| Abstract: |
Acute pancreatitis can be life threatening and nurse practitioners must know the signs, symptoms, and risk factors for pancreatitis. This article reviews the identification of pancreatitis in the ambulatory setting. The author uses a case study of a 59 year old white woman who presents to the clinic with vague complaints of abdominal pain. Her symptoms began the evening before presentation and are progressively worsening. The author uses this case to illustrate the differential diagnostic process. The most common differential diagnoses for this patient's symptoms include appendicitis, acute pancreatitis, mesenteric ischemia or infarction, perforated gastric or duodenal ulcer, intestinal obstruction, biliary colic, and perhaps even inferior wall myocardial infarction. Making a diagnosis of acute pancreatitis depends on clinical history, physical examination, serum enzyme assays, and radiologic tests. The main goal of treatment for pancreatitis is supportive care, limitation of complications, and prevention of necrosis (tissue death) of the pancreas. In the case example, the patient's pancreatitis was thought to be caused by a mixture of estrogen and an ACE inhibitor. Although alcohol consumption and gallstones are the most frequent causes of pancreatitis in the general population, mediations are now being recognized as important causative agents that are often overlooked. The author reiterates that early recognition and treatment of acute pancreatitis can reduce suffering and serious complications for the patient. 3 tables. 7 references. |