Diagnostic Criteria for Pancreatitis and Treatment

Diagnostic Criteria for Acute Pancreatitis

• Computed tomography signs of acute pancreatitis
• Three-fold elevation of lipase (from upper normal limit)
• Kidney failure
• Rebound tenderness
• Abdominal pain, vomiting

Diagnostic Criteria for Chronic Autoimmune Pancreatitis

• Positive effect from corticosteroid therapy is not a diagnostic criterion
• Histological findings are not a diagnostic criterion
• Other organ involvement is not a diagnostic criterion
• Microbiological culture is not a diagnostic criterion

Diagnostic Methods for Hemodynamically Unstable Patients with Suspected Bleeding

• MRI angiography
• Contrast-enhanced computed tomography
• FAST ultrasonography
• Diagnostic peritoneal lavage

Indications for Interventional/Surgical Treatment in Acute Pancreatitis

• Gastric outlet obstruction
• Asymptomatic acute peripancreatic fluid collection
• Infected Walled-off necrosis
• Severe pain syndrome

Charcot Triad

• Fever
• Vomiting
• Jaundice

Imaging Tool for Detection of Stones in Common Bile Duct

• Magnetic Resonance Cholangiopancreatography (MRCP)
• Abdominal ultrasound

Tumor Markers Specific for Pancreas Adenocarcinoma

• CA19-9

Indications for Surgical Treatment of Chronic Pancreatitis

• Unresolved pseudocyst (size 9 cm)
• Ductal hypertension with pain syndrome
• Exocrine insufficiency
• Infected pseudocyst (size 4.5 cm)

Acute Cholecystitis Treatment

• Laparoscopic cholecystectomy

Zollinger-Ellison Syndrome Cause

• Gastrinoma

Mild Acute Pancreatitis Characteristics

• Absence of organ failure
• One organ failure that lasts <48 hours
• Acute necrotic collection (confirmed by computed tomography)

Signs of Mechanical Jaundice

• Increased CRP
• Increased liver enzymes
• Dilation of the common bile duct
• Intrahepatic cholestasis
• Increased bilirubin levels

Surgical Treatment Methods for Acute Necrotizing Pancreatitis

• Percutaneous US-guided drainage of fluid collection
• Pancreatoduodenectomy
• Retroperitoneal drainage/necrosectomy
• Distal pancreatectomy
• Endoscopic transgastric drainage of fluid collection

Radical Surgery in Pancreatic Head Ductal Adenocarcinoma

• Pancreatoduodenectomy (Whipple procedure)

Exclusion Criteria for Lethal Trauma Triad

• Hyperthermia
• Tachycardia
• Hypothermia
• Coagulopathy
• Acidosis

Bile Duct Injury Causes

• Misinterpretation of bile duct anatomy
• Lack of surgeon experience
• Increased CRP
• Obesity

Normal Gallbladder Wall Size

• 0.3-0.5 cm

Imaging for Pancreas Head Cancer Diagnosis

• Computed tomography (CT) with intravenous contrast

Acute Cholecystitis Diagnostic Criteria (Tokyo Guidelines 2018)

• Increased CRP
• Right upper abdominal pain
• Dilated gallbladder
• Thickened gallbladder wall
• Fever
• Vomiting

Post-Endoscopic Hemostasis Treatment

• Continuous PPI infusion for 48 hours (or more)

Signs of Shock

• Warm extremities
• Good pulse volume
• Hypertension
• Tachycardia
• Acidosis

Lymph Characteristics

• Product of interstitial fluid, originating from ultrafiltration of plasma in capillaries
• Not a product of ultrafiltration in the lymph nodes, heart, or cristerna chyli

Radical Liver Flexure Adenocarcinoma Operation

• Hemicolectomy
• Hartmann's procedure
• Anterior resection
• Liver flexure resection