Causes of Acute Pancreatitis

In this article, we will discuss various Causes of Acute Pancreatitis. So, let’s get started.

Acute pancreatitis is defined as an acute inflammation of the pancreas with variable involvement of regional tissues and remote organ systems. It results from premature activation of zymogen granules which activate and release pancreatic enzymes (proteases), vasoactive substances and toxic material that digest the pancreas and the surrounding tissues leading to local and systemic complications.

Causes

Common (90%)

  • Gall stones
  • Alcohol abuse
  • Idiopathic (microlithiasis)
  • Abdominal trauma (blunt)
  • Hyperlipidemia
  • Hypercalcemia
  • Post-ERCP (Endoscopic Retrograde Cholangiopancreatography)
  • Post-surgical (abdominal/extra-abdominal)

Uncommon (10%)

  • Infection e.g. viral (mumps, cytomegalovirus, coxsackie), bacterial (salmonella), fungal, and parasitic
  • Drugs e.g. azathioprine, thiazides, isoniazid, leflunomide, tamoxifen valproate, dapsone, pentamidine, didanosine, sitagliptin, etc.
  • Perforating peptic ulcer
  • End-stage kidney disease, peritoneal dialysis
  • Congenital anomaly (pancreatic divisum)
  • Pancreatic outflow obstruction
  • Severe hypothermia, shock, bites, etc.
  • Organ transplantation (kidney, liver), cardiopulmonary bypass
  • Vasculitis
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Antibiotic Treatment of Acute Diarrhea

In this article, we will discuss the Antibiotic Treatment of Acute Diarrhea. So, let’s get started.

Antibiotic Treatment of Acute Diarrhea

Empirical antibiotic therapy in bacterial diarrhea is controversial and generally not required in patients with mild or resolving disease but should be considered in patients with Shigellosis, traveler’s diarrhea, pseudomembranous colitis, cholera, food poisoning, and immunocompromised patients, etc. Empiric treatment with fluoroquinolones e.g. ciprofloxacin 500 mg, ofloxacin 400 mg twice daily is recommended in patients with fever, tenesmus or blood stools. The treatment is revised after culture and sensitivity reports. Only 5-10% of patients with diarrhea require specific antibiotic therapy, below is the list that specifies some organism and the associated choice of antibiotic.

  • Shigella and E.coli: Quinolones (norfloxacin 400 mg BID or ciprofloxacin 500 mg BID for 5 days)
  • Traveler’s diarrhea: Rifaximin 200 mg thrice a day for 3 days.
  • Cholera (Vibrio cholerae): Tetracycline
  • C.difficile: Vancomycin (250-500 mg QID for 7-10 days)
  • Campylobacter: Erythromycin 250-500 mg QID for 5 days or Azithromycin 500 mg OD for 5 days
  • Yersinia: Tetracycline 1-2 g/day for 7 days
  • Giardia: Metronidazole 200-400 mg TID for 7 days
  • E.histolytica: Metronidazole (400-800 mg TID for 5-7 days) or Tinidazole 600 mg BID for 5-7 days or Ornidazole 500 mg BID.