in this video we're going to look at acute pancreatitis this is an overview and introduction acute pancreatitis is inflammation of the pancreas by enzyme mediated autodigestion pancreatitis is mild in 80% of cases but 20% develop serious complicated life-threatening diseases the inflammation ranges from mild edema to Perry pancreatic necrosis G stones and ethanol are the major causes of acute pancreatitis here is a patient with epigastric pain hunched over and has been nauseous and has vomited he is suspected of having pancreatitis what is the pancreas well the pancreas is an organ that sits behind the stomach situated partly retrop peraonal here is the liver gallbladder stomach and the small intestine and here is the pancreas this is a close-up image of the pancreas the pancreas makes contact with the duodenum which is the first part of the small intestine the B duct from the gallbladder and liver connect with the pancreatic ducts which then then makes its way to the duodenum the pancreas has two main functions it works as an exocrine gland where it secretes digestive enzymes through the pancreatic duct into the small intestine and the pancreas also works as an endocrine organ by secreting hormones in the blood such as insulin and glucagon the normal pancreas have a cluster of cells called the pancreatic ASA these work as the exocrine glands here are cells that produce the digestive enzymes which then travel through the pancreatic duct into the small intestine in acute pancreatitis there is inflammation of part of the pancreas due to a number of causes because of the inflammation the pancreas becomes damaged the ASA get damaged and release its digestive enzymes around them resulting in further damage of surrounding structures the pancreas secretes three important enzymes these are proteases amalay and lipase because the enzymes are released not into the duct but to the surrounding pancreatic tissue the proteases causes damage to cell and vasculature through Pro protein mediated damage the amas levels increase in the blood which is useful for diagnosing pancreatitis but it is not specific the lipases also increase in the blood and can result in a serious complication of fatty necrosis of the pancreas the iology of acute pancreatitis the cause of pancreatic inflammation mediated by enzyme autodigestion can be remembered by a useful acronym get smashed G stands for gal Stones which can plug at the ampul Vata resulting in backflow of bile and pancreatic juices into the pancreas e is for ethanol G stones and ethanol are the two most common causes of acute pancreatitis T is for trauma s for anabolic steroids M for bumps virus a for autoimmune diseases s for scorpion venom H is for hyper calcemia and hyperlipidemia e is for ercp which is a investigation method and treatment method used for pancreatitis and D is for drugs as certain medications can trigger acute pancreatitis acute pancreatitis typically presents with the following signs and symptoms including vomiting gradual or sudden severe epigastric central pain the pain can radiate to the back in 50% of cases tripoding position relieves some pain tachicardia jaundice and fever may also occur investigations to be performed in suspected acute pancreatitis include serum Amal and lipase which as mentioned increase in the blood serum lipase is more specific for the pancreas an ultrasound of the pancreas can also be performed and an arterial blood gas the management of acute pancreatitis firstly do not feed the patient by mouth nasogastric tube can be used canulation for for administration of fluids as well as anti-emetic agents and Pain Relief with analgesia such as morphine urinary catheterization is important in monitoring urine output further monitoring include daily serology of full blood count amalay levels and EU hourly blood pressure heart rate and urinary output is also advised complications of acute pancreatitis include chronic pancreatitis pancreatic atis another important complication of pancreatitis involves the lungs because the pancreas sits below the diaphragm under the lung inflammation that occurs can spread locally and cause acute lung injury serious pancreatitis can result in fistula forming between the pancreas and the prial plural of the lungs this results in a fusion in the plural cavity this is called pancreatic Fusion other complications include acute renal failure and infected pancreatic necrosis which is related to 80% of deaths and also there was fatty necrosis which I mentioned earlier