Pancreatitis

Pancreatitis is inflammation in the pancreas. Pancreas is a gland organ that secrets juices to digest food, help absorb nutrients, and releases hormones balancing blood sugar. In pancreatitis, the pancreatic juices digest the pancreas itself. This can happen as mild, moderate, and severe diseases. In mild pancreatitis, small damage is done to the pancreas, which produces mild symptoms and may go away without special treatment except bowel rest. On the contrary, severe pancreatitis has a lot of damage to the pancreas resulting in dead pancreatic tissues and leaking of pancreatic digestive juices all around, which lead to a lot of complications. Pancreatitis can happen acutely and also repeatedly which is known as chronic pancreatitis.

Causes and Risk Factors

Pancreatitis has many causes. The most common causes and risk factors are:

  • Alcoholism
  • Gallstones (see picture right, removed by ERCP)
  • Smoking
  • Cystic fibrosis
  • Pancreatic divisum
  • Abdominal surgery and trauma
  • Some medications
  • ERCP
  • Family history of pancreatitis
  • Pregnancy
  • Hypertriglyceridemia
  • Hypercalcemia
  • Hyperparathyroidism
  • Pancreatic cancer
  • Vasculitis
  • Porphyria
  • Infectious causes. A number of virus, fungi, bacteria and parasites are known to cause pancreatitis.
  • Unidentified causes

Symptoms and Signs

Common signs and symptoms are:

Complications

Common early complications:

  • Infection
  • Abscess formation
  • Dehydration
  • Electrolites abnormalities
  • Multiple organs failure, such as kidney failure, lung failure, heart failure, etc

Common late complications:

Pancreatic pseudocysts, which is the accumulation of pancreatic secretions that are unable to secret into the small intestine given the normal structure of the pancreas is destroyed and replaced by scar tissue.

Diagnosis and Treatment

Diagnosis is mostly based on risk factors, clinical presentation, and one or more of following tests:

  • Blood works
  • Stool studies
  • Abdominal ultrasound
  • CT scan
  • MRI/MRCP
  • Liver biopsy
  • Endoscopy
  • ERCP
  • EUS

The treatment of pancreatitis depends on the severity, acute, or chronic. Mild pancreatitis may not need specific treatment expect bowel rest. Treatment should also be focused on reducing complications and treat them properly if they happen.

References:

  1. PubMed Health.
  2. Wikipedia.
  3. Mayo clinic online health information.
  4. Sleisenger and Fordtran's Gastrointestinal and Liver Disease- by Mark Feldman MD, et al.
  5. The Little Black Book of Gastroenterology-by David W. Hay.
  6. Principles of Clinical Gastroenterology by Tadataka Yamada, et al.

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