The causes of pancreatitis can be recalled from the mnemonic GET SMASH'D: gallstones, ethanol, trauma, steroids, mumps, autoimmune diseases, scorpion stings, hypertriglyceridemia, and drugs (e.g., azathioprine or diuretics).
In patients with typical symptoms and diagnostic laboratory tests, CT or MR imaging is not required to confirm the diagnosis of acute pancreatitis. CT or MR imaging are primarily used to detect complications of acute pancreatitis...
Chronic pancreatitis occurs when there is irreversible and progressive destruction of the pancreas. While the etiology of the pain in chronic pancreatitis is not well understood, it is most likely due to: chronic inflammation, altered nociception and tissue ischemia
The pathophysiology of acalculous cholecystitis is thought to start with an acute or acute-on-chronic condition that leads to endothelial injury and gallbladder ischemia.
A classic “you’ll miss it if it’s not on your differential,” ascending cholangitis refers to a bacterial infection of the biliary system, requiring both obstruction and bacterial colonization of the biliary tract.
Recognition of severe acute pancreatitis (SAP) is tricky, as many of the criteria, such as Ranson, Imrie-Glasgow, and APACHE II, are determined 24 to 48 hours after presentation. This renders them unhelpful in the emergency department (ED) time frame.
Jaundice (icterus) is the yellow discoloration of the skin, sclera, and mucosae, which is detectable when serum bilirubin concentrations exceed approximately 2.5 mg/dL. Jaundice can arise as a result of increased red blood cell (RBC) breakdown, disordered bilirubin metabolism, or reduced bilirubin excretion.
Serious ingestions can immediately result in perforation, shock, and even death. Intentional ingestions in adults tend to have more serious consequences. Long-term complications can lead to strictures and an increased risk of esophageal cancer.
Boerhaave syndrome is a spontaneous rupture of the esophagus. It usually results from barotrauma related to retching or any sudden increase in intraabdominal pressure against a closed glottis.
Blood clotting in the setting of chronic liver disease is complex and may result in a net prothrombotic or antithrombotic state. Complicating this situation is the lack of accurate lab assays to measure the net thrombotic state in liver disease patients.