Clinical Case Database / Category: Patient Management
Management of a patient with not so "mild" acute pancreatitis
Mr AL Widdison, Cara McLaughlin, Catherine O'Brien
Foundation Years Journal, volume 9, issue 7, p.52 (123Doc Education, London, July 2015)
We present the management of a 73 year old lady with acute pancreatitis (AP). She was initially predicted as having mild AP with a Glasgow score of 1 and treated with analgesia and intravenous fluids before being discharged after 7 days. She was readmitted 4 days later and diagnosed with necrotizing pancreatitis on CT scan. Antibiotics were started and 4 days later she was discharged home. She was readmitted 6 days later septic and a repeat CT scan showed infected walled off necrosis. This was treated with a cyst-gastrostomy, debridement of necrotic tissue and cholecystectomy. She made an uneventful recovery and was discharged after 9 days. An out-patient MRCP was normal. The cause of her AP was likely to be due to gallstones but this was not proven. We discuss the importance of measuring serum amylase, severity scoring systems, the accuracy of ultrasound, and the role antibiotics.
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Mr AL Widdison (Corresponding author)
Royal Cornwall Hospital, Treliske, Cornwall, TR1 3LJ
Royal Cornwall Hospital, Treliske, Cornwall, TR1 3LJ
Peninsula College of Medicine and Dentistry
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