Pankreatitis
Lernkarten zu PACT
Lernkarten zu PACT
Was kommt bei Pankreatitis intial im Aszites nicht vor?
Was ist beweisend?
keine Erreger!
hohe Amylase
CT-Zeichen einer Pankreatitis?
- Schwellung
- Regionen mit spontaner Hypointensität (Nekrosezonen)
- fehlende KM-Anreicherung bei i.v.-KM-Gabe
- Peripankreatische Flüssigkeitsansammlung
Was ist der Glasgow/Imrie-Score?
>2 Kriterien->Schwerer Anfall
Wer hat die schlechteste Prognose?
early (on admission), multiple, persistent or evolving organ dysfunctions carry the worst prognosis
Welche Möglichkeit der Prophylaxe von Infektion der Nekrose?
selective decontamination of the digestive system (SDD). Non-absorbed antibiotics are used to reduce the number of aerobic Gram-negative bacteria and yeasts in the gastrointestinal tract, whilst retaining the normally predominant anaerobic flora and so modulating colonisation in the digestive tract. Current evidence is not conclusive enough to allow a firm recommendation in Severe Pancreatitis patients.
Was tun bei infizierter Pankreatitis?
Antibiotics are merely an adjuvant therapy in infected pancreatic necrosis. Drainage is mandatory for most if not all pancreatic infections.
Absolute Indikation für Chirurgie bei Pank.?
- Infected pancreatic necrosis when percutaneous/other techniques not indicated
- Severe retroperitoneal haemorrhage
- Acute abdomen – peritonitis
- Abdominal compartment syndrome where percutaneous/other drainage techniques not successful.
Kein Argument für chirurgische Intervention?
Neither the extent of sterile pancreatic necrosis, the clinical severity of the disease or the duration of intensive supportive therapy should be regarded as indications for surgery.
Welche Gründe gibt es FüR die Ernährung von Pankretitis-Patienten? 5
- Increased energy expenditure, oxygen consumption and a hyperdynamic circulation
- High protein catabolism and ureagenesis
- Increased amino acid oxidation
- Increased and unsuppressible gluconeogenesis while glucose clearance and oxidation are diminished (insulin resistance)
- Increased rate of lipolysis and free fatty-acid oxidation
Folgen der Fehlernährung von Pankreas-Patienten?
- Poor pancreatic healing
- Impaired immune, gut, and lung function
- Increased risk for nosocomial and pancreatic infection
- Worsened outcome
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Lernkarten
Was kommt bei Pankreatitis intial im Aszites nicht vor?
Was ist beweisend?
keine Erreger!
hohe Amylase
CT-Zeichen einer Pankreatitis?
- Schwellung
- Regionen mit spontaner Hypointensität (Nekrosezonen)
- fehlende KM-Anreicherung bei i.v.-KM-Gabe
- Peripankreatische Flüssigkeitsansammlung
Was ist der Glasgow/Imrie-Score?
>2 Kriterien->Schwerer Anfall
Wer hat die schlechteste Prognose?
early (on admission), multiple, persistent or evolving organ dysfunctions carry the worst prognosis
Welche Möglichkeit der Prophylaxe von Infektion der Nekrose?
selective decontamination of the digestive system (SDD). Non-absorbed antibiotics are used to reduce the number of aerobic Gram-negative bacteria and yeasts in the gastrointestinal tract, whilst retaining the normally predominant anaerobic flora and so modulating colonisation in the digestive tract. Current evidence is not conclusive enough to allow a firm recommendation in Severe Pancreatitis patients.
Was tun bei infizierter Pankreatitis?
Antibiotics are merely an adjuvant therapy in infected pancreatic necrosis. Drainage is mandatory for most if not all pancreatic infections.
Absolute Indikation für Chirurgie bei Pank.?
- Infected pancreatic necrosis when percutaneous/other techniques not indicated
- Severe retroperitoneal haemorrhage
- Acute abdomen – peritonitis
- Abdominal compartment syndrome where percutaneous/other drainage techniques not successful.
Kein Argument für chirurgische Intervention?
Neither the extent of sterile pancreatic necrosis, the clinical severity of the disease or the duration of intensive supportive therapy should be regarded as indications for surgery.
Welche Gründe gibt es FüR die Ernährung von Pankretitis-Patienten? 5
- Increased energy expenditure, oxygen consumption and a hyperdynamic circulation
- High protein catabolism and ureagenesis
- Increased amino acid oxidation
- Increased and unsuppressible gluconeogenesis while glucose clearance and oxidation are diminished (insulin resistance)
- Increased rate of lipolysis and free fatty-acid oxidation
Folgen der Fehlernährung von Pankreas-Patienten?
- Poor pancreatic healing
- Impaired immune, gut, and lung function
- Increased risk for nosocomial and pancreatic infection
- Worsened outcome
