|
What is pancreatitis?
Pancreatitis is inflammation of the pancreas that may occur as an acute, painful attack, or may be a chronic condition developing gradually over time. It is caused when pancreatic enzyme secretions build up and begin to digest the organ itself.
Another term for this condition is auto digestion, which occurs when, for some unknown reason, the pancreas' powerful enzymes are activated in the pancreas itself rather than in the duodenum.
It is believed that trypsin sets off a domino effect,
activating other enzymes to speed the auto digestive process.
Risk factors for developing pancreatitis include:
 |
Gallstones |
|
Alcohol use |
|
Some medications |
|
Severe viral or bacterial infection |
|
Injury to the abdomen |
|
Elevated triglyceride levels, called Hyperlipidemia |
|
Elevated calcium blood levels, called Hypercalcemia |
Pancreatitis ranges in severity from relatively mild to severe, and in its worst form may not respond to treatment.
Chronic Pancreatitis Explained
Chronic pancreatitis develops over a period of years, most often in individuals who have experienced pancreatic damage from earlier episodes of acute pancreatitis.
It is frequently caused by long-term alcohol use, but, as with acute pancreatitis, no cause may be found. Edema (swelling) and inflammation confined to the pancreas are typical symptoms of mild or chronic pancreatitis.
Symptoms may develop over a period of time without the sudden dramatic occurrence of an acute attack.
However, those with undiagnosed chronic pancreatitis may develop acute episodes.
There is a decrease in the secretion of enzymes needed for digestion and absorption of dietary fats. Fat digestion is impaired, resulting in fatty stools.
This is called exocrine insufficiency.
Recurrent abdominal pain may be accompanied by nausea and weight loss.
Diagnostic scans may find stones or areas of calcified tissue within the pancreas.
Alcoholism is the most common cause of adult pancreatic exocrine insufficiency, occurring 50 times greater than the rate among nondrinkers.
Symptoms of Chronic Pancreatitis
Signs and symptoms of chronic pancreatitis include:
|
Weight loss |
|
Nausea and vomiting |
|
Onset of diabetes mellitus |
|
Pale colored stools |
Acute Pancreatitis Explained
Acute pancreatitis is characterized by severe, steady pain in the upper-middle part of the abdomen, often radiating into the back.
Associated symptoms include nausea, vomiting, fever, lowered blood pressure, fast heart rate, and clammy skin.
Hypotension, low blood pressure, or circulatory shock may follow these symptoms.
The tissue of the pancreas may become necrotic (tissue death) and late complications may include pseudocysts and abscesses.
Signs and symptoms of acute pancreatitis include:
|
Jaundice |
|
Abdominal pain that is intense and lasting, and may radiate into the back or chest |
|
Low-grade fever |
|
Nausea or vomiting |
|
Clammy skin |
|
Abdominal distention and tenderness |
|
Bruising (ecchynosis) in the flanks and midsection |
How is pancreatitis diagnosed?
This disorder is diagnosed on the basis of symptoms and blood testing for elevated levels of the enzymes amylase and lipase.
Serum amylase and lipase tests are the most common for diagnosing acute pancreatitis.
Ultrasonography or CT scans help determine whether gallstones are present and also detect swelling, abscesses, or cysts in the pancreas, as well as free fluid (ascites) in the abdomen.
Once an acute episode has resolved, endoscopy, or ERCP may help define the cause.
How is pancreatitis treated?
We manage acute pancreatitis by treating its symptoms.
It is important to reduce the flow of pancreatic enzymes as much as possible by not eating or drinking, although intravenous fluids are usually necessary to maintain the body's biochemical balance.
Oral fluid intake is restricted to inhibit stimulation of the pancreas and secretion of its enzymes.
Nourishment may be given intravenously.
If the condition is caused by gallbladder disease, a cholecystectomy (removal of the gallbladder) is usually performed, after the pancreatitis has subsided.
If caused by an obstructed pancreatic duct, it may be resolved by ERCP or surgery.
If a stone is present in the common bile or pancreatic ducts at the entrance to the small intestine your physician may consider a procedure to enlarge the duct so the stone can be removed.
What are Pseudocysts?
Pseudocysts are abnormal deposits of tissue, fluid and debris that can result after episodes of acute pancreatitis, typically 1 to 4 weeks after the onset of pancreatitis.
|
Abdominal pain that may radiate into the back |
|
Unusual abdominal hardness or mass that can be felt |
|
Jaundice, nausea or vomiting |
Diagnosis for pseudocysts will entail abdominal ultrasound and/or CT scan and blood amalyse testing.
Treatment generally is surgical or endoscopic removal/drainage.
Related Links
| 
