tag:blogger.com,1999:blog-2760353953251845523.post3148995702646266324..comments2024-02-10T02:14:39.898-05:00Comments on Buckeye Surgeon: Acute abdomen and other thoughtsJeffrey Parks MD FACShttp://www.blogger.com/profile/15650563299849196122noreply@blogger.comBlogger9125tag:blogger.com,1999:blog-2760353953251845523.post-80229168375682889162007-09-06T13:24:00.000-04:002007-09-06T13:24:00.000-04:00Pancreatitis comes in 2 flavors: acute and chroni...Pancreatitis comes in 2 flavors: acute and chronic. Chronic Pancreatitis is a result of years and years of alcohol abuse (much like cirrhosis of the liver) Acute pancreatitis can happen to anyone subsequent to a single binge. HArd to put absolute number on the amount of ingested alcohol that will lead to such complications. Everyone is different. Genetics certainly play a role; not everyone metabolizes alcohol the same. <BR/><BR/>For necrotizing pancreatitis you look on CT scan for non-enhancement of pancreatic tissue, fluid collections, and air bubbles within the retroperitoneum.Jeffrey Parks MD FACShttps://www.blogger.com/profile/15650563299849196122noreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-47267115295767261452007-09-06T01:05:00.000-04:002007-09-06T01:05:00.000-04:00From a lay reader... Can you give us a feel for h...From a lay reader... Can you give us a feel for how much alcohol consumption can lead to pancreatic problems? <BR/><BR/>Any guidelines or figures on daily intake, years of consumption, other mitigating effects?<BR/><BR/>Are there any reliable diagnostic tests to check<BR/>pancreatic and/or liver function to see if<BR/>alcohol is taking a toll on a person's organs, or if all is normal? Is blood workup sufficient, or is<BR/>imaging also required?<BR/><BR/>Spiral CTs for Kidney stones are available for the patient in the last month.<BR/><BR/>Would anything abnormal Panreatically or Liverly<BR/>show up in these scans, or would a different type of scan be required (such as w/ contrast agent or other xray exposure conditions for optimal organ<BR/>contrast)?<BR/><BR/>Thanks in advance if you can annswer these. Your Blog as well as the Blogs you have linked are absolutely fascinating, and I look forward to reading more!!Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-46978292171609908262007-08-24T15:35:00.000-04:002007-08-24T15:35:00.000-04:00ct would have been good, but hindsight is so clear...ct would have been good, but hindsight is so clear. i think i would have done what you did. by the way, i haven't seen too much success with this degree of pancreatitis.Bongihttps://www.blogger.com/profile/12918640034313468627noreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-82988497336262577642007-08-23T11:27:00.000-04:002007-08-23T11:27:00.000-04:00I'm thinking even if the CT had been done it might...I'm thinking even if the CT had been done it might have been pretty hard to sit by with that level of acidosis and peritonitis. Tough call. Once there, you certainly did the right thing. One would expect another trip or two, but it sounds like a save...Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-91894642151803124072007-08-21T18:02:00.000-04:002007-08-21T18:02:00.000-04:00The diagnosis was not definitely not in question. ...The diagnosis was not definitely not in question. This was necrotizing pancreatitis. Amylase and lipase are very non-specific (not even a part of Ranson's criteria), so even if they are high, normal or low, it wouldn't change the clinical diagnosis. The reason I blogged about this case was the unusual presentation: severe metabolic acidodis, peritonitis, hypotension, leukocytosis.....Jeffrey Parks MD FACShttps://www.blogger.com/profile/15650563299849196122noreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-58074631243541878072007-08-21T15:58:00.000-04:002007-08-21T15:58:00.000-04:00HI , I know its a nightmare for a surgeon to open ...HI , I know its a nightmare for a surgeon to open for pancreatitis , but I am wondering since you are not sure about the diagnosis , did you ask for amylase and lipase first ?, retreospectively speaking , will you ask for CT abdomen before going to the OR ,<BR/>I hope your patient will go through it .ahmed maasherhttps://www.blogger.com/profile/04851920245177182255noreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-47172009221873142862007-08-21T14:12:00.000-04:002007-08-21T14:12:00.000-04:00Will do, Monash.Will do, Monash.Jeffrey Parks MD FACShttps://www.blogger.com/profile/15650563299849196122noreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-81737247063985249022007-08-21T10:20:00.000-04:002007-08-21T10:20:00.000-04:00hi Buckeye Surgeon.i am jeffrey, MS 2. i have sub...hi Buckeye Surgeon.<BR/><BR/>i am jeffrey, MS 2. i have submitted this post on your behalf to Surgexperiences 103 (a new surgical blog carnival) which will be hosted by Dr Jon at http://www.unboundedmedicine.com/ <BR/><BR/>Look out for the release this week!Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-89020529294452069962007-08-19T21:31:00.000-04:002007-08-19T21:31:00.000-04:00Pancreatitis is nasty stuff. Sure hope your patien...Pancreatitis is nasty stuff. Sure hope your patient continues to improve. Lucky for him you didn't quit looking.rlbateshttps://www.blogger.com/profile/15236331355857884458noreply@blogger.com