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 Disease Of The Pancreas >
Acute Pancreatitis
Acute
Pancreatitis
What
is the pancreas?
What
is Acute Pancreatitis?
What are symptoms of Acute Pancreatitis?
What
procedures are used to diagnose Acute Pancreatitis?
What are causes of Acute Pancreatitis?
What are the treatment options for Acute
Pancreatitis?
What is the prognosis of Acute Pancreatitis?
What is the
pancreas?
 The
pancreas is an elongated, tapered gland, located behind the
stomach. The pancreas produces digestive enzymes
needed to break down proteins and carbohydrates. In addition, the
organ has specialized endocrine cells that produce insulin and
glucagon. The digestive enzymes flow directly into the duodenum,
which is the first part of the small inte stine. The hormones
insulin and glucagon are released into the blood.
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Definition
of Acute Pancreatitis
Acute
pancreatitis is a sudden attack causing inflammation of the
pancreas and usually associated with severe upper abdominal
pain. The pain may last several days and may be serious.
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Symptoms
of Acute Pancreatitis
The primary symptom of acute
pancreatitis is severe pain in the middle of your upper abdomen,
often radiating to the back. Pain is sudden and then steady,
and is often aggravated by walking or lying down and relieved by
sitting or leaning forward. Other symptoms may include:
- Nausea
- Vomiting
- Diarrhea
- Bloating
- Fever
- Clammy Skin
- Mild Jaundice
If you have any of these signs
with abdominal pain, see your doctor immediately.
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Diagnosis
of Acute Pancreatitis
Your doctor will ask about your
medical history, particularly about how much alcohol you drink and
if you have had symptoms of gallstones or common bile duct stones.
He or she will examine you and order blood tests to confirm the
cause of your symptoms.
Lab tests that may be used for
diagnosis are:
•
serum amylase and lipase
• liver function tests
• blood calcium test
• blood glucose test
• complete blood count
• urinalysis.
Your abdomen and chest may be
x-rayed to confirm whether your symptoms are caused by acute
pancreatitis or by other disorders that can cause similar
symptoms. In addition, the following tests may be done to detect
changes in the size of your pancreas:
•
ultrasound exam
• endoscopic retrograde cholangiopancreatography (ERCP), an exam
in which the doctor inserts an endoscope, an instrument with a
light, into your throat and guides it through your stomach and
into your small intestine
• CT (computed tomography) scan.
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Causes
of Acute Pancreatitis
The chief causes of acute
pancreatitis in adults are gallstones, other gallbladder (biliary)
disease, and alcohol use. Viral infection (mumps, coxsackie B,
mycoplasma pneumonia, and campylobacter), hereditary conditions,
traumatic injury, pancreatic or common bile duct surgical
procedures and certain medications (especially estrogens,
corticosteroids, thiazide diuretics, and azathioprine) are other
causes. Pancreatitis without any apparent cause- this is known as
idiopathic pancreatitis.
The exact cause of acute pancreatitis may differ among different
patients, but in general it is not well understood. It is thought
that enzymes normally secreted by the pancreas in an inactive form
become activated inside the pancreas and start to digest the
pancreatic tissue. This process is called autodigestion and causes
swelling, hemorrhage, and damage to the blood vessels. An attack
may last several days and the pain may be severe.
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Treatment
of Acute Pancreatitis
Treatment for acute
pancreatitis depends on the severity of the condition. Generally
the patient needs hospitalization with administration of
intravenous fluids to help restore blood volume. Medication for
pain and nausea are provided to ease these symptoms and food is
withheld until these symptoms have subsided considerably.
Antibiotics are often prescribed in cases of severe acute
pancreatitis or if infection occurs. Surgery is sometimes needed
when complications such as infection, cysts or bleeding
occur.
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Prognosis of
Acute Pancreatitis
Patients
usually recover fully from acute pancreatitis and do not
experience recurrence if the cause is removed. Alcohol consumption
should be eliminated even if it is not the determined as the cause
of the disease. Smoking, which stresses the body's defenses
against inflammation, should be stopped. If gallstones were the
cause, then removal of the gallbladder is required to prevent
further attacks. For those patients in whom a cause is not readily
identified, there should be consideration of other diagnostic
testing such as endoscopic ultrasound.
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lori.hagerty@ucphysicians.com