- Published on
Pathology – Acute Pancreatitis
Acute pancreatitis is defined as acute inflammation of the pancreas and surrounding tissues.
Epidemiology • Uncommon.
Aetiology • Gallstones and alcohol are responsible for the majority of instances. • Other reasons include abdominal trauma, endoscopic retrograde cholangiopancreatography (ERCP), medications, hypercalcemia, pancreatic divisum, and viral infection. • Most cases are idiopathic.
Pathogenesis • Pancreatic injury triggers the release of digestive enzymes, resulting in necrosis of pancreatic and peripancreatic tissues. • Exudation of plasma into the retroperitoneal area causes hypovolemia and cardiovascular instability. • Paralytic ileus can also be caused by severe inflammation near the gut.
Presentation: Sudden onset of severe upper abdominal discomfort spreading to the back, accompanied by nausea, vomiting, and fever. Hypotension may occur, leading to shock.
Biochemistry: A significant increase in serum amylase can indicate acute pancreatitis in the appropriate clinical situation.
Macroscopy reveals an enlarged and squishy pancreas. • Peripancreatic tissues show white flecks of fat necrosis. • Severe instances result in bleeding into the necrotic pancreas.
Histopathology reveals acute inflammation, oedema, and localized necrosis of the pancreas. • There is fat necrosis around the peripancreatic tissue. • Severe cases have extensive necrosis and bleeding within the gland.
Prognosis: • Most instances are moderate and treatable with supportive measures. • Severe cases may require organ support in an intensive care unit. • Infection of necrotic pancreatic tissue can result in disseminated intravascular coagulation and multiple organ failure. • Pancreatic pseudocysts, an accumulation of fluid within the pancreas, are a typical late consequence.
Acute pancreatitis is defined as acute inflammation of the pancreas and surrounding tissues.
Epidemiology • Uncommon.
Aetiology • Gallstones and alcohol are responsible for the majority of instances. • Other reasons include abdominal trauma, endoscopic retrograde cholangiopancreatography (ERCP), medications, hypercalcemia, pancreatic divisum, and viral infection. • Most cases are idiopathic.
Pathogenesis • Pancreatic injury triggers the release of digestive enzymes, resulting in necrosis of pancreatic and peripancreatic tissues. • Exudation of plasma into the retroperitoneal area causes hypovolemia and cardiovascular instability. • Paralytic ileus can also be caused by severe inflammation near the gut.
Presentation: Sudden onset of severe upper abdominal discomfort spreading to the back, accompanied by nausea, vomiting, and fever. Hypotension may occur, leading to shock.
Biochemistry: A significant increase in serum amylase can indicate acute pancreatitis in the appropriate clinical situation.
Macroscopy reveals an enlarged and squishy pancreas. • Peripancreatic tissues show white flecks of fat necrosis. • Severe instances result in bleeding into the necrotic pancreas.
Histopathology reveals acute inflammation, oedema, and localized necrosis of the pancreas. • There is fat necrosis around the peripancreatic tissue. • Severe cases have extensive necrosis and bleeding within the gland.
Prognosis: • Most instances are moderate and treatable with supportive measures. • Severe cases may require organ support in an intensive care unit. • Infection of necrotic pancreatic tissue can result in disseminated intravascular coagulation and multiple organ failure. • Pancreatic pseudocysts, an accumulation of fluid within the pancreas, are a typical late consequence.
0 Comments
