Pancreas 1

Function:
1. Eksokrin
Pancreas damage occurred because the enzyme autodegestif of pancreas itself

Patogenesis autodegestif
Normally tripsinogen changed to tripsin by enterokinse, in lumen enzyme aktivasion intestine and pancreas. If there tripsin entry through the blood or directly into the pancreas is normal inhibitor tripsin.

The occurrence of interference because tripsin entry keduktus pankreatikus to the papilla Vater; spingter Oddi. Ductus this experience that caused a disruption tripsin remain in the ductus (stopple, atonia, udem, refluk, spasme on alkoholik). Tripsin this is the enzyme in the pancreas that digested pancreas itself.

Enzyme in the pancreas and its function:
- Fosfolipase; digested fosfolipid cells
- Elastase; digested vein (bleeding)
- Kalikerin; vasodilatasi (udem)
- Lipase;digested fat (nekrosis)

Autodegestif This process causes inflammation in the pancreas (pankreasitis)
Pankreasitis divided into 2:
a. Acute;
damaged pancreas and enzyme-free exit in the stomach cavity be divided into 2;
- Acute phase; happen redemption SIRS (systemic inflammatory response syndrome) in 72 hours (example sepsis symptoms) but no evidence of infection.
- Chronicles phase; happened on the second day is marked with multiorgan failure.

Alert
1. alkoholik history.
2. kembung nausea, vomiting, sweat a lot, ileus paralitik, ikterus, hot.
3. sick circle for dorsum.
4. Cullen sign; periumbilicus noisy.
5. Gray signs - Tunner; noisy on the waist.

Ranson criteria; if there is ≥ 3 means that the complications bad sign
1. age> 55 th
2. AL> 16 rb/mm3
3. glucose> 200 mg / dl
4. LDH> 350 IU / l
5. SGOT> 250 IU / l


Handling:
1. ABC
2. infuse NaCl 9%, NGT, kateter
3. diet oral stop, wait until a peristaltic
4. analgetik drug (pethidin im), antibiotic (if suspicious infection)
5. Calcium convulsions when given iv Glukonas
6. watching 48 hours; check whether, when a poor prognosis means
a. hematokrit down> 10%
b. BUN rise> 5 mg / ml
c. arterial pO2 <60mmhg> 6 l
f. basa decrease> 4 mEq / l
b. Chronicles

b. cronik

1. ABC
2. history alcoholic, DM.
3. BB down, diarrhea steatore chronicles.
4. epigastrik painful, for left dorsum, light, pressure, sharp.

Handling:
1. break, low-fat diet.
2. see additional complications.
3. surgical consultation.