90% 10%EpigasticPain
90% 10%
NauseaAnd
Vomiting
50%
50%
PainRadiatingToBack
3%97%
GreyTurnerSign
AmylaseSensitivity
67-83%
AmylaseSpecificity
85-98%
LipaseSensitivity
82-100%
LipaseSpecificity
82-100%
UltrasoundNondiagnostic
25-35%
MRISensitivity
83%
MRISpecificity
91%
CTSensitivity
78%
CTSpecificity
86%
Grade Findings Score
A Normal pancreas 0
B Focal or diffuse enlargementwithout inflammation
1
C Peripancreatic inflammation 2
D Intrapancreatic or extrapancreatic fluid collections
4
E Gas collections 4
Percent Necrosis Score
0% 0
Less than 33% 2
33-50% 4
50% or more 6
CTSI = Grade Score + Necrosis Score
CTSI of 6 or more is severe pancreatitis
Pancreatitis
Fluids
Pain Control
Antibiotics
Nutrition
DVT
Prophylaxis
Intervention
Pancreatitis
Fluids
Pancreatitis
Fluids
Vital SignsHematocritRenal Function
Pancreatitis
Pain Control
Pancreatitis
Antibiotics
Pancreatitis
Antibiotics
Difficult evaluate sepsisInfected necrosis
- Culture (IR)- Antibiotics
Pancreatitis
Nutrition
OralEnteralParenteral (TPN)
Pancreatitis
Nutrition
Early enteralnutrition reducesmortality
Pancreatitis
DVT
Prophylaxis
Pancreatitis
DVT
Prophylaxis
High risk of DVT
Splanchnic thrombosis- 1-24%
Pancreatitis
Aspiration/Drainage
Focused on underlyingcause
Intervention
Pancreatitis
Fluids
Pain Control
Antibiotics
Nutrition
DVT
Prophylaxis
Intervention