Medicine an Surgery notes

Apr 25th, 2015
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PANCREATITIS INPAEDIARICSH12/70011/10DEFINITION AND STRUCTUREPancreatitis is the inflammation of thepancreas.ACUTE PANCREATITISHas been further clinically sub-classified into Edematous Necrotising HaemorrhagicEPIDEMIOLOGYAcute pancreatitis accounts for 3% of allcases of abdominal pain admitted to hospital. Mortality has remained unchanged at 10%. Most of the deaths occur due to MOSF as aresult of sepsis Retrospective study in KNH shows thatattacks came earlier in females-in whomalcohol was not a contributory factor.AETIOLOGY-ACUTE PANCREATITISTrauma Obstruction Infection Hereditary disorders Systemic disease Drugs and toxinsPATHOGENESISFailure of pancreatic protective mechanismswhich are Enzymesecretion directly into ducts Pancreatic proteases secretion in inactive forms Segregation of enzymes in granulesintracellularly Presence of protease inhibitors in zymogengranules and in the cytoplasmPATHOPHYSIOLOGYOver secretion of trypsinogen may exceed thepancreas innate ability of protection fromautodigestion.Trypsinogen will be activated to trypsin thusactivating the other proenzymes resulting inautodigesion.Hyperstimulation by CCK will damage thepancreatic acinar cytoskeleton resulting in enzymerelease from zymogen granules.The enzymes will cause pancreatic injury byoxidative stress. Cytokine release will causevasoconstriction-isc

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