Acute pancreatitis history and symptoms: Difference between revisions

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{{Acute pancreatitis}}
{{Acute pancreatitis}}
{{CMG}}; {{AE}} {{RT}}
{{CMG}}; {{AE}} {{RT}}


==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.
==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><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]]
* [[Alcohol]] abuse
* [[Gall stone disease]]
* [[Diabetes mellitus]]
* Morbid [[obesity]]
* [[Hyperlipidemia]]
* [[Steroid]] abuse
* History of medication intake (which are known to cause pancreatitis)
* [[Autoimmune]] diseases like [[SLE]]
* Family history of [[pancreatitis]], [[hyperlipidemia]]


==Symptoms==
==Symptoms==
Common symptoms include:
===Common Symptoms===
* Severe upper [[abdominal pain]]. The pain:
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
** May be worse within minutes after eating or drinking at first, especially if foods have a high fat content
| last      = Forsmark
** Becomes constant and more severe, lasting for several days
| first      = Chris E.
** May be worse when lying flat on the back
| last2      = Vege
** May spread (radiate) to the back or below the left shoulder blade
| first2    = Santhi Swaroop
*[[Nausea]], [[vomiting]], [[diarrhea]] and [[loss of appetite]].
| last3      = Wilcox
*[[Fever]] / [[Chills]]
| first3    = Mel
*[[Shock (medical)|Shock]], hemodynamic instability
| date      = November 17,2016
*Mild yellowing of the skin
| title      = Acute Pancreatitis
*[[Hiccups]]
| 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]]
* [[Shock (medical)|Shock]], hemodynamic instability
* Mild yellowing of the skin
* [[Hiccups]]
 
===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><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]]
* Clay-colored stools
* Gaseous abdominal fullness
* [[Hiccups]]
* [[Skin rash]] or lesion
* Swollen abdomen


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}


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{{WH}}
{{WH}}
{{WS}}

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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