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Consultant Corner: Pancreatitis

  • Shawn Tejiram
  • Laura S. JohnsonEmail author
Chapter

Abstract

Surgical consultation is useful in three specific scenarios: (1) when a surgical etiology of pancreatitis is identified, (2) when surgical complications of pancreatitis are identified, and (3) when a team approach is necessary to manage the long-term sequelae of pancreatitis. Computed tomography (CT) of the abdomen and pelvis may be the first imaging study obtained, but if the diagnosis of pancreatitis is confirmed, ultrasound imaging of the gallbladder and hepatobiliary tree will help identify the most common etiologies (e.g., gallstone pancreatitis). Gallstone pancreatitis should prompt an evaluation for cholecystectomy during the index presentation. With the most recent literature suggesting that both under- and over-resuscitations have negative implications for patients with AP, we recommend using clinical markers of shock (skin perfusion, mental status, and urine output) coupled with laboratory markers of hypoperfusion (acidosis, hemoconcentration, organ failure) to guide resuscitation.

Keywords

Pancreatitis Gallstone pancreatitis Abdominal pain Surgical perspective 

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.MedStar Georgetown University Hospital - Washington Hospital Center Residency Program in General Surgery, Department of Surgery, MedStar Washington Hospital CenterWashington, DCUSA
  2. 2.Georgetown University School of MedicineWashington, DCUSA

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