Acute Pancreatitis

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Acute Pancreatitis is sudden swelling and inflammation of the pancreas. It is accompanied by severe abdominal pain. Acute Pancreatitis usually resolves itself within a few days with treatment but can be life-threatening with severe complications. This condition usually develops from gallstones or  moderate to heavy alcohol consumption over a period of years.

Effects of alcohol abuse !!!

CAUSES

Most cases of acute pancreatitis are caused by gallstones and alcohol however in some cases the cause is unknown. Other causes of acute pancreatitis includes

  • autoimmune problems
  • high levels of triglycerides
  • damage to pancreas during  surgery
  • blockage of pancreatic duct or common bile duct
  • certain medications such as estrogens, corticosteroids and  thiazide diuretics
  • viral infections such as mumps
  • heredity
  • Reyes syndrome

RISK FACTORS

Acute pancreatitis affects more men than women. Having a family history increases your risk and so does being an alcoholic.

SYMPTOMS

The main symptoms for acute pancreatitis is abdominal pain felt in the upper left side or middle of the abdomen. This pain

  • typically last for days and is relieved by leaning forward
  • radiates to the back  or below the left shoulder-blade
  • worsen when lying flat on the back
  • appears suddenly and becomes constant and more severe
  • feels worse after eating

Other symptoms include

  • jaundice
  • clay colored stools
  • swollen abdomen
  • indigestion
  • skin rash
  • skin lesions
  • gaseous abdominal fullness
  • nausea and vomiting
  • rapid pulse
  • fever

TEST AND DIAGNOSIS

To diagnose this disease, the doctor will ask for your medical history. He will also do a physical examination that may reveal

  • abdominal tenderness or mass
  • rapid heart beat
  • rapid breathing
  • low pressure

He may also order blood tests which include a complete blood count and a comprehensive  metabolic panel ( it provides the overall picture  of your body’s chemical balance and metabolism ).

Imaging tests may also be done. These include :

Abdominal ultrasound to check for inflammation

CAT scan to check for gallstones and extent of damage to the pancreas

MRI to show the pancreas, gallbladder, and pancreatic and bile ducts.

Endoscopic ultrasound (EUS) to create visual images of the pancreas and bile duct.

Endoscopic retrograde cholangiopancreatography (ERCP)  to remove stones from the bile duct if your condition is caused by gallstones. It can also be used to treat some causes of pancreatitis.

TREATMENT

Treatment usually requires hospitalization for intravenous fluids, antibiotics and pain medications. A tube may be inserted through the nose or mouth to remove stomach contents if you vomiting or have severe pain that does not improve. In severe cases, the patient may require nasogastric feeding in which a special feed is given through a thin long tube inserted  through the nose and throat and into the stomach. This may be done for several weeks until the pancreas heals.If no complications occur, most cases of pancreatitis resolves itself within a few days.

In some cases fluid around the pancreas may be collected, gallstones may be removed or blockages of the pancreatic duct may be relieved.

In more severe cases , surgery may be needed to remove dead or infected pancreatic tissues.

Before leaving the hospital, patient may be advised not to smoke, drink alcoholic beverages, or eat fatty meals.

Smoking cessation !!!

COMPLICATIONS

Complications that may be associated with pancreatitis include

  • acute kidney failure
  • Acute respiratory distress syndrome (ARDS)
  • hypotension
  • heart failure
  • abscesses in the pancreas

PREVENTION

Take these precautions to prevent this disease.

Drink alcohol in moderation

Avoiding treating children with aspirin to prevent Reyes syndrome.

Children should be vaccinated to avoid childhood diseases such as mumps.

REFERENCES
Acute pancreatitis, National Library of Medicine. PubMed Health. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001332/. Accessed December 27, 2013.

Pancreatitis. The National Digestive Diseases Information Clearinghouse. Accessed December 27, 2013

Acute pancreatitis (Beyond the Basics). UpToDate. http://www.uptodate.com/contents/acute-pancreatitis-beyond-the-basics. Accessed December 27,2013

Acute Pancreatitis. Clinical Key. https://www.clinicalkey.com/topics/gastroenterology/acute-pancreatitis.html Accessed December 27, 2013

Understanding Pancreatitis. American Gastroenterological Association. http://www.gastro.org/patient-center/digestive-conditions/pancreatitis. Accessed December 27, 2013

The American Heritage® Stedman’s Medical Dictionary. Retrieved December 2013 from Dictionary.com website.http://dictionary.reference.com.

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