By Prof. Dr. med. P. G. Lankisch, Prof. Dr. med. M. Büchler, Prof. Dr. med. J. Mössner, Prof. Dr. S. Müller-Lissner (auth.)
Read Online or Download A Primer of Pancreatitis PDF
Best nonfiction_11 books
The equipment of interventional neuroradiology signify a different and hard department with within the new box of interventional radiology. The editor of this quantity, Anton Valavanis, is a pioneer during this sector, and one of many extraordinary neuroradiologists on the planet. additionally, he has introduced jointly the most important scientists and scientific neuroradiologists within the box to give the person chapters.
Themes coated Include:Development of Psychotropic DrugsResearch method for Drug TrialsPharmacokineticsAntidepressant DrugsPharmacological remedy of Psychiatric DisordersPharmacoeconomicsand Many extra. ..
Additional info for A Primer of Pancreatitis
32 Practical management Main symptom: acute abdominal pain Case history, symptoms, clinical findings, ultrasound, serum lipase and/or amylase acute pancreatitis? Yes Esti mate the severity (see page 24), with CT if the clinical picture is severe (see page 20) Mild formoedematous pancreatitis Serious form necrotising pancreatitis Intensive medical care - fine needle aspiration of necrosis (see page 29) Surgery (see page 31) 33 Chronic pancreatitis Aetiology and pathogenesis Alcohol-induced chronic pancreatitis This is the most common form in industrialized countries.
For prolonged pain, continuous treatment is given with regular doses according to a fixed time plan. Pancreatic enzymes Increased pressure in the altered pancreatic duct system is considered to be a cause of pain. Pancreatic secretion should be inhibited and hence duct pressure be decreased by the administration of proteases. It has, however, been questioned whether this negative feedback system exists, and furthermore, whether pancreatic enzymes are helpful in pain reduction. g. g. g. o. g. 2 mg sublingually; 55 Chronic pancreatitis Supplementation therapy Choice of enzyme preparation Due to the acid lability oflipase, acid-protected preparations are preferred.
28 Conservative therapy Basic therapy • Pain therapy - procaine hydrochloride! ) • Heparin When required • Correction of acid-base balance • Catecholamines for hypotension despite volume replacement • Insulin in the event of hyperglycaemia > 250 mg% • 02 by nasal intubation in the event of p02 < 70 mm Hg • Controlled ventilation in the event of p02 < 50 mm Hg • Haemodialysis in the event of acute renal failure • Fresh plasma in the event of coagulation disorders • Parenteral feeding Antibiotics in the event of necrotising pancreatitis • If possible, according to antibiotic sensitivity tests (fine needle aspiration, blood culture) • Otherwise, empirical therapy: - ureidopenicillin + metronidazole - cefuroxime - 3rd generation cephalosporin + metronidazole • Carbapeneme (imipenem, meropenem) 1 2 2 gl24 h as infusion e.
A Primer of Pancreatitis by Prof. Dr. med. P. G. Lankisch, Prof. Dr. med. M. Büchler, Prof. Dr. med. J. Mössner, Prof. Dr. S. Müller-Lissner (auth.)