- fish-shaped organ extending from duodenal curve to the spleen
- both an endocrine and exocrine gland
- pancreatic cells - empty into duodenum at the hepatopancreatic papilla; secrete enzymes which digest fats, carbohydrates and proteins
- alpha cells secrete glucagon to promote liver glycogenolysis and gluconeogenesis which ultimately increases blood glucose level
- beta cells secrete insulin
Acute Pancreatitis
- Inflammation of the pancreatic tissue due to premature activation of the pancreatic digestive enzymes
- Auto digestion
- Etiology:
- Alcoholism
- Hyperlipidemia
- Biliary tract disease or obstruction
- Trauma
- Infection
- Injuries to the pancreas causes abnormal activation of the proteolytic enzymes: trypsin, chemotrypsin, elastase
- Destruction of tissues in and around the pancreas – autodigestion
- Damage tissues could lead to perforation and abscess
- Clinical Manifestation
- Pain unrelenting and sometimes vague; may radiate to chest and back
- Jaundice
- Wt loss
- low grade fever anorexia
- Steatorrhea and dark urine
- Grey Turner’s sign- dicoloration of the flank
- Cullen’s sign – discoloration in the umbilicus area
- Pleural effusion
- Peritonitis
- Diagnostics
- Upper GI series shows delayed in gastric emptying and enlarged duodenum due to edema of the head of the pancreas
- Endoscopic cholangiopancreatography can confirm pancreatits
- CT scan may show tumors and abcess
- Elevated AST,ALT, Bilirubin, lactate dehydrogenase, glucose levels, WBC
- Decrease protein, potassium, calcium
- Management
- Analgesics
- Anticholinergic
- Insulin
- Prophylactic antibiotics
- H2 antagonist to decrease HCl thus decrease pancreatic enzymes
- IV fluids
- NGT lavage
- Biliary drainage
- Nursing interventions
- manage pain
- monitor breathing patterns disturbances
- monitor nutritional status
- oral care when NPO
- if eating is allowed, diet high in proteins and carbohydrates and low in fat
- monitor fluid and electrolyte balances
- monitor vital signs
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