Acute Pancreatitis

Introduction AG is 50yo female with a history of Sclerosing Mesenteritits, diabetes, hypothyroidism, smoking and alcohol abuse. She was admitted on 1-27-12 for severe abdominal pain along with nausea and vomiting. CT scan of the abdomen revealed a massive gastric dilation and thickening of the duodenal wall leading to occlusion of the duodenal lumen. I met AG on 2-23-12 when she was three weeks post-operative (post-op), gastrojejunostomy, resection of the pancreatic head mass biopsy, and gastrostomy tube (gtube) placement. The patient had her first episode of acute pancreatitis in 2006 with four recurrences over two years. In 2007 she underwent Laparotomy and had a biopsy of an inflammatory periduodenal mass. She was treated with radiation and chemotherapy for a short period. In 2008 following several episodes of abdominal pain she underwent endoscopic retrograde cholangiopancreatography and had placement of a biliary endoprosthesis. In 2009 she had placement of a feeding jejuostomy for duodenal obstruction. She then underwent the Frey Lateral Pancreaticojejunostomy with resection of the Pancreatic head and Hepaticojejunostomy with Roux-en-Y reconstruction and small bowel resection in 2010. The procedure was complicated by liver abscess requiring percutaneous drainage. Diabetes was diagnosed after her pancreatic surgery in 2010. She is currently on an insulin sliding scale. AG has been dealing with her medical ailments since 2006. She is a recovering alcoholic, who quit several years ago. She admits to smoking half a pack of cigarettes a day for the last 40 years and denies any use of illicit drugs. She is in the process of smoking cessation with the aid of nicotine patches. She has received most of her medical care at a hospital in Mexico City, where she practiced as a surgeon prior to becoming ill herself. The objective of this paper is to give an overview of the nursing care and management of a patient with pancreatitis.

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