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G.I. – Awesome

complications of pancreatitis

Complications of pancreatitis after 2 days (2) pleural effusions, fluid collections
When do you see pancreatic necrosis in pancreatitis 1 to 14 days
How do you dx pancreatic necrosis? CT abd with contrast
How do you treat pancreatic necrosis? agressive IVF; if signs of infection, then abx and CT guided aspiration
What organs usually fail as a complication of pancreatitis? renal failure, hypotension, encephalopathy, metabolic
When do you see pseudocyst in pancreatitis 1 to 4 weeks
How do you treat pseudocyst if symptomatic, then drain; otherwise, monitor
When might you get a surgical consult? pseudocyst > 4 cm may not resolve on its own
How much time out would you expect to see pseudo aneurysm, hemorrhage, rupture, or fistula in pancreatitis? These are complications of pseudocyst - 1 to 4 weeks
What complication of pancreatitis would you expect to see from 4 to 6 weeks? What would you see on imaging? abscess; soap bubble sign
How do you manage pancreatic abscess? get aspirate of abscess --> gram stain and culture, abx. If persistent fever > 72 hrs after abx, then open drainage.
when would you expect to see splenic vein thrombosis any time
how to manage if there is a solid component / nodule to the pancreatic pseudocyst resection
what to do if there is a dilated duct in pancreatic pseudocyst? if dilation > 10 cm then resect
how do you manage a pseudocyst with a thickened wall? resect
CEA level > 400 on aspiration of pseudocyst suggestive of malignancy; if elevated CEA at all, should resect
What to do if there is blood and inflammatory cells in pseudocyst? resect
When do you have to monitor a pancreatic pseudocyst? < 3 cm, no worrisome features, then surveillance with MRI or endoscopic US every 3 to 6 months. If < 2cm, no worrisome features, then MRI or CT q2-3y
name the worrisome features of a pancreatic pseudocyst (6) IF confirmed on EUS: > 3 cm, thickened enhanced wall, nodules, main pancreatic duct >4cm, abrupt change in pancreatic duct diameter, enlarged LNs
Created by: christinapham



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