Pancreatic Fistula
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PANCREATIC FISTULA 1.
CHIEF COMPLAINT •Pancreatic fistula
2.
HPI
3.
ROS
4.
SYMPTOMS
•Recent weight loss •Ascites 5.
HISTORY •FAMILY HISTORY •SOCIAL HISTORY •PASTMEDICAL HISTORY o Acute pancreatitis o Pancreatic cancer o Trauma o Pancreatic pseudocyst •SURGICAL HISTORY o Pancreatoduodenectomy o Distal pancreatectomy o Surgery on organs adjacent to pancreas •CHRONIC CONDITIONS o Chronic pancreatitis
6.
ALLERGIES
7.
PHYSICAL EXAMINATION
8.
SPECIFIC DATA LIKE GRADING ETC
9.
TESTS TO BE ORDERED •CBP •X-ray •Pleural fluid analysis •ascitic fluid analysis
•Serum amylase •USG •CT scan •MRI •Endoscopic retrograde cholangiopancreatography (ERCP) 10. ASSESSMENT /PLAN •The production of pancreatic enzymes is suppressed by restricting the patient's oral intake of food patient in conjunction with the use of long-acting somatostatin analogues. •The patient's nutrition is maintained by total parenteral nutrition. •This treatment is continued for 2-3 weeks, and the patient is observed for improvement. •Surgical reconstruction of fistula 11. EDUCATION 12. MEDICATION •Octreotide •Lanreotide •Somatostatin •Ethinyloestradiol •Dexamethasone 13. FOLLOW-UP
CHIEF COMPLAINT •Pancreatic fistula
2.
HPI
3.
ROS
4.
SYMPTOMS
•Recent weight loss •Ascites 5.
HISTORY •FAMILY HISTORY •SOCIAL HISTORY •PASTMEDICAL HISTORY o Acute pancreatitis o Pancreatic cancer o Trauma o Pancreatic pseudocyst •SURGICAL HISTORY o Pancreatoduodenectomy o Distal pancreatectomy o Surgery on organs adjacent to pancreas •CHRONIC CONDITIONS o Chronic pancreatitis
6.
ALLERGIES
7.
PHYSICAL EXAMINATION
8.
SPECIFIC DATA LIKE GRADING ETC
9.
TESTS TO BE ORDERED •CBP •X-ray •Pleural fluid analysis •ascitic fluid analysis
•Serum amylase •USG •CT scan •MRI •Endoscopic retrograde cholangiopancreatography (ERCP) 10. ASSESSMENT /PLAN •The production of pancreatic enzymes is suppressed by restricting the patient's oral intake of food patient in conjunction with the use of long-acting somatostatin analogues. •The patient's nutrition is maintained by total parenteral nutrition. •This treatment is continued for 2-3 weeks, and the patient is observed for improvement. •Surgical reconstruction of fistula 11. EDUCATION 12. MEDICATION •Octreotide •Lanreotide •Somatostatin •Ethinyloestradiol •Dexamethasone 13. FOLLOW-UP
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