Medical Surgical Pancreatitis #3

Question

Which client is at the highest risk for pancreatitis?

Answers

  1. A 45-year-old female with rheumatoid arthritis.
    • Rationale:

      This answer is not correct because although rheumatoid arthritis is an autoimmune disease and is a risk factor, it is not the highest risk. Autoimmune diseases have the potential for attacking the pancreas, causing pancreatitis.

  2. A 22-year-old female diagnosed with cholelithiasis.
    • Rationale:

      This answer is not correct although it is a common cause of pancreatitis, a person with gallstones is not at higher risk than a person who abuses alcohol. Pancreatitis is caused by gallstones when the stones block the pancreatic duct outlet.

  3. A 62-year-old male post-ERCP (endoscopic retrograde cholangiopancreatography).
    • Rationale:

      This answer is not correct since it is only associated with a 5-10% risk of pancreatitis. This occurs when there is mechanical injury to the pancreas or hypostatic injury from contrast injection during the ERCP.

  4. A 35-year-old male with long-standing alcohol abuse.
    • Rationale:

      This answer is correct because heavy alcohol consumption damages the pancreas and can cause fatal inflammation of the pancreas. The pancreas metabolizes alcohol into toxic byproducts that are damaging to the pancreatic ducts. In addition, pancreatitis is more common in men of the ages 30-40.

Overview

Alcoholism is the single most important risk factor for pancreatitis. Other diseases that are at risk for pancreatitis include those with autoimmune diseases, gallstones, clients post-ERCP, and men between the ages of 30-40.

Explanation

Learning Outcomes

Pancreatic cells metabolize alcohol, causing destructive results to the pancreas, more specifically, the pancreatic ducts. The enzymes from the pancreas that are normally released into the digestive tract, build up and begin promoting necro-inflammation. This results in irreversible injury to the pancreas. This is why unhealthy alcohol use is the single most important risk factor for pancreatitis. Autoimmune diseases have the potential for attacking the pancreas, causing pancreatitis. Pancreatitis is caused by gallstones when the stones block the pancreatic duct outlet. During an ERCP, mechanical injury or hypostatic injury can occur, causing a post-ERCP pancreatitis.

Test Taking Tip

Recognize important risk factors for pancreatitis.

Video Rationale