ASGE Annual GI Advanced Practice Provider Course (Virtual) - Clinical Case-based Learning (Day Two) | March 2025-Pancreatitis Acute and Chronic

Pdf Summary

The document provides a comprehensive overview of pancreatitis, with a focus on its acute (AP) and chronic (CP) forms, along with management strategies for complications. Acute pancreatitis is highlighted as a significant cause of hospitalization in the U.S., often induced by gallstones or alcohol. The document elaborates on various etiologies, including iatrogenic causes and autoimmune conditions. Diagnosis of AP is confirmed through criteria such as abdominal pain, elevated serum enzymes, and imaging. Severity is assessed using prognostic indicators, and treatment includes hospital admission with specific interventions like ERCP for certain causes.<br /><br />Management of AP involves goal-directed fluid therapy, appropriate nutrition, and cautious use of antibiotics, emphasizing supportive care and timely intervention. Complications like pancreatic pseudocysts and necrosis are discussed, with management approaches ranging from observation to drainage.<br /><br />Chronic pancreatitis is characterized as a fibroinflammatory syndrome often linked to genetic and environmental factors. Diagnosis integrates imaging and function tests, and management focuses on nutrition, enzyme replacement, and pain relief. Complications such as exocrine and endocrine insufficiency, opioid dependency, and the risk of pancreatic cancer are noted.<br /><br />The document underscores a multidisciplinary approach for CP management, involving nutritional adjustments, lifestyle modifications, and potentially surgical interventions for severe cases. It addresses the need for addressing the pain through various analgesics, CBT, and considering neuromodulators and endoscopic treatments when necessary. Surgical options, their indications, and outcomes are detailed. The risk of pancreatic cancer is higher in hereditary cases, though general screening is not widely supported.<br /><br />The document concludes with practical insights to improve the diagnosis and management of both forms of pancreatitis, highlighting early intervention, imaging techniques, and a focus on quality of life improvements.

Asset Subtitle

Sarah Enslin, PA-C

Keywords

pancreatitis

acute pancreatitis

chronic pancreatitis

hospitalization

gallstones

alcohol

management strategies

diagnosis

complications

multidisciplinary approach