Acute pancreatitis causes all of the following except: March 2005, March 2013 (g)
Ans. A: Hypercalcemia Complications of acute pancreatitis: Intra-abdominal: Pancreatic "collections": Phlegmon Pseudocyst Abscess Necrosis Intestinal: Paralytic ileus Gastrointestinal haemorrhage - from stress ulceration, gastric varices due to splenic vein obstruction, or rupture of pseudoaneurysm Necrotising obstruction or fistulisation of colon - Hepatic - obstructive jaundice due to oedematous narrowing of common bile duct - Renal - hydronephrosis and hydroureter of right kidney due to peripancreatic inflammation in perirenal space - Spleen - rupture or haematoma, from spread of peripancreatic inflammation Systemic complications range from minor pyrexia to rapidly fatal, multiple organ-system failure. They include: - Circulatory shock - kinin activation, haemorrhage - Disseminated intravascular coagulation - Respiratory insufficiency: Mild e.g. hypoxaemia, atelectasis, pleural effusion Severe e.g. adult respiratory distress syndrome - Acute renal failure - Metabolic: Hypocalcaemia Hyperglycaemia / diabetes mellitus Hyperiglyceridaemia - Pancreatic encephalopathy - confusions, delusions, coma - Retinal aeriolar obstruction causing sudden blindness Puscher's retinopathy - Metastatic fat necrosis A serum level three to four times above normal serum amylase level, is indicative of acute pancreatitis, but a normal level does not exclude the disease.
Hypercalcemia
Increased amylase level
Subcutaneous fat necrosis
Hyperlipidemia