click below
click below
Normal Size Small Size show me how
G.I. – Awesome
complications of pancreatitis
Question | Answer |
---|---|
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 |