Acute Pancreatitis

Pancreatitis is diagnosed by a combination of clinical features (epigastric pain with radiation to back, nausea/vomiting etc) and diagnostic tests (lipase 3x normal, CT scan) A RUQ US should be performed looking for gallstones as this finding significantly alters management The focus of management is on supportive care. IV fluids, while central to therapy, should […]

Mesenteric Ischaemia – Time is Bowel

What is the “CLASSIC” presentation of Mesenteric Ischemia? Acute Abdominal pain which out of proportion to examination in an elderly patient. An elevated lactate level should raise suspicion of mesenteric ischaema. High lactate suggests BOWEL NECROSIS. Classic presentations are not always seen.

Pancreatitis risk stratification (BISAP)

Bedside Index of Severity in Acute Pancreatitis (BISAP), a simple tool ideal for rapid risk-stratification. The tool is based on a 5-point score, derived from 5 parameters collected within a patient’s first 24 hours in hospital.

DID YOU KNOW: Peritonitis

Determining the presence or absence of peritonitis is a primary objective of the abdominal examination. All the methods alone are inaccurate. Thoracic inflammatory process adjacent to the diaphragm, a voluntary contraction of the abdominal wall in apprensive patients, a rough painful examination, may be misleading. But what is more interesting is that NO TEST ALONE […]

Emergency Medicine Kenya Foundation