Akut pankreatit
Senast uppdaterad: Senast reviderad:
Sakkunnig:Remy Waardenburg
Definition:
Akut, reversibel inflammation i pankreas med hastig debut. Ofta utlöst av gallstenar eller långvarig överkonsumtion av alkohol.
Förekomst:
Incidensen varierar i olika studier från 5,4 per 100 000 till 79,8 per 100 000 per år.
Symtom:
Kan variera från ett mindre allvarligt till ett livshotande tillstånd. Måttliga till kraftiga smärtor i epigastriet/periumbikalt med utstrålning mot ryggen, bröstet, flankerna eller nedre delen av buken.
Kliniska fynd:
Buken kan vara öm. Tarmljud kan vara frånvarande med associerad paralytisk ileus och kan leda till en utspänd buk. Eventuellt feber på 38–39 °C, takykardi med hypotoni, takypné och andra tecken på hypovolemi.
Diagnostik:
Kräver minst två av följande: abdominala smärtor som talar för tillståndet, S-lipas eller -amylas >3 x övre referensvärdet, bilddiagnostiska fynd förenliga med akut akut pankreatit på DT.
Behandling:
Symtomlindring, vätsketerapi, näring och behandling vid eventuell organsvikt. Vid gallsten som utlöser tillståndet rekommenderas ERCP med kolecystektomi. Alkoholabstinens.
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- Remy Waardenburg, specialist i allmänmedicin, medicinsk redaktör Medibas
Tidigare sakkunniga
- Matthias Löhr, professor och överläkare, Gastrocentrum Kirurgi, Karolinska universitetssjukhuset