Acute pancreatitis causes all of the following except:March 2005, March 2013 (g)

Ans. A: HypercalcemiaComplications of acute pancreatitis:Intra-abdominal:Pancreatic "collections":PhlegmonPseudocystAbscessNecrosisIntestinal:Paralytic ileusGastrointestinal haemorrhage - from stress ulceration, gastric varices due to splenic vein obstruction, or rupture of pseudoaneurysmNecrotising obstruction or fistulisation of colon- Hepatic - obstructive jaundice due to oedematous narrowing of common bile duct- Renal - hydronephrosis and hydroureter of right kidney due to peripancreatic inflammation in perirenal space- Spleen - rupture or haematoma, from spread of peripancreatic inflammationSystemic complications range from minor pyrexia to rapidly fatal, multiple organ-system failure. They include:- Circulatory shock - kinin activation, haemorrhage- Disseminated intravascular coagulation- Respiratory insufficiency:Mild e.g. hypoxaemia, atelectasis, pleural effusionSevere e.g. adult respiratory distress syndrome- Acute renal failure- Metabolic:HypocalcaemiaHyperglycaemia / diabetes mellitusHyperiglyceridaemia- Pancreatic encephalopathy - confusions, delusions, coma- Retinal aeriolar obstruction causing sudden blindnessPuscher's retinopathy- Metastatic fat necrosis A serum level three to four times above normal serum amylase level, is indicative of acute pancreatitis, but a normal level does not exclude the disease.