急性胰腺炎acute pancreatitis（八年制）ppt课件.pptVIP

Acute Pancreatitis;Teaching Objective;Definition;Etiology;Etiology;Pathogenesis;;Pathology;;Symptoms abdominal pain: located in epigastrium and radiates to the back. The lateral kneel-chest position with the neck flexed may relieve the abdominal pain. Nausea, vomiting, abdominal distention: 90% patients Fever: low-grade fever in mild pancreatitis; high fever suggests coexisting infection. Hypotension or shock: often in severe pancreatitis;Signs;Complications;Systemic complications;Laboratory Studies;Amylase;;;;;Imaging examination;Ultrasonography It is a useful method to find an enlarged pancreas, a pseudocyst, ascites, biliary stone, dilated common bile duct and other pancreatic mass;CT MRI;;Diagnosis-criteria;Clinical manifestations Scoring systems: APACHE-II, Ranson CT grading Serum biomarkers: CRP, IL-6 ;Diagnosis-classification;Diagnosis-classification;Differential diagnosis;Therapy-MAP;Therapy-SAP;;;;;prognosis;Questions;Thank you;;necrotic pancreatitis;Grey-Turner sign;Cullen sign;jaundice;Pseudocyst of pancreas;;Colon cut-off sign. Supine abdominal radiograph obtained in a patient with acute pancreatitis shows an abrupt termination of air in the left side of the transverse colon (arrows). ;;On admission: Age 55 Leukocyte count 16,000/mm3 Blood glucose 11mmol/L LDH 350 IU/L AST 250 After 48 hours: Hct decrease 10% BUN rise 5 mmol/L Serum calcium 2 mmol/L PaO2 60mmHg Base deficit 4mmol/L Estimated fluid sequestration 6 L;CT grading