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Definition Return to top
Acute pancreatitis is an inflammation (irritation and swelling) of the pancreas. The pancreas is an elongated, tapered gland, located behind the stomach, that secretes digestive enzymes and the hormones insulin and glucagon.Causes, incidence, and risk factors Return to top
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), traumatic injury, pancreatic or common bile duct surgical procedures and certain medications (especially estrogens, corticosteroids, thiazide diuretics, and azathioprine) are other causes. Acute pancreatitis may also be caused by abnormal anatomy of the pancreas (pancreas divisum), genetic factors (hereditary pancreatitis), high lipid levels in the blood (hypertriglyceridemia), and complications of cystic fibrosis.
The mechanism that causes pancreatitis is not well known. 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.
The disease affects men more often than women. Alcohol abuse is an important risk factor.
In children, this disorder may be associated with:
Symptoms Return to top
Additional symptoms that may be associated with this disease:
Signs and tests Return to top
General examination may show fever, low blood pressure, rapid heart rate or rapid respiratory rate.
Tests that show release of pancreatic enzymes:
Test that show inflammation of the pancreas:
In other blood tests results:
Treatment Return to top
Treatment is aimed at supportive measures such as fluid replacement by intravenous (IV) infusion, pain relief, and withholding food or fluid by mouth to restrict pancreatic activity that makes symptoms worse. Occasionally nasogastric suctioning may be required if there is persistent vomiting or severe pain or if a paralytic ileus develops.
Recurrent attacks may be prevented by treating the underlying condition.
In some cases, radiologic or endoscopic therapy is needed to remove gallstones, relieve obstructions or the pancreatic duct, or drain fluid collections in or around the pancreas. In the most severe cases, surgery is necessary to remove necrotic, infected pancreatic tissue.
Expectations (prognosis) Return to top
While most cases resolve in a week, some cases develop into life-threatening illness. The death rate is high with hemorrhagic pancreatitis or necrotizing pancreatitis and complications such as liver, heart, or kidney impairment may occur. Recurrences are common.
Complications Return to top
Calling your health care provider Return to top
Call your provider if intense, constant abdominal pain is present, or if other symptoms suggestive of acute pancreatitis develop.
Prevention Return to top
Prevention of acute pancreatitis is associated with prevention of the causative disorders.
If you develop acute pancreatitis as a result of alcohol use, you should avoid all alcohol indefinitely. If you develop acute pancreatitis as a result of a medication, avoid the medication entirely.
Update Date: 5/14/2004 Updated by: Christian Stone, M.D., Division of Gastroenterology, Washington University in St. Louis School of Medicine, St. Louis, MO. Review provided by VeriMed Healthcare Network.
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Page last updated: 28 October 2004 |