1. Treatment of Pancreatitis MLTTP (case study)
Bakur Ahmed Wedaa Ali
57752
Monday
17/12/2013

2. There are 2 forms of pancreatitis:
acute pancreatitis
chronic pancreatitis.

3. During acute attacks of pancreatitis
the blood has high levels of digestive enzymes
blood may also have high levels of other important chemicals Ca,Mg,K and Na

4. Why should we know that??!!
Treatment for acute pancreatitis depends on how bad the attack is. Unless complications occur, acute pancreatitis usually gets better by itself with treatment.
Chronic pancreatitis happens if damage to the pancreas continues after acute pancreatitis has occurred.

5. In severe cases of acute pancreatitis
the patient may need to be fed through IV for 3-6 weeks while the pancreas heals.
If signs of infection show up, antibiotics are given. If complications such as infection, cysts, or bleeding occur, the doctor may need to do surgery to:
remove the gallbladder
eliminate the possibility of other abdominal problems that can imitate pancreatitis
remove cysts in the damaged pancreas
remove dead tissue (necrosis)

6. How to treat Acute Panreatitis
An acute attack of pancreatitis usually only lasts a few days, unless gallstones block the common bile and pancreatic ducts. These stones are taken out through a scope
This procedure is called ERCP, which stands for endoscopic retrograde cholangiopancreatography.

8. What about Chronic Pancreatitis??
Diagnosis of chronic pancreatitis is difficult but several advanced medical techniques are available. Pancreatic function blood tests help the doctor decide if the pancreas can still make enough digestive enzymes.

9. 1. Behavior modification
Cessation of alcohol consumption and tobacco smoking are important.

10. 2. Medical tratment A -Analgesics: to relieve tha abdominal pain.
B -Hormones: Reduction of pancreatic exocrine secretion.
C-Antidepressants: (Amitriptyline hydrochloride)
D-Pancreas enzyme supplements:
Used as a dietary supplement to aid digestion in patients with pancreatic enzyme deficiency.

11. 3. Endoscopic treatment:
I-Papillary stenosis II-Pancreatic duct strictures III-Pancreatic duct stones IV-Pancreatic pseudocysts

12. 4. Surgical treatment:
I-Pancreatic duct drainage: In patients with a dilated pancreatic duct, pancreaticojejunostomy is indicated.
II-Pancreatic resection: If the disease is limited to the head of the pancreas, a Whipple operation (pancreaticoduodenectomy) can produce good results.

13. III-Total pancreatectomy and islet autotransplantation: In selected patients, the long-term morbidity caused by diabetes following total pancreatectomy can be avoided.
IV- Drainage of pseudocyst: The indications include rapid enlargement, compression of surrounding structures (duodenal, biliary obstruction or vascular occlusion), pain, or signs of infection and abscess formation, suspected malignancy, hemorrhage and intraperitoneal rupture.

14. The underlying cause should also be treated
(targeting gallstones, discontinuing medications, cessation of alcohol etc.) The patient is monitored for complications.

16. Prognosis:
The prognostic factors associated with chronic pancreatitis are age at diagnosis, smoking, continued use of alcohol, and the presence of liver cirrhosis.