Acute Pancreatitis

The pancreas located behind the stomach is responsible for the production of enzymes and hormones such as insulin and glucagon. The enzymes aid in the digestion of food and converting it into fuel required for the body’s cells. More specifically, the exocrine function aids digestion and the endocrine function aids in the regulation of blood sugar.
Usually the enzymes that are produced are activated in the small intestine. But when the enzymes start getting active in the pancreas itself, they digest the tissue of the pancreas. This leads to hemorrhage and swelling and damages the organ and its blood vessels. This causes acute pancreatitis. There is a sudden inflammation and swelling of the pancreas.

acute-pancreatitis1

Causes

  • Gallstones
  • Alcohol abuse
  • Metabolic disorders such as hyperlipidemia, malnutrition, hereditary pancreatitis, hypercalcemia
  • Ulcers
  • Injury to the pancreas after an accident or a procedure such as ERCP or EUS with FNA (fine needle aspirate)
  • Damage to pancreas during surgery
  • Use of diuretics like gliptins: vidagliptin, sitagliptin, saxagliptin etc
  • Any infections like viral hepatitis, mumps and Mycoplasma Pneumoniae
  • Choledochocele
  • Pancreas divisum
  • Cystic fibrosis
  • Anorexia or bulimia

Symptoms

  • Severe upper or  middle abdominal pain radiating to the back or left shoulder blade: this can worsen within minutes of eating and drinking foods with high fat content
  • Nausea and vomiting
  • Rapid heartbeat
  • Loss of appetite
  • Chills with shivering
  • Fever
  • Indigestion
  • Jaundice: yellowing of skin and white of the eyes
  • Swollen abdomen and gaseous fullness of the abdomen
  • Clay-colored stools
  • Hiccups

Diagnosis

Physical exam reveals abdominal tenderness, rapid heart rate and respiratory rate, fever and low blood pressure.

Lab test and blood tests :Lab tests for release of pancreatic enzymes will reveal increase in amylase levels, serum blood lipase levels and urine amylase levels. Blood tests such as CBC and comprehensive metabolic panel are done to detect pancreatitis.

CT scan: An abdominal CT scan produces cross-sectional images of the abdomen with the help of x-rays.

MRI scan :Several image slices of the belly are put together with a technology that uses magnets and radio waves.

Abdominal Ultrasound produces images of the internal organs and structures using sound waves.

Treatment

Depending on the severity of the inflammation a variety of treatments are available which include endoscopic, laparoscopic and open surgical techniques. ICU treatment may also be needed at times. Multiple Scans may also be necessary during the treatment of this condition.