Acute Pancreatitis

Acute Pancreatitis

The pancreas is a fish shaped organ located behind the stomach. The head of the pancreas is located on the right and the tail is located on the left side of the abdomen. The pancreas produces digestive enzymes called pancreatic enzymes which breakdown fats, carbohydrates and proteins so they are digested and absorbed into your system.
Acute pancreatitis is a sudden attack causing inflammation of the pancreas and is often associated with severe abdominal pain. The pain is often located in the center of the upper abdomen, between the naval and lower end of the breastbone. It can also occur either on the right or left side of the upper abdomen/chest area. The pain can radiate to your back, and often causes nausea and vomiting. Frequently the pain is severe enough to lead to an emergency room visit.
If pancreatitis is diagnosed, frequently patients are admitted to the hospital. Symptoms do diminish fairly quickly with the limitation of food/liquids. Often pain medication and IV fluids are necessary for the initial period. Severe acute pancreatitis may cause death of some of the pancreatic tissue and subsequent infection of that tissue. Antibiotics may be indicated should this happen.
Pancreatic pseudocyst, which is a collection of fluid from the pancreas, may also develop if the pancreatitis is severe.

What causes acute pancreatitis?

Approximately 80% of the cases of pancreatitis are caused by excessive alcohol intake and gallstones. Alcohol damages the pancreas. Most cases of pancreatitis caused by alcohol are caused by excessive amounts; however, lesser amounts can also cause pancreatitis.
Gallstones or thick bile (sludge) can block the bile duct. This leads to the gallbladder’s inability to drain bile. Sludge is thick bile (think of sand) and if it should block the duct, there is no drainage and pancreatitis results. Both the bile duct and pancreatic duct are small tubes, so it doesn’t take a very large stone to block the duct. Any condition that causes blockage to the pancreatic duct or bile duct has the opportunity to cause pancreatitis.
Elevated triglycerides can also cause pancreatitis. When the blood is thick, there is a lack of oxygen carried to the pancreas and can lead to pancreatitis.
Some medication may also have a side effect of causing pancreatitis.
Autoimmune pancreatitis is when the body’s immune system attacks the pancreas.
ERCP or manipulation of the pancreatic/bile ducts with a special scope can also cause pancreatitis. The rate of post procedure pancreatitis is less than 5%.

How is pancreatitis treated?

  • Limiting of food/fluids until the pain is gone
  • Pain/nausea medication and IV fluids to maintain hydration during the acute phase of illness.
  • Usually hospitalization is only a few days as the acute phase usually is short.
  • Sometimes if there is severe pancreatitis, blood pressure, and vital organ function can be impaired and require ICU care.
  • Pseudocyst (fluid collections) can develop in cases of severe pancreatitis.
  • ERCP can be performed to reduce insult to the pancreas. ERCP is performed with a scope and stents are placed into the bile duct and pancreatic duct to allow drainage of enzymes. If gallstones are the cause of pancreatitis, ERCP can remove the stones to allow drainage.

Preventing pancreatitis

  • A heart healthy low fat diet is usually recommended.
  • Weight loss is usually indicated as there can be compression of the pancreas by the abdominal fat.
  • Abstaining from alcohol and tobacco products as both directly affect the pancreas.