How Is The Severity Of Acute Pancreatitis Assessed Clinically
This document was uploaded by user and they confirmed that they have the permission to share it. If you are author or own the copyright of this book, please report to us by using this DMCA report form. Report DMCA
Overview
Download & View How Is The Severity Of Acute Pancreatitis Assessed Clinically as PDF for free.
More details
- Words: 248
- Pages: 2
Surgery Essay
How is the severity of acute pancreatitis assessed clinically? What is the value of such classification? Assessment of the severity of acute pancreatitis is carried out by a multifactorial scoring system such as Ranson’s scoring system. Alternatively, measurement of the C-reactive proteins particularly if carried out as repeated measurements can also provide an accurate assessment of severity. In Ranson’s Criteria, one point is given for each variable, 3 or more points indicate severe pancreatitis. 1. At admission a.
Age greater than 55 years
b. Blood glucose >11mmol/l c. Serum LDH >500 IU/l d. AST >200 IU/l e.
White blood cell count >16x109/l
2. At 48h after admission a. Haematocrit fall of > 10% b. Blood urea >16mmol/l c. Serum Calcium <2mmol/l d. Arterial pO2 <8kPa e. Base deficit <4mmol/l 1
Surgery Essay
Early assessment of severity is worthwhile as these patients will need constant monitoring. The patient’s urine output must be monitored and kept more than 30ml/h by resuscitation of patient with intravenous fluids. Fluid balance charts should also be checked. The patient should also be monitored for signs of renal and respiratory failures as these worsen the prognosis. If pancreatitis is found to be severe, antibiotic prophylaxis should be given, to prevent a necrotic pancreas becoming infected, as this carries a high mortality. The agents in common usage are ciprofloxacin and cefuroxine. Also if pancreatitis is severe, and the aetiology is gallstones, the patient should be considered for urgent ERCP and endoscopic spinchterotomy. 09/02/09
2
How is the severity of acute pancreatitis assessed clinically? What is the value of such classification? Assessment of the severity of acute pancreatitis is carried out by a multifactorial scoring system such as Ranson’s scoring system. Alternatively, measurement of the C-reactive proteins particularly if carried out as repeated measurements can also provide an accurate assessment of severity. In Ranson’s Criteria, one point is given for each variable, 3 or more points indicate severe pancreatitis. 1. At admission a.
Age greater than 55 years
b. Blood glucose >11mmol/l c. Serum LDH >500 IU/l d. AST >200 IU/l e.
White blood cell count >16x109/l
2. At 48h after admission a. Haematocrit fall of > 10% b. Blood urea >16mmol/l c. Serum Calcium <2mmol/l d. Arterial pO2 <8kPa e. Base deficit <4mmol/l 1
Surgery Essay
Early assessment of severity is worthwhile as these patients will need constant monitoring. The patient’s urine output must be monitored and kept more than 30ml/h by resuscitation of patient with intravenous fluids. Fluid balance charts should also be checked. The patient should also be monitored for signs of renal and respiratory failures as these worsen the prognosis. If pancreatitis is found to be severe, antibiotic prophylaxis should be given, to prevent a necrotic pancreas becoming infected, as this carries a high mortality. The agents in common usage are ciprofloxacin and cefuroxine. Also if pancreatitis is severe, and the aetiology is gallstones, the patient should be considered for urgent ERCP and endoscopic spinchterotomy. 09/02/09
2
Related Documents
Acute Pancreatitis
July 2020 7
Acute Pancreatitis
June 2020 10
Acute Pancreatitis
June 2020 5
Acute Pancreatitis
July 2020 7