Liver, Pancreas, and Biliary Tract Problems

Lower GI Disorders

Acute pancreatitis

Cholelithiasis and cholecystitis

Acute Pancreatitis

Inflammation of the pancreas caused by pancreatic enzymes spilling into the surrounding pancreatic tissue causing autodigestion of the pancreas

Acute pancreatitis etiology

gallstones, alcohol intake, hypertiglyceridema

acute pancreatitis clinical manifestations

- severe abdominal pain (LUQ but may radiate to the back, aggrevated by eating)

- N/V

- Low-grade fever and elevated WBC

Acute Pancreatitis diagnosis

Amylase and lipase

Acute pancreatitis treatment

- make patient NPO to decrease pancreatic enzyme secretion

- monitor for shock

- if d/t gallstones then: emergent ERCP, emergent laparoscopic cholecystectomy

Cholelithiasis

gallstones in the gallbladder or bile ducts

Cholecystitis

inflammation of the gallbladder; usually associated with gallstones

The High Risk 4 Fs of cholelithiasis/cholecystitis

female, fat, forty, fertile

cholelithiasis/cholecystitis clinical manifestations

- biliary colic lasting up to 1 hour after ingesting a high fat meal

- n/v

- jaundice

cholelithiasis/cholecystitis diagnosis

- Ultrasound of the gallbladder

- Bilirubin

Cholelithiasis/Cholecystitis - Treatment

- ERCP with stone removal

- Laparoscopic cholecystectomy