Surgery: Small Bowel Obstruction High-Yield
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1
What is the most common cause of small bowel obstruction?
Intra-abdominal adhesions (75%)
2
What percentage of SBO cases are caused by neoplasms?
Approximately 3%
3
What is the hallmark of complete SBO?
Obstipation (absence of stool and flatus)
4
What are the classic SBO X-ray findings?
Dilated small bowel >3 cm, air-fluid levels, and paucity of colonic gas
5
What is the diagnostic threshold for air-fluid levels in SBO?
At least 3 air-fluid levels
6
What is the most reliable imaging test for SBO?
CT scan
7
What is the typical CT finding in closed-loop obstruction?
U-shaped or C-shaped dilated loops with converging mesenteric vessels
8
What CT findings suggest strangulated SBO?
Bowel wall thickening, pneumatosis intestinalis, portal venous gas, and poor contrast enhancement
9
What is the initial management of uncomplicated SBO?
IV fluids, electrolyte correction, NPO, and NGT decompression
10
When is surgery indicated in SBO?
Failed conservative treatment or signs of strangulation
11
What is the most common cause of postoperative ileus?
Abdominal surgery and bowel manipulation
12
What distinguishes ileus from mechanical SBO on auscultation?
Ileus has diminished bowel sounds; SBO has hyperactive, high-pitched sounds
13
When does small intestinal peristalsis typically return after surgery?
24 hours
14
When does gastric motility typically return after surgery?
48 hours
15
When does colonic motility typically return after surgery?
2–5 days
16
What is the most reliable indicator of returning bowel motility?
Passage of flatus or bowel movement
17
What is Crohn's disease?
Chronic idiopathic transmural inflammatory disease that can affect any part of the GIT
18
What is the most commonly affected site in Crohn's disease?
Distal ileum (75%)
19
What is the characteristic distribution of Crohn's disease?
Skip lesions
20
What layers are affected in Crohn's disease?
All bowel wall layers (transmural)
21
What is the characteristic mucosal appearance of Crohn's disease?
Cobblestoning
22
What is the earliest lesion in Crohn's disease?
Aphthous ulcers
23
What is the pathognomonic mesenteric finding in Crohn's disease?
Creeping fat (fat wrapping)
24
What antibody is associated with Crohn's disease?
ASCA positive, pANCA negative
25
What type of granulomas occur in Crohn's disease?
Non-caseating granulomas
26
What is the main diagnostic procedure for Crohn's disease?
Ileocolonoscopy
27
What is the characteristic histologic finding in intestinal tuberculosis?
Caseating granulomas
28
What is the main surgical procedure for Crohn's complications?
Segmental resection with end-to-end anastomosis
29
What is the purpose of stricturoplasty?
Widening a narrowed intestinal lumen without bowel resection
30
What is the indication for Heineke-Mikulicz stricturoplasty?
Short strictures less than 12 cm
31
What is the indication for Finney stricturoplasty?
Longer strictures up to 25 cm
32
What is a contraindication to stricturoplasty?
Abscess or fistula
33
What is an intestinal fistula?
Abnormal communication between two epithelialized hollow surfaces
34
What defines a low-output fistula?
Less than 200 mL/day
35
What defines a high-output fistula?
More than 500 mL/day
36
What is the most important external fistula in surgery?
Enterocutaneous fistula
37
What is the most common cause of enterocutaneous fistula?
Iatrogenic injury
38
What does FRIENDS stand for in fistula management?
Foreign body, Radiation, Infection, Epithelialization, Neoplasm, Distal obstruction, Short tract
39
What is the most useful initial investigation for enterocutaneous fistula?
CT scan
40
What is the most sensitive test for identifying fistula origin?
Fistulogram
41
What is the initial management of enterocutaneous fistula?
Stabilization, sepsis control, nutrition, and output control
42
What medication decreases high-output fistula drainage?
Octreotide
43
What is the most common benign small intestinal neoplasm?
Adenoma
44
Which adenoma subtype has the highest malignant potential?
Villous adenoma
45
What is the most common primary malignant tumor of the small intestine?
Adenocarcinoma
46
What is the most common location of small bowel adenocarcinoma?
Duodenum
47
What is the most common mesenchymal tumor of the small intestine?
Gastrointestinal stromal tumor (GIST)
48
What cells give rise to GIST?
Interstitial cells of Cajal
49
What immunohistochemical marker identifies GIST?
CD117 (KIT)
50
What is the preferred surgical treatment for localized GIST?
Segmental resection without lymphadenectomy
51
What medication is used for metastatic GIST?
Imatinib (Gleevec)
52
What is the main treatment for small bowel lymphoma?
Chemotherapy (CHOP)
53
What is the most common extranodal lymphoma involving the small intestine?
Intestinal lymphoma
54
Where is small intestinal lymphoma commonly located?
Terminal ileum, particularly Peyer's patches
55
What is the most common location of small intestinal neuroendocrine tumors?
Ileum (appendix is the most common overall GI site)
56
What causes carcinoid syndrome?
Systemic release of serotonin and other mediators, usually with liver metastases
57
What are the classic manifestations of carcinoid syndrome?
Flushing, diarrhea, hypotension, and tachycardia
58
What is the most effective pharmacologic treatment for carcinoid syndrome?
Octreotide
59
What is Meckel's diverticulum?
True diverticulum caused by incomplete obliteration of the vitelline duct
60
During which embryonic week does Meckel's diverticulum originate?
8th week
61
Where is Meckel's diverticulum located?
Antimesenteric ileum, approximately 2 feet from the ileocecal valve
62
What is the Rule of 2s for Meckel's diverticulum?
2% prevalence, 2:1 male predominance, 2 feet from ileocecal valve, 2 inches long, symptomatic before age 2
63
What is the gold standard diagnostic test for Meckel's diverticulum?
Tc-99m pertechnetate scan
64
What is the most common complication of Meckel's diverticulum in children?
Bleeding
65
What is the most common complication of Meckel's diverticulum in adults?
Intestinal obstruction
66
What is an acquired intestinal diverticulum?
False diverticulum containing mucosa and submucosa without muscularis propria
67
What is the most common location of acquired small bowel diverticula?
Duodenum, particularly periampullary
68
What is the most sensitive investigation for jejunoileal diverticula?
Enteroclysis
69
What is acute mesenteric ischemia?
Sudden reduction in intestinal blood supply causing bowel ischemia and possible infarction
70
What is the most common cause of acute mesenteric ischemia?
Arterial embolism
71
What is the most common source of mesenteric arterial emboli?
Cardiac emboli
72
What is the hallmark symptom of acute mesenteric ischemia?
Abdominal pain out of proportion to physical findings
73
What is the initial imaging test for acute mesenteric ischemia?
CT scan
74
What is the most reliable diagnostic investigation for acute mesenteric ischemia?
Angiography
75
What is non-occlusive mesenteric ischemia?
Mesenteric vasospasm without mechanical vascular obstruction
76
What medication can be infused intra-arterially for non-occlusive mesenteric ischemia?
Papaverine
77
What is the most common location of venous mesenteric thrombosis?
Superior mesenteric vein
78
What is pneumatosis intestinalis?
Presence of gas within the bowel wall
79
What is short bowel syndrome?
Residual small bowel less than 200 cm with significant malabsorption
80
What vitamin is primarily absorbed in the terminal ileum?
Vitamin B12
81
Where are bile salts primarily reabsorbed?
Terminal ileum
82
What is the primary treatment for short bowel syndrome?
Nutritional support, including TPN when necessary
83
What is intussusception?
Telescoping of one bowel segment into another
84
What is the most common type of pediatric intussusception?
Ileocolic
85
What is the characteristic imaging finding in intussusception?
Target or donut sign
86
What is Dance's sign?
Empty right lower quadrant due to intussusception
87
What is the usual initial treatment for uncomplicated pediatric intussusception?
Hydrostatic reduction
88
What is SMA syndrome?
Compression of the third portion of the duodenum between the SMA and aorta
89
What aortomesenteric angle suggests SMA syndrome?
Less than 22°
90
What aortomesenteric distance suggests SMA syndrome?
Less than 8 mm
91
What is radiation enteritis?
Intestinal injury caused by radiation exposure
92
At what cumulative radiation dose does radiation enteritis commonly occur in the reviewer?
At least 4,500 cGy
93
What is chylous ascites?
Accumulation of triglyceride-rich, milky lymphatic fluid in the peritoneal cavity
94
What is the most important initial test for chylous ascites?
Paracentesis
95
What is the gold standard investigation for identifying lymphatic leakage?
Lymphangiography
96
What is the adult small intestine length?
Approximately 4–6 meters
97
What are the three segments of the small intestine?
Duodenum, jejunum, and ileum
98
Which small intestinal segment is primarily retroperitoneal?
Duodenum
99
What is the length of the duodenum?
Approximately 25–30 cm
100
What ligament marks the duodenojejunal junction?
Ligament of Treitz
101
Which small intestinal segment comprises the proximal 40% after the duodenum?
Jejunum
102
Which small intestinal segment comprises the distal 60%?
Ileum
103
Which segment has more Peyer's patches?
Ileum
104
Which segment has longer vasa recta?
Jejunum
105
Which segment has more mesenteric fat and arterial arcades?
Ileum
106
What is the predominant absorptive cell of the small intestine?
Enterocyte
107
Which intestinal cells secrete mucus?
Goblet cells
108
Which intestinal cells secrete antimicrobial peptides?
Paneth cells
109
Which intestinal cells sample antigens over Peyer's patches?
M cells
110
Where is Meissner's plexus located?
Submucosa
111
Where is Auerbach's plexus located?
Between the circular and longitudinal muscle layers
112
What is the main function of Auerbach's plexus?
Regulation of peristalsis
113
What is the main function of Meissner's plexus?
Regulation of mucosal secretion and vascular tone
114
Which transporter absorbs glucose and galactose?
SGLT1
115
Which transporter absorbs fructose?
GLUT5
116
Where is vitamin B12 absorbed?
Terminal ileum, bound to intrinsic factor
117
Which hormone stimulates gallbladder contraction?
Cholecystokinin (CCK)
118
Which hormone stimulates pancreatic and intestinal secretions?
Secretin
119
Which hormone stimulates the migrating motor complex?
Motilin
120
Which hormone inhibits intestinal motility and secretion?
Peptide YY
121
Which hormone stimulates intestinal epithelial proliferation?
GLP-2
122
What is the appendix?
A narrow, blind-ended tubular organ arising from the cecum
123
Where is the base of the appendix located?
At the convergence of the three taeniae coli
124
What is the average length of the appendix?
Approximately 6–9 cm
125
What is the most common cause of acute appendicitis?
Luminal obstruction, commonly by a fecalith
126
What is the most common cause of appendiceal obstruction in children?
Lymphoid hyperplasia
127
What are the four stages of acute appendicitis?
Obstruction, congestion, suppuration, and gangrene/necrosis
128
What nerve fibers initially transmit appendicitis pain?
C fibers
129
Where is the initial pain of appendicitis usually located?
Periumbilical region
130
Which nerve fibers transmit localized appendicitis pain?
A-delta fibers
131
Where does appendicitis pain typically migrate?
Right lower quadrant
132
What is the most common organism associated with appendicitis?
Escherichia coli
133
Which anaerobic organism is commonly associated with appendicitis?
Bacteroides
134
What is McBurney's point?
Point approximately one-third of the distance from the right ASIS to the umbilicus
135
What is Rovsing's sign?
Left lower quadrant pressure produces right lower quadrant pain
136
What is the psoas sign?
Pain with resisted right hip flexion or extension
137
What does a positive obturator sign suggest?
Pelvic appendix irritation
138
What is Dunphy's sign?
Increased abdominal pain with coughing
139
What is the MANTRELL or Alvarado score's maximum?
10 points
140
How many Alvarado points are assigned for RLQ tenderness?
2 points
141
How many Alvarado points are assigned for leukocytosis?
2 points
142
What Alvarado score indicates high probability of appendicitis?
9–10 points
143
What is the preferred diagnostic approach for appendicitis according to the reviewer?
History and physical examination
144
What pregnancy-related test should be obtained in reproductive-age females with suspected appendicitis?
Serum beta-hCG
145
What is the standard surgical treatment for acute appendicitis?
Appendectomy
146
What is stump appendicitis?
Inflammation of residual appendiceal tissue after appendectomy
147
What is the most common malignant tumor of the appendix?
Carcinoid (neuroendocrine tumor)
148
What operation is generally recommended for appendiceal adenocarcinoma?
Right hemicolectomy
149
What are the three possible outcomes of appendiceal rupture?
Peritonitis, periappendiceal abscess, and phlegmon
150
What is Cantlie's line?
Functional division of the liver following the middle hepatic vein
151
What structures does Cantlie's line extend between?
Gallbladder fossa and inferior vena cava
152
What is the falciform ligament?
Surface anatomical landmark separating the apparent right and left liver lobes
153
Which structure divides the functional right and left liver?
Middle hepatic vein
154
What is the largest solid organ in the body?
Liver
155
What is the approximate adult liver weight?
1,200–1,500 g
156
What is the fibrous covering of the liver?
Glisson's capsule
157
What are the components of the portal triad?
Portal vein, hepatic artery, and bile duct
158
What is the Pringle maneuver?
Temporary clamping of the hepatoduodenal ligament to control hepatic inflow
159
What is the approximate contribution of the hepatic artery to liver blood flow?
25%
160
What is the hepatic arterial buffer response?
Hepatic artery dilation when portal venous flow decreases
161
What is Couinaud segment I?
Caudate lobe
162
Which Couinaud segments comprise the left lateral section?
Segments II and III
163
Which Couinaud segment corresponds to the left medial section?
Segment IV
164
Which segments comprise the right anterior section?
Segments V and VIII
165
Which segments comprise the right posterior section?
Segments VI and VII
166
Where do caudate lobe veins drain?
Directly into the inferior vena cava
167
Which hepatic vein is the functional transection landmark?
Middle hepatic vein
168
What does the left umbilical vein become after birth?
Ligamentum teres
169
What does the ductus venosus become after birth?
Ligamentum venosum
170
What is the primary function of the liver in carbohydrate metabolism?
Glycogen storage and glucose regulation
171
What is the main function of Kupffer cells?
Phagocytosis of microorganisms and debris
172
What is the main function of hepatocytes?
Metabolism, detoxification, and bile production
173
What does ALT primarily indicate?
Hepatocellular injury
174
What does AST indicate?
Hepatocellular injury, but it is less liver-specific than ALT
175
What laboratory pattern suggests cholestasis?
Elevated alkaline phosphatase and GGT
176
What laboratory measurement reflects hepatic synthetic function?
Albumin and prothrombin time/INR
177
What does elevated direct bilirubin suggest?
Conjugated hyperbilirubinemia, often from impaired excretion
178
What is acute liver failure?
Acute severe hepatic dysfunction with coagulopathy and encephalopathy in a patient without established cirrhosis
179
What are the major causes of acute liver failure?
Drug-induced injury, viral hepatitis, and other severe hepatic insults
180
What is the Child-Turcotte-Pugh score used for?
Assessment of cirrhosis severity and prognosis
181
What are the five Child-Turcotte-Pugh parameters?
Bilirubin, albumin, INR/PT, ascites, and encephalopathy
182
What CTP score corresponds to Class A?
5–6
183
What CTP score corresponds to Class B?
7–9
184
What CTP score corresponds to Class C?
10–15
185
What is the MELD score used for?
Assessment of end-stage liver disease and transplant prioritization
186
What is portal hypertension?
Increased pressure within the portal venous system
187
What is the most common cause of portal hypertension?
Cirrhosis
188
What is the most serious complication of portal hypertension?
Variceal hemorrhage
189
What are the major portosystemic collateral sites?
Esophageal, gastric, rectal, and paraumbilical regions
190
What is the initial pharmacologic treatment for acute esophageal variceal bleeding?
Vasoactive therapy such as octreotide
191
What is the preferred endoscopic treatment for bleeding esophageal varices?
Endoscopic variceal ligation
192
What procedure creates a portosystemic shunt to reduce portal pressure?
TIPS (transjugular intrahepatic portosystemic shunt)
193
What is hepatocellular carcinoma?
Primary malignancy arising from hepatocytes
194
What is the strongest established risk factor for hepatocellular carcinoma?
Cirrhosis
195
What tumor marker is associated with hepatocellular carcinoma?
Alpha-fetoprotein (AFP)
196
What is the Milan criterion for liver transplantation?
Single tumor ≤5 cm or up to three tumors each ≤3 cm, without gross vascular invasion or extrahepatic spread
197
What is the most common cause of gallstones?
Cholesterol supersaturation of bile
198
What are the two major types of gallstones?
Cholesterol stones and pigment stones
199
What is the most important risk factor for gallbladder carcinoma?
Gallstones
200
What gallstone size is associated with increased gallbladder cancer risk?
Greater than 3 cm
201
What is the most common presentation of acute cholecystitis?
Right upper quadrant pain, fever, and positive Murphy's sign
202
What is Murphy's sign?
Inspiratory arrest caused by pain during palpation of the right upper quadrant
203
What is the preferred initial imaging for suspected gallstones?
Right upper quadrant ultrasonography
204
What is the initial treatment for acute cholecystitis?
Supportive care, antibiotics when indicated, and early cholecystectomy
205
What is the critical view of safety in laparoscopic cholecystectomy?
Identification of only two structures entering the gallbladder before division
206
What is Calot's triangle?
An anatomical space used to identify the cystic artery and related structures during cholecystectomy
207
What is choledocholithiasis?
Presence of gallstones within the common bile duct
208
What type of jaundice is commonly caused by CBD stones?
Obstructive jaundice
209
What is the gold standard procedure for common bile duct stone clearance?
ERCP
210
What is Charcot's triad?
RUQ pain, fever, and jaundice
211
What is Reynolds' pentad?
Charcot's triad plus hypotension and altered mental status
212
What is acute ascending cholangitis?
Infection of the biliary tree associated with biliary obstruction
213
What is the preferred initial definitive treatment for acute cholangitis?
Biliary drainage, commonly through ERCP, alongside supportive care and antibiotics
214
What is gallstone ileus?
Mechanical intestinal obstruction caused by a gallstone entering the bowel through a biliary-enteric fistula
215
What is Bouveret syndrome?
Gastric outlet obstruction caused by an impacted gallstone near the pylorus or duodenum
216
What is a choledochal cyst?
Congenital cystic dilatation of the extrahepatic and/or intrahepatic bile ducts
217
What is the classic triad of choledochal cyst?
Jaundice, abdominal pain, and palpable abdominal mass
218
What is the definitive treatment for choledochal cyst?
Surgical excision of the affected extrahepatic biliary tree with biliary reconstruction
219
What is the most common presentation of cholangiocarcinoma?
Painless obstructive jaundice
220
What is a Klatskin tumor?
Perihilar cholangiocarcinoma involving the hepatic duct confluence
221
What classification is used for perihilar cholangiocarcinoma?
Bismuth-Corlette classification
222
What is the most common location of colorectal cancer?
Distal colon and rectosigmoid region
223
What is the dominant risk factor for colorectal cancer?
Increasing age
224
What proportion of colorectal cancers are sporadic?
Approximately 80%
225
What proportion of colorectal cancers are familial or hereditary?
Approximately 20%
226
What is the most common symptom of colorectal cancer?
Change in bowel habits
227
What is the most common presentation of right-sided colon cancer?
Occult bleeding and iron-deficiency anemia
228
What is the typical presentation of left-sided colon cancer?
Altered bowel habits and intestinal obstruction
229
What are the major hereditary colorectal cancer syndromes?
FAP and Lynch syndrome
230
What is familial adenomatous polyposis?
Autosomal dominant disorder characterized by hundreds to thousands of colorectal adenomas
231
What gene is associated with classic FAP?
APC gene
232
What is the lifetime colorectal cancer risk in untreated classic FAP?
Nearly 100%
233
What is attenuated FAP?
A milder form with approximately 10–100 adenomas, often right-sided
234
What is Lynch syndrome?
Hereditary nonpolyposis colorectal cancer caused by mismatch repair gene defects
235
Which genes are associated with Lynch syndrome?
MLH1, MSH2, MSH6, PMS2, and EPCAM
236
What is Gardner syndrome?
FAP associated with osteomas, epidermoid cysts, and supernumerary teeth
237
What is Muir-Torre syndrome?
Lynch-associated syndrome with sebaceous tumors and internal malignancies
238
What is Peutz-Jeghers syndrome?
Hamartomatous polyposis with mucocutaneous pigmentation
239
What is juvenile polyposis syndrome?
Hereditary hamartomatous polyposis characterized by numerous juvenile polyps
240
What is the most important preventive treatment for adenomatous colorectal polyps?
Endoscopic polypectomy
241
What is the Haggitt classification used for?
Depth of invasion in pedunculated malignant colorectal polyps
242
What is the Kikuchi classification used for?
Depth of submucosal invasion in sessile malignant colorectal polyps
243
What does TNM staging describe?
Tumor extent, lymph node involvement, and distant metastasis
244
What is total mesorectal excision?
Complete removal of the rectum and surrounding mesorectal tissue
245
What is the circumferential resection margin?
Radial margin surrounding the rectal tumor and mesorectal specimen
246
What imaging is particularly useful for local rectal cancer staging?
Pelvic MRI
247
What tumor marker is used in colorectal cancer surveillance?
CEA
248
What is the operation for a low rectal cancer requiring removal of the sphincter complex?
Abdominoperineal resection
249
What is the consequence of abdominoperineal resection?
Permanent end colostomy
250
What is the purpose of a right hemicolectomy?
Removal of the right colon with associated lymphovascular drainage
251
What is the most common form of inflammatory bowel disease?
Ulcerative colitis
252
What is the characteristic distribution of ulcerative colitis?
Continuous mucosal inflammation beginning in the rectum
253
What layers are primarily affected in ulcerative colitis?
Mucosa and submucosa
254
What is the characteristic distribution of Crohn's disease compared with ulcerative colitis?
Crohn's has skip lesions; ulcerative colitis has continuous disease
255
Which inflammatory bowel disease has greater colorectal cancer risk with extensive longstanding colitis?
Ulcerative colitis
256
What is the comb sign in Crohn's disease?
Engorgement of mesenteric vasa recta
257
What is diverticulosis?
Presence of colonic diverticula
258
What is diverticulitis?
Inflammation of colonic diverticula
259
What is the most common site of colonic diverticula?
Sigmoid colon
260
What is the most common location of anal fissures?
Posterior midline
261
What is the classic symptom of anal fissure?
Severe tearing pain during defecation
262
What is the first-line treatment for acute anal fissure?
Stool softeners, fiber, hydration, and warm sitz baths
263
What is the surgical treatment for chronic anal fissure?
Lateral internal sphincterotomy
264
What are internal hemorrhoids located relative to the dentate line?
Above the dentate line
265
What are external hemorrhoids located relative to the dentate line?
Below the dentate line
266
What is the classic symptom of internal hemorrhoids?
Painless bright-red rectal bleeding
267
Why are external hemorrhoids painful when thrombosed?
They are covered by somatically innervated anoderm
268
What are the four grades of internal hemorrhoids?
Grade I no prolapse; II spontaneous reduction; III manual reduction; IV irreducible
269
What is the treatment for grade III–IV hemorrhoids?
Hemorrhoidectomy when indicated
270
What is the principle of rubber band ligation?
Compression causes hemorrhoidal tissue necrosis and subsequent sloughing
271
What is an anorectal abscess?
Localized collection of pus in the anorectal spaces
272
What is the definitive treatment for anorectal abscess?
Surgical drainage
273
What is a fistula-in-ano?
Abnormal tract connecting the anal canal to perianal skin
274
What is Goodsall's rule?
Anterior external openings usually follow a straight tract; posterior openings usually curve to the posterior midline
275
What is Fournier's gangrene?
Necrotizing infection of the perineal and genital fascia
276
What is the definitive treatment for Fournier's gangrene?
Urgent surgical debridement and broad-spectrum antibiotics
277
What is pilonidal disease?
Hair-containing sinus or abscess in the intergluteal cleft
278
What is the most common permanent ileostomy configuration?
End ileostomy (Brooke)
279
What is the recommended location of a stoma?
Through the rectus muscle and below the belt line
280
What is the main pancreatic duct called?
Wirsung's duct
281
What is the accessory pancreatic duct called?
Santorini's duct
282
Where does the main pancreatic duct usually open?
Major duodenal papilla
283
Where does the accessory pancreatic duct usually open?
Minor duodenal papilla
284
What is the primary exocrine function of the pancreas?
Secretion of digestive enzymes and bicarbonate
285
What is the endocrine function of the pancreas?
Regulation of blood glucose through islet hormones
286
Which pancreatic cells produce insulin?
Beta cells
287
Which pancreatic cells produce glucagon?
Alpha cells
288
Which pancreatic cells produce somatostatin?
Delta cells
289
Which pancreatic cells produce pancreatic polypeptide?
PP cells
290
What is acute pancreatitis?
Acute inflammation of the pancreas
291
What are the two most common causes of acute pancreatitis?
Gallstones and alcohol
292
What is the most characteristic pain of acute pancreatitis?
Severe epigastric pain radiating to the back
293
Which laboratory enzyme is most useful for diagnosing acute pancreatitis?
Serum lipase
294
What are the two commonly used diagnostic criteria for acute pancreatitis?
Serum lipase/amylase at least three times normal and characteristic abdominal pain
295
What is the Ranson score used for?
Assessment of acute pancreatitis severity and prognosis
296
What is BISAP used for?
Early severity and mortality risk assessment in acute pancreatitis
297
What are Cullen's and Grey Turner's signs associated with?
Severe hemorrhagic pancreatitis
298
What is Cullen's sign?
Periumbilical ecchymosis
299
What is Grey Turner's sign?
Flank ecchymosis
300
What is the initial management of acute pancreatitis?
IV fluid resuscitation, analgesia, and appropriate nutritional support
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