Acute pancreatitis history and symptoms: Difference between revisions

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==Overview==
==Overview==
Patient history should include the evaluation of risk factors for pancreatitis, such as heavy alcohol use, certain medications, family history, history of autoimmune diseases, and history of gallstone diseases. Common symptoms of acute pancreatitis include severe epigastric abdominal pain (which worsens on eating) radiating to the back and and the shoulder blades, anorexia, [[nausea]], [[vomiting]], [[diarrhea]], [[fever]] and [[chills]]. There may also be symptoms of indigestion and abdominal bloating.<ref name="pmid22735715">{{cite journal| author=Dellinger EP, Forsmark CE, Layer P, Lévy P, Maraví-Poma E, Petrov MS et al.| title=Determinant-based classification of acute pancreatitis severity: an international multidisciplinary consultation. | journal=Ann Surg | year= 2012 | volume= 256 | issue= 6 | pages= 875-80 | pmid=22735715 | doi=10.1097/SLA.0b013e318256f778 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22735715  }} </ref><ref name="pmid23100216">{{cite journal| author=Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD, Sarr MG et al.| title=Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus. | journal=Gut | year= 2013 | volume= 62 | issue= 1 | pages= 102-11 | pmid=23100216 | doi=10.1136/gutjnl-2012-302779 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23100216  }} </ref>
Patient history should include the evaluation of risk factors for pancreatitis, such as heavy alcohol use, certain medications, family history, history of autoimmune diseases, and history of gallstone diseases. Common symptoms of acute pancreatitis include severe epigastric abdominal pain (which worsens on eating) radiating to the back and and the shoulder blades, anorexia, [[nausea]], [[vomiting]], [[diarrhea]], [[fever]] and [[chills]]. There may also be symptoms of indigestion and abdominal bloating.


==History==
==History==
Obtaining the right history assists in making a precise diagnosis in [[acute pancreatitis]].  The following history should be obtained from a patient presenting with acute [[abdominal pain]]:<ref name="pmid22735715">{{cite journal| author=Dellinger EP, Forsmark CE, Layer P, Lévy P, Maraví-Poma E, Petrov MS et al.| title=Determinant-based classification of acute pancreatitis severity: an international multidisciplinary consultation. | journal=Ann Surg | year= 2012 | volume= 256 | issue= 6 | pages= 875-80 | pmid=22735715 | doi=10.1097/SLA.0b013e318256f778 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22735715  }} </ref><ref name="pmid23100216">{{cite journal| author=Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD, Sarr MG et al.| title=Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus. | journal=Gut | year= 2013 | volume= 62 | issue= 1 | pages= 102-11 | pmid=23100216 | doi=10.1136/gutjnl-2012-302779 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23100216  }} </ref>
Obtaining the right history assists in making a precise diagnosis in [[acute pancreatitis]].  The following history should be obtained from a patient presenting with acute [[abdominal pain]]:<ref name="pmid22735715">{{cite journal| author=Dellinger EP, Forsmark CE, Layer P, Lévy P, Maraví-Poma E, Petrov MS et al.| title=Determinant-based classification of acute pancreatitis severity: an international multidisciplinary consultation. | journal=Ann Surg | year= 2012 | volume= 256 | issue= 6 | pages= 875-80 | pmid=22735715 | doi=10.1097/SLA.0b013e318256f778 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22735715  }} </ref><ref name="pmid23100216">{{cite journal| author=Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD, Sarr MG et al.| title=Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus. | journal=Gut | year= 2013 | volume= 62 | issue= 1 | pages= 102-11 | pmid=23100216 | doi=10.1136/gutjnl-2012-302779 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23100216  }} </ref><ref name="acutepancreatitis">{{cite journal
| last      = Forsmark
| first      = Chris E.
| last2      = Vege
| first2    = Santhi Swaroop
| last3      = Wilcox
| first3    = Mel
| date      = November 17,2016
| title      = Acute Pancreatitis
| url        = http://www.nejm.org/doi/full/10.1056/NEJMra1505202
| journal    = The New England Journal of Medicine
| volume    =
| issue      =
| pages      = 1972 - 1981
| doi        = 10.1056/NEJMra1505202
| pmc        =
| pmid      =
| access-date = November 25,2016
| name-list-format = vanc
}}</ref>
* Onset, duration, location, radiation, aggravating and relieving factors of [[abdominal pain]]
* Onset, duration, location, radiation, aggravating and relieving factors of [[abdominal pain]]
* [[Alcohol]] abuse
* [[Alcohol]] abuse
* [[Gall stone disease]]
* [[Gall stone disease]]
* [[Diabetes mellitus]]
* [[Diabetes mellitus]]
* Morbid [[obesity]]
* [[Hyperlipidemia]]
* [[Hyperlipidemia]]
* [[Steroid]] abuse
* [[Steroid]] abuse
* History of medication (which are known to cause pancreatitis) intake
* History of medication intake (which are known to cause pancreatitis)
* [[Autoimmune]] diseases like [[SLE]]
* [[Autoimmune]] diseases like [[SLE]]
* Family history of [[pancreatitis]], [[hyperlipidemia]]
* Family history of [[pancreatitis]], [[hyperlipidemia]]
Line 20: Line 40:
==Symptoms==
==Symptoms==
===Common Symptoms===
===Common Symptoms===
Common symptoms include:<ref name="pmid22735715">{{cite journal| author=Dellinger EP, Forsmark CE, Layer P, Lévy P, Maraví-Poma E, Petrov MS et al.| title=Determinant-based classification of acute pancreatitis severity: an international multidisciplinary consultation. | journal=Ann Surg | year= 2012 | volume= 256 | issue= 6 | pages= 875-80 | pmid=22735715 | doi=10.1097/SLA.0b013e318256f778 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22735715  }} </ref><ref name="pmid23100216">{{cite journal| author=Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD, Sarr MG et al.| title=Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus. | journal=Gut | year= 2013 | volume= 62 | issue= 1 | pages= 102-11 | pmid=23100216 | doi=10.1136/gutjnl-2012-302779 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23100216  }} </ref>
Common symptoms include:<ref name="pmid22735715">{{cite journal| author=Dellinger EP, Forsmark CE, Layer P, Lévy P, Maraví-Poma E, Petrov MS et al.| title=Determinant-based classification of acute pancreatitis severity: an international multidisciplinary consultation. | journal=Ann Surg | year= 2012 | volume= 256 | issue= 6 | pages= 875-80 | pmid=22735715 | doi=10.1097/SLA.0b013e318256f778 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22735715  }} </ref><ref name="pmid23100216">{{cite journal| author=Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD, Sarr MG et al.| title=Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus. | journal=Gut | year= 2013 | volume= 62 | issue= 1 | pages= 102-11 | pmid=23100216 | doi=10.1136/gutjnl-2012-302779 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23100216  }} </ref><ref name="acutepancreatitis">{{cite journal
* Severe upper [[abdominal pain]]. The pain:
| last      = Forsmark
** May be worse within minutes after eating or drinking at first, especially if foods have a high fat content
| first      = Chris E.
** Becomes constant and more severe, lasting for several days
| last2      = Vege
** May be worse when lying flat on the back
| first2    = Santhi Swaroop
** May spread (radiate) to the back or below the left shoulder blade
| last3      = Wilcox
* [[Nausea]], [[vomiting]], [[diarrhea]] and [[loss of appetite]].
| first3    = Mel
| date      = November 17,2016
| title      = Acute Pancreatitis
| url        = http://www.nejm.org/doi/full/10.1056/NEJMra1505202
| journal    = The New England Journal of Medicine
| volume    =
| issue      =
| pages      = 1972 - 1981
| doi        = 10.1056/NEJMra1505202
| pmc        =
| pmid      =
| access-date = November 25,2016
| name-list-format = vanc
}}</ref>
* Severe upper [[abdominal pain]]. The pain:
** May be worse within minutes after eating or drinking at first, especially if foods have a high fat content;
** Becomes constant and more severe, lasting for several days;
** May be worse when lying flat on the back;
** May spread (radiate) to the back, or below the left shoulder blade.
* [[Nausea]], [[vomiting]], [[diarrhea]] and [[loss of appetite]]
* [[Fever]] / [[Chills]]
* [[Fever]] / [[Chills]]
* [[Shock (medical)|Shock]], hemodynamic instability
* [[Shock (medical)|Shock]], hemodynamic instability
Line 33: Line 72:


===Less Common Symptoms===
===Less Common Symptoms===
Other symptoms that may occur with this disease:<ref name="pmid22735715">{{cite journal| author=Dellinger EP, Forsmark CE, Layer P, Lévy P, Maraví-Poma E, Petrov MS et al.| title=Determinant-based classification of acute pancreatitis severity: an international multidisciplinary consultation. | journal=Ann Surg | year= 2012 | volume= 256 | issue= 6 | pages= 875-80 | pmid=22735715 | doi=10.1097/SLA.0b013e318256f778 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22735715  }} </ref><ref name="pmid23100216">{{cite journal| author=Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD, Sarr MG et al.| title=Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus. | journal=Gut | year= 2013 | volume= 62 | issue= 1 | pages= 102-11 | pmid=23100216 | doi=10.1136/gutjnl-2012-302779 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23100216  }} </ref>
Other symptoms that may occur with this disease:<ref name="pmid22735715">{{cite journal| author=Dellinger EP, Forsmark CE, Layer P, Lévy P, Maraví-Poma E, Petrov MS et al.| title=Determinant-based classification of acute pancreatitis severity: an international multidisciplinary consultation. | journal=Ann Surg | year= 2012 | volume= 256 | issue= 6 | pages= 875-80 | pmid=22735715 | doi=10.1097/SLA.0b013e318256f778 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22735715  }} </ref><ref name="pmid23100216">{{cite journal| author=Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD, Sarr MG et al.| title=Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus. | journal=Gut | year= 2013 | volume= 62 | issue= 1 | pages= 102-11 | pmid=23100216 | doi=10.1136/gutjnl-2012-302779 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23100216  }} </ref><ref name="acutepancreatitis">{{cite journal
| last      = Forsmark
| first      = Chris E.
| last2      = Vege
| first2    = Santhi Swaroop
| last3      = Wilcox
| first3    = Mel
| date      = November 17,2016
| title      = Acute Pancreatitis
| url        = http://www.nejm.org/doi/full/10.1056/NEJMra1505202
| journal    = The New England Journal of Medicine
| volume    =
| issue      =
| pages      = 1972 - 1981
| doi        = 10.1056/NEJMra1505202
| pmc        =
| pmid      =
| access-date = November 25,2016
| name-list-format = vanc
}}</ref>
* [[Indigestion]]
* [[Indigestion]]
* Clay-colored stools
* Clay-colored stools
Line 44: Line 102:
{{Reflist|2}}
{{Reflist|2}}


[[Category:Gastroenterology]]
[[Category:Surgery]]
[[Category:Emergency medicine]]


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Latest revision as of 15:14, 2 December 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2]

Overview

Patient history should include the evaluation of risk factors for pancreatitis, such as heavy alcohol use, certain medications, family history, history of autoimmune diseases, and history of gallstone diseases. Common symptoms of acute pancreatitis include severe epigastric abdominal pain (which worsens on eating) radiating to the back and and the shoulder blades, anorexia, nausea, vomiting, diarrhea, fever and chills. There may also be symptoms of indigestion and abdominal bloating.

History

Obtaining the right history assists in making a precise diagnosis in acute pancreatitis. The following history should be obtained from a patient presenting with acute abdominal pain:[1][2][3]

Symptoms

Common Symptoms

Common symptoms include:[1][2][3]

  • Severe upper abdominal pain. The pain:
    • May be worse within minutes after eating or drinking at first, especially if foods have a high fat content;
    • Becomes constant and more severe, lasting for several days;
    • May be worse when lying flat on the back;
    • May spread (radiate) to the back, or below the left shoulder blade.
  • Nausea, vomiting, diarrhea and loss of appetite
  • Fever / Chills
  • Shock, hemodynamic instability
  • Mild yellowing of the skin
  • Hiccups

Less Common Symptoms

Other symptoms that may occur with this disease:[1][2][3]

References

  1. ↑ 1.0 1.1 1.2 Dellinger EP, Forsmark CE, Layer P, Lévy P, Maraví-Poma E, Petrov MS; et al. (2012). "Determinant-based classification of acute pancreatitis severity: an international multidisciplinary consultation". Ann Surg. 256 (6): 875–80. doi:10.1097/SLA.0b013e318256f778. PMID 22735715.
  2. ↑ 2.0 2.1 2.2 Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD, Sarr MG; et al. (2013). "Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus". Gut. 62 (1): 102–11. doi:10.1136/gutjnl-2012-302779. PMID 23100216.
  3. ↑ 3.0 3.1 3.2 Forsmark CE, Vege SS, Wilcox M (November 17,2016). "Acute Pancreatitis". The New England Journal of Medicine: 1972–1981. doi:10.1056/NEJMra1505202. Retrieved November 25,2016. Check date values in: |access-date=, |date= (help)


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