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Kamal Bani-Hani FRCS Glasgow, M.D., Ph.D. Leeds King Abdullah University Hospital Department of Surgery Faculty of Me

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Kamal Bani-Hani FRCS Glasgow, M.D., Ph.D. Leeds King Abdullah University Hospital Department of Surgery Faculty of Me

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    2. Acute pancreatitis Autodigestion of the pancreas by its escaped enzymes

    3. Etiological Factors

    4. Drug Induced pancreatitis

    5. Surgical Pathology Edema Exudation Hemorrhage Suppuration Necrosis Fat necrosis (combination of liberated fatty acids from hydrolized fat with calcium) Fluid loss ? Hypovolemia Pseudocyst

    6. Clinical features (Symptoms) Pain (sudden,intense,continuous, upper abdomen ?back, bizarre position) Nausea and Vomiting

    7. Clinical features (Signs)

    8. Investigation

    9. Intra-abdominal Disorders associated with Hyperamylasemia

    10. Extra-abdominal Disorders associated with Hyperamylasemia

    11. D Dx MI Perforated peptic ulcer Acute cholecystitis

    12. Mortality and Prognosis Mortality rate is 6-20% Causes of death: Hypovolaemic shock Electrolyte disturbances Toxaemia Renal failure Respiratory failure (collapse, consolidation, effusion)

    13. Ranson’s Criteria

    14. Mortality and Prognosis (3) ¨      <2 ? no mortality ¨      3-4 ? 15% mortality ¨      5-6 ? 50% mortality ¨      ? 7 ? test the limits of modern medicine

    15. Treatment (When diagnosis certain

    16. Treatment (When diagnosis uncertain) Peritoneal lavage Laparotomy

    17. Treatment (When complications become apparent ) Toxic patient Abdominal mass Persistently high gastric aspiration

    18. Complications MOF Abscess formation Cyst formation Recurrent acute attacks Chronic pancreatitis

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