Pacncreatitis Case Study. This paper summarizes the publishings of Doenges, Moorhouse, and Murr (2010) and Christenson and Kockrow (2011) which describes the disease process pancreatitis. Christenson et al. (2011) discusses common signs and sympt

Authors Avatar



PFC Bell


This paper summarizes the publishing’s of Doenges, Moorhouse, and Murr (2010) and Christenson and Kockrow (2011) which describes the disease process pancreatitis. Christenson et al. (2011) discusses common signs and symptoms patients experience with pancreas disorders. Doenges et al. (2010) discusses the most common diagnostic techniques and the most popular medical and nursing management procedures that are practiced today. Christenson et al. (2010) defines the abbreviation AST as Aspartate aminotransferase and ALT as alanine aminotransferase. Both of these publishing’s have the same definitions of pancreatitis and both suggest that lifestyle changes, medications, and surgical intervention may be necessary to decrease the chance of more acute episodes.

On Wednesday September 28 CS 51-year-old man, with recent laparoscopic cholecystectomy, presented to the emergency department with complaints of severe abdominal pain. The episode started around 1100 and was initially mild. He was able to eat normally, but around 1400, the pain became much worse to the point that he had difficulty breathing. He took an oxycodone, which provided little relief.  CS found that flexing his hips and staying still helped relieve the pain. He described the pain as cramping and wrapping around to his back, worse on the right side. He has nausea, but has not experienced vomiting. In the emergency department he was given diluadid, which relieved the pain. He has had four episodes similar to this since June and has not seen improvement since the cholecystectomy in August.

Christenson et al. (2011), states that the pancreas is a gland located in the upper posterior abdomen which is responsible for both endocrine and exocrine functions. The endocrine function refers to the Islets of Langerhans, which produce and secrete insulin into the bloodstream where they travel to distant organs. The exocrine function includes glands that produce and secrete enzymes which accumulate in the intralobular ducts, and empty into the main pancreatic duct, which then drains into the duodenum when needed for digestion. Doenges et al. (2010) states that amylase breaks down carbohydrates into sugars which are more easily absorbed by the body.  This enzyme can also be found in saliva. Another pancreatic enzyme lipase works with bile from the gallbladder to break down fat. Protease breaks down proteins and helps keep the intestine free of bacteria, yeast and protozoa.

Doenges et al. (2010) describes pancreatitis as an inflammation of pancreas. The most common cause of pancreatitis is obstruction by gallstones which accounts for forty percent of cases. Doenges et al. (2010), states that alcohol abuse is another major cause which contributes to thirty-five percent. Certain procedures, viral or bacterial infections, and certain pharmaceutical drugs can cause pancreatitis also. This inflammation can cause activation of pancreatic enzymes resulting in localized damage to the pancreas, autodigestion, and fibrosis of the pancreas. Christenson et al. (2011) states that if left untreated pancreatitis can lead to widespread range of consequences and life-threatening complications, including hypovolemia, shock, acute renal failure, diabetes, acute respiratory distress syndrome, and multi organ failure. It is estimated by Doenges et al. (2010) that eighty-seven thousand people are diagnosed with chronic pancreatitis each year in the United States.  Twenty-two thousand were said to be hospitalized for acute pancreatitis in 2007. The mortality rate is less than one percent for mild acute pancreatitis, but can approach ten percent to thirty percent for severe acute pancreatitis.  It is also estimated by Doenges et al. (2010) that more than two billion dollars are spent each year in the United States on treatment and diagnosis of pancreatitis. Doenges et al. (2010) separates pancreatitis into two categories, acute or chronic. Acute is when a sudden inflammation occurs over a short period of time. Chronic pancreatitis is associated with chronic alcoholism sixty percent of the time.

Join now!

Patients can present with a range of signs and symptoms. Christenson et al. (2011) states that some general signs and symptoms include fatigue, restlessness, apprehension, hypertension, hypotension, ascites, pale or yellow skin, Positive Cullen’s sign, diarrhea, hypoactive bowl sounds, abdominal distension and tenderness, dark and decreased urine, steatorrhea, loss of appetite, weight loss, severe deep abdominal pain, usually in the epigastric region and  may radiate to the back, patient may curl up on left side with both arms over abdomen and knees and hips flexed, tachypnea with or without dyspnea, and decreased depth of respiration.

There are several diagnostic procedures ...

This is a preview of the whole essay