PATHOPHYSIOLOGY
Where is your appendix and pancreas located?
Appendix is located in the right lower quadrant
Pancreas right upper quadrant
Where is the pain usually felt during an appendicitis?
Right lower quadrant
What are the treatments for appendicitis?
Position of comfort
IV fluids
Antiemetics
Pain control
Watch for signs of septic shock
How is the physical exam performed to assess pain in appendicitis?
By applying gentle pressure on the area of pain - once pressure is released the pain will often feel worse signaling the appendix is inflamed
What treatment would be provided at the hospital to treat appendicitis?
Appendicitis treatment involves surgery to remove the inflamed appendix.
Before surgery you may be given a dose of antibiotics to treat infection.
What are the two types of pancreatitis?
Acute pancreatitis and Chronic pancreatitis
Where is the pain usually felt with pancreatitis?
Pancreatic pain goes straight through from the epigastrium to the back in the midline.
What are the treatments for pancreatitis?
Position of comfort
Antiemetics
Pain management
IV fluids
Watch for signs of septic shock
How is the physical exam performed for pancreatitis?
Abdominal examination is usually performed by palpating the abdomen looking for tenderness, rigidity, distention or patient guarding the abdomen due to pain.
What treatment would be provided at the hospital to treat pancreatitis?
IV fluids - treat dehydration, pain medications and antibiotics, and be put on a low-fat diet.
Surgery- A surgical procedure can help relieve pressure or blockage in your pancreatic duct, or to remove the damaged or infected part of your pancreas.
What are the causes of appendicitis?
Caused by accumulation of material, usually feces.
Appendix swells, blood flow gets cut off (ischemia) and tissues start to die, which leads to an infection
What are the symptoms of pancreatitis?
Pain/tenderness in abdomen
Nausea/vomiting
Fever/chills
Tachycardia
SOB
Hypotension
Jaundice
What medication can you give for appendicitis?
Antiemetics - Ondansetron
Do not give anything by mouth
What are other tests/procedures that can help determine the diagnosis of appendicitis and what would they indicate?
Blood test- The level on white blood cell count, if the count is high this may indicate an infection.
Urine test- Providing a urinalysis will help to determine that you don't have a UTI or kidney stone that is causing or contributing to your pain.
Imaging tests- Ultrasound, X-ray, or CT scan can help determining appendicitis.
What are ways to help prevent appendicitis?
There’s no sure way to prevent appendicitis, but it can be managed by lowering the risk of developing it by eating a fiber-rich diet such as fruits, vegetables, lentils, oatmeal, whole grains.
Avoid processed, fried, and junk foods that are fatty and can irritate the digestive system
What are the causes of pancreatitis?
Most common cause is alcohol abuse and gallstones
What are the symptoms of appendicitis?
Sudden pain that begins around the belly button and localizes to the right lower quadrant
Rebound pain in that same area
Nausea/vomiting
Loss of appetite
Constipation/diarrhea
Fever
What medications can you give for pancreatitis?
Analgesics - Acetaminophen
Antiemetics - Ondansetron
What are tests/procedures that can help determine pancreatitis and what would they indicate?
Blood tests- high amylase and lipase levels, high blood glucose, high levels of blood fat.
Imaging test- Ultrasound, CT scan, Endoscopic ultrasound (a thin, flexible tube that goes down your throat through the stomach and into your small intestine to create an image of your pancreas and bile duct).
Stool test- In chronic pancreatitis this procedure is to measure levels of fat that could suggest your digestive system isn't absorbing nutrients adequately - called malabsorption.
What are ways to prevent pancreatitis?
Slow or stop alcohol intake - continuing to drink alcohol when you have acute pancreatitis can lead to more episodes of acute pancreatitis and chronic pancreatitis.
Stop smoking- even if your pancreatitis is mild or in the early stages, smoking with pancreatitis can raise the risk for pancreatic cancer.
Eat a heart-healthy diet - include whole grains and variety of fruits/vegetables. Avoid fatty or fried foods.
What complications can pancreatitis cause?
Kidney failure
Breathing problems
Infection
Malnutrition
Diabetes
Pancreatic cancer
What is a common serious complication with appendicitis?
The appendix rupturing- which can lead to a serious infection within the abdominal cavity, possibly life threatening.
What medication should you be cautious about giving a patient experiencing pancreatitis?
Morphine - can be given but may cause spasms of the gallbladder, increasing the patient's pain.
What is the gold standard for diagnosing appendicitis?
An ultrasound
What is the best and most helpful way to recover from pancreatitis and appendicitis?
Pancreatitis - eat small portions, avoid fatty foods and alcohol.
Alcohol cannot be ingested with patients with chronic pancreatitis. They must take pancreatic enzymes in the form of supplements to avoid malabsorption.
Glycaemia must be monitored because there is a risk of diabetes mellitus
Appendicitis - stay on top of the antibiotics provided and proper diet with the right amount of nutrition.