ACUTE PANCREATITIS Xu San rong Department of Gastroenterology Huashan Hospital Fudan university
1 ACUTE PANCREATITIS Xu San rong Department of Gastroenterology Huashan Hospital Fudan university
DEFINITION An acute inflammatory process of the pan creas usually associated with sever pain in the upper abdomen in most instances blood levels of pancrea tic enzymes are increased sever acute pancreatitis: organs failure and/or local complications(necrosis, absc ess, psuedocyst)
2 DEFINITION • An acute inflammatory process of the pancreas usually associated with sever pain in the upper abdomen • in most instances, blood levels of pancreatic enzymes are increased • sever acute pancreatitis: organs failure and/or local complications(necrosis, abscess, psuedocyst)
PATHOLOGY(1) Mild acute pancreatitIs(MAP) characterized by interstitial edema associ- ated with inflammatory cell within parench yma, and microscopic parenchyma necro sis can be detectable
3 PATHOLOGY(1) • Mild acute pancreatitis(MAP) characterized by interstitial edema associated with inflammatory cell within parenchyma, and microscopic parenchyma necrosis can be detectable
PATHOLOGY(2) Sever acute pancreatitis(SAP) Sever necrotizing pancreatitIs(SNP) macroscopic evidence of either focal or diffuse necrosis and hemorrhage of the pancreatic parenchyma
4 PATHOLOGY(2) • Sever acute pancreatitis(SAP) Sever necrotizing pancreatitis(SNP) macroscopic evidence of either focal or diffuse necrosis and hemorrhage of the pancreatic parenchyma
PATHOGENY AND PATHOGENESIS(1) 1 common channel and reflux of duodenal juice Ki nIn stems Sever pain gallstones elastase hemorrhage Bile →( trypsin reflux Trypsin chymotrypsin infection Phospho NipaseA2 Free fat erum Steatolvtic acid calcium enzymes
5 PATHOGENY AND PATHOGENESIS(1) 1 common channel and reflux of duodenal juice gallstones infection Bile juice reflux trypsin Kinin systems elastase Trypsin chymotrypsino PhospholipaseA2 Steatolytic enzymes Sever pain hemorrhage Free fat acid Serum calcium