Sunday, 17 February 2008

2007_05_01_archive



More on acute pancreatitis

Surgeonsblog is the blog of a "mostly retired general surgeon," Sid

Schwab, who shares stories of past experiences with surgery, patients,

families, and the healthcare system, full of interesting and

informative anecdotes from a surgeon's perspective.

A couple of Surgeonsblog posts relevant to this month's Journal of the

Medical Library Association case study, "Using the literature to

evaluate diagnostic tests: amylase or lipase for diagnosing acute

pancreatitis?":

- Surgeons and Sweetbreads: an in-depth (and consideration of the

anatomy of pancreas and surgical intervention in the patient with

acute pancreatitis:

The good news is most of us will never have a reason to find out.

The bad news is we all walk around with a self-destruct button in

us, and I'm not getting all Freudian here. Of all the vital organs,

there's only one that can -- sometimes with only the slightest of

provocations -- turn on us and literally become our worst

nightmare: it can eat us alive, from the inside. All the while,

doing only what it thinks it's supposed to do.

- and a follow-up post, Pancreas stuff, #2:

It's that combination of highly unfortunate location and the power

of self-digestion that turns the upper abdomen into a seething and

distorted mess. Imagine a nicely-tended garden overtaken by sewage.

Think of trying to find your way through a mine-field, knowing a

misstep could cause death, while wearing size twenty shoes, and

blindfolded. Compare being required to reach into a shallow pan of

water to find by feel a couple of well-defined objects, with

groping into hot mush, mittened and scared...

...Tucked behind the stomach and colon, that space is clean and

quiet, opens sort of magically; and its backside is -- ideally --

that pink and normally-firmer-than-normal organ, the pancreas.

There for your viewing pleasure. With acute pancreatitis, not only

is that space completely obliterated, it's filled with

indistinguishable stinky goo, and the edges of the stomach and

colon -- out of which you'd dearly like to stay -- are absolutely


No comments: