Acute pancreatitis nazmul mbbs student .pdf
Original filename: Acute pancreatitis_nazmul mbbs student.pdf
Title: Acute Pancreatitis
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• The 1992 Atlanta Symposium definition of acute
pancreatitis, which is “”An acute inflammatory process of
the pancreas with variable involvement of other regional
tissues or remote organ systems”
Criteria for DX
The diagnosis of AP is most oft en established by the
presence of 2 of the 3 following criteria:
1. Abdominal pain consistent with the disease,
2. Serum amylase and / or lipase greater than three
times the upper limit of normal, and / or
3. Characteristic findings from abdominal imaging
of Acute Pancreatitis
theories of pathogenesis:
• Auto digestion theory.
• Obstructive theory.
• Reflux theory.
Pathogenesis of Acute Pancreatitis
Activation of Pancreatic enzymes :
Several recent studies have suggested that
Pancreatitis is a disease that evolves in three
1st phase: Intrapancreatic digestive enzyme (e.g. Zymogene)
activation and acinar cell injury.
2nd Phase: Activation, chemo attraction and sequestration of
neutrophils in the pancreas resulting in an intrapancreatic
inflammatory reaction of variable severity.
3rd phase: due to the effects of activated proteolytic enzymes
(e.g. Trypsin) and mediators released by inflammed
pancreas on distant organs. Trypsin not only digests
pancreatic tissue but also activates other enzymes such
as elastase and phospholipase.