystic Fibrosis• Vascular Disease• Multiple Drugs

Signs & Symptoms of Pancreatitis

• Abdominal Pain• Nausea & Vomiting• Abdominal Distention• Jaundice• Malnutrition• Hematemesis• Grey Turner’s Sign• Cullen’s Sign• Elevated Amylase, Lipase, LDH,

AST, WBC’s BUN, and Glucose

Complications of Pancreatitis• Hypocalcemia• Hypotension• Acute Tubular Necrosis• DIC• Obstructive Jaundice• Erosive Gastritis• Paralytic Ileus• Pseudocyst or Abscess• Bowel Infarction• Internal Bleeding• Fat Necrosis

• Pleural Effusion• Pulmonary Infiltrates• Hypoxemia • Atelectasis• ARDS• Pericardial Effusion• Mediastinal Abscess• Hyperglycemia• Hypertriglyceridemia• Encephalopathy

Treatment of Pancreatitis

• Stabilization: Correct Fluid And Electrolyte Status

• Respiratory Support (as needed)• Control Pain (Demerol)• NG Tube (NPO)• TPN (Restricted Diet)• Monitor For Complications• Monitor Blood Sugar• Drug Therapies (Somatostatin, Anticholinergics)• Watch For Signs Of Infection• Pray

Pancreatitis Can Be Fatal

THE END