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Pankreatitt, akutt

Sist oppdatert: Sist revidert:
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Definisjon:
Akutt, reversibel betennelse i pankreas der gallesten og alkoholmisbruk er de vanligste årsakene
Forekomst:
Insidensratene varierer fra 13 til 45 per 100.000 per år
Symptomer:
Relativt akutt oppståtte sterke smerter i øvre del av abdomen, kvalme, oppkast, ev. forverring etter fødeinntak, ev. smerteutstråling til rygg 
Funn:
Øm abdomen, ev. peritonitt, feber, takykardi, bradykardi, tegn på dehydrering 
Diagnostikk:
Forhøyede pankreasenzymer i blod og urin, ev. unormale inflammasjonsmarkører, leverprøver, elektrolytter. Ev. CT eller MR ved mistanke om komplikasjoner
Behandling:
Skal innlegges i sykehus. Behandlingen er aggressiv væskebehandling, kontrollert ernæringstilførsel, smertekontroll, nøye monitorering og behandling av komplikasjoner. Ved gallesteinspankreatitt ev. ERCP, kolecystektomi. Ved kolangitt eller infisert nekrotiserende pankreatitt gis iv. antibiotika. Ved nekrotiserende pankreatitt ev. kirurgisk, radiologisk eller endoskopisk intervensjon
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  • Terje Johannessen, professor i allmennmedisin, Trondheim
  • Peter D. Jost, spesialist allmennmedisin, redaktør NEL